Nefazodone
Serzone
Serotonin Antagonist / Reuptake InhibitorGeneric available
Nefazodone inhibits serotonin reuptake (SERT) combined with postsynaptic 5-HT2A receptor antagonism. Dual mechanism enhances antidepressant and anxiolytic effects while reducing sexual dysfunction and weight gain vs SSRIs. Moderate alpha-1 adrenergic antagonism contributes anxiolytic and sleep-promoting effects but causes hypotension.
Compare Nefazodone →FDA-Approved Indications
- Major depressive disorder in adults
Common Off-Label Uses
- PTSD (preliminary efficacy data)
- Panic disorder (preliminary data)
- Agitated depression in elderly with early dementia (adjunct with trazodone at bedtime)
What Sets This Drug Apart
- Dual mechanism (SERT + 5-HT2A antagonism) with lower sexual dysfunction vs SSRIs
- Alpha-1 antagonism provides sleep benefit but causes orthostatic hypotension
- CRITICAL: Hepatotoxicity black box — liver failure and death reported
- Moderate CYP3A4 inhibitor — requires 50% benzodiazepine dose cuts
- Brand Serzone withdrawn; generic available at lower cost
- Short t1/2 (2-4h) requires BID dosing; food increases absorption
Boxed Warning
HEPATOTOXICITY: Liver failure, transplant, death reported
Boxed Warning
Suicidality in pediatric and young adult patients