nefazodone SERZONE

Class: SARI/​Phenylpiperazine
FDA Indications: MDD, Relapse Prevention In MDD
Off-Label Use: PTSD, Panic Disorder
Forms: 50, 100, 150, 200, 250mg tablet
Dose Range: 200-600 mg/day
Starting: 100 mg bid, titrate as tolerated up to max dose 600 mg bid; typically most effective in the 300-600mg/day range

NAMI drug fact sheet

Contraindications: active liver disease or with elevated baseline serum transaminases
Serious Side Effects: hepatotoxicity ~ 1 in 250,000 per year of treatment
Side Effects: nausea, xerostomia, constipation, dyspepsia, increased appetite, headache, dizziness, visual changes, sedation/somnolence, insomnia, agitation, confusion, ataxia, memory impairment, weakness/asthenia, paresthesia, orthostatic hypotension
1° MOA: Serotonin antagonist/reuptake inhibitor
2° MOA: Norepinephrine reuptake inhibition
Target: Antagonism at:
t½: 3.5 (2-4)° TMAX:
Substrate of: 3A4
Inhibits: 3A4, 2D6; Induces:
Active Metabolites: HO-NEF, mCPP, Triazole-dione
  • - nonlinear pharmacokinetics; inhibits its own metabolism
  • - Food delays the absorption and decreases its bioavailability ~20%
  • - very effective antidepressant
  • - more sedating than other antidepressants, but causes less sexual side effects
Special Populations

Category C—Although the animal data suggest moderate risk, the limited human pregnancy experience suggests that the risk of developmental toxicity is low. However, long-term studies on functional and/ or neurobehavioral deficits have not been conducted.

RID 0.3-0.45%; Limited Human Data—Potential Toxicity

Initiate at half the usual adult dose, and then follow same titration schedule as younger patients

No adjustments necessary

Contraindicated in patients with known hepatic impairment


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Last updated February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.