Brand names: Nefazodone hydrochloride
Nefazodone is prescribed for the treatment of depression severe enough to interfere with daily functioning. Possible symptoms include changes in appetite, weight, sleep habits, and mind/body coordination, increased fatigue, feelings of guilt or worthlessness, difficulty concentrating, slowed thinking, and suicidal thoughts.
Nefazodone may cause serious liver problems, which can lead to death. Patients with active liver disease or with high enzyme levels on liver function tests should not take nefazodone. Call your doctor right away if you get any of the following symptoms while taking nefazodone:
Yellowing of the skin or whites of eyes (jaundice)
Unusually dark urine
Loss of appetite that lasts several days or longer
Nausea or lower stomach (abdominal) pain
Take nefazodone exactly as prescribed by your doctor even if you no longer feel depressed. Your doctor should check your progress periodically.
Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Nefazodone hydrochloride.
If you are sensitive to or have ever had an allergic reaction to nefazodone or similar drugs, such as trazodone, you should not take Nefazodone hydrochloride. You should also avoid it permanently if previous treatment had to be stopped due to signs of liver injury.
Serious, sometimes fatal reactions have occurred when nefazodone is used in combination with drugs known as MAO inhibitors, including the antidepressants phenelzine and tranylcypromine. Never take nefazodone with one of these drugs; and do not begin therapy with nefazodone within 14 days of discontinuing treatment with one of them. Also, allow at least 7 days between the last dose of nefazodone and the first dose of an MAO inhibitor.
Nefazodone should also be avoided if you are taking haloperidol or carbamazepine, and should never be combined with pimozide, as heart problems could result.
In clinical studies, antidepressants increased the risk of suicidal thinking and behavior in children and adolescents with depression and other psychiatric disorders. Anyone considering the use of nefazodone or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Nefazodone has not been studied in children or adolescents and is not approved for treating anyone less than 18 years old.
Additionally, the progression of major depression is associated with a worsening of symptoms and/or the emergence of suicidal thinking or behavior in both adults and children, whether or not they are taking antidepressants. Individuals being treated with nefazodone and their caregivers should watch for any change in symptoms or any new symptoms that appear suddenly—especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior—and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose.
Your doctor will prescribe nefazodone with caution if you have a history of seizures or mania (extreme agitation or excitability) or heart or liver disease. Nefazodone should also be used with caution if you have had a heart attack, stroke, or angina; take drugs for high blood pressure; or suffer from dehydration. Under these circumstances, nefazodone could cause an unwanted drop in blood pressure. Be sure to discuss all of your medical problems with your doctor before taking Nefazodone hydrochloride.
Nefazodone may cause you to become drowsy or less alert and may affect your judgment. Do not drive or operate dangerous machinery or participate in any hazardous activity that requires full mental alertness until you know how the drug affects you.
Before having surgery, dental treatment, or any diagnostic procedure requiring anesthesia, tell the doctor or dentist you are taking nefazodone. If you develop an allergic reaction such as a skin rash or hives while taking nefazodone, notify your doctor. If you are male and experience a prolonged or inappropriate erection while taking nefazodone, discontinue Nefazodone hydrochloride and call your doctor.
If you have ever been addicted to drugs, tell your doctor before you start nefazodone.
If nefazodone is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining nefazodone with the following:AlcoholAlprazolamAntidepressants that boost serotonin levelsBuspironeCarbamazepineCholesterol-lowering drugs known as statinsCyclosporineDigoxinHaloperidolMAO inhibitorsPimozideTriazolam
The effects of nefazodone during pregnancy have not been adequately studied. If you are pregnant or are planning to become pregnant, tell your doctor immediately. Nefazodone should be used during pregnancy only if clearly needed. Nefazodone may appear in breast milk. If Nefazodone hydrochloride is essential to your health, your doctor may tell you to discontinue breastfeeding until your treatment with nefazodone is finished.
The usual starting dose is 200 milligrams a day, divided into 2 doses. If needed, your doctor may increase your dose gradually to 300 to 600 milligrams a day.
The safety and effectiveness of nefazodone have not been established in children under 18 years of age.
The usual starting dose for older people and those in a weakened condition is 100 milligrams a day, taken in 2 doses. Your doctor will adjust the dose according to your response.
Any medication taken in excess can have serious consequences. If you suspect an overdose, seek medical attention immediately.