Jeffrey Panko NP Psychiatry · Patient education
Nefazodone
Generic tablets / Former Serzone brand
A guide for adults taking nefazodone.
Follow the directions on your prescription and your provider's recommendations.
Formulations: Oral tablets are generally taken twice daily. Doses are adjusted gradually based on benefit and tolerability.
What it is used for
Nefazodone treats depression. Its rare risk of severe liver failure and substantial medication interactions are central to deciding whether it is appropriate.
How it works
It blocks selected serotonin receptors and inhibits serotonin and norepinephrine reuptake. These actions influence mood and may also affect sleep.
What to expect over time
Sleep, energy, or appetite may change before mood improves. Benefit usually builds over several weeks; some conditions need a longer trial at a useful dose.
Track the symptoms you are treating and how you manage daily activities. Keep follow-up appointments. Schedule an earlier appointment if your mood gets worse.
Taking your medication
- Take consistently, with or without food.
- If you miss a dose, take it when you remember unless it is almost time for the next dose. Then skip it. Do not double a dose.
- Stand up slowly if lightheaded.
- Consult with your provider before routine stopping; liver symptoms require immediate medical advice.
When to get help
Emergency symptoms. Get emergency care for a seizure, severe allergic reaction, or sudden eye pain with vision changes. Fever with agitation, diarrhea, and stiff or twitching muscles may be serotonin syndrome and needs urgent assessment.
Prompt medical advice. Stop nefazodone and contact your provider immediately for yellow skin or eyes, dark urine, persistent nausea, poor appetite, unusual fatigue, or upper-right abdominal pain.
If you feel unsafe or have thoughts of self-harm, call 911 or go to an emergency department.
Possible side effects
- Drowsiness, dizziness, or weakness
- Dry mouth, nausea, or constipation
- Blurred vision or low blood pressure
Keeping track of treatment
Some side effects resolve with time; others may require a change of medication. Discuss persistent or bothersome side effects with your provider.
Antidepressants can increase suicidal thoughts in people under 25. Watch for changes in mood or behavior at any age, especially when starting treatment or changing a dose.
Tell your provider about emotional numbness, unusual agitation, or a reduced need for sleep with increased energy. These changes may call for a treatment adjustment.
Your provider may order liver tests, but routine testing cannot reliably prevent severe injury. Know the symptoms and seek care promptly even if prior results were normal.
If you take too much
For a suspected overdose, call Poison Control at 1-800-222-1222 immediately, even if you feel well. Call 911 for a seizure, collapse, trouble breathing, or inability to wake.
Before you start
Discuss any history of mania or bipolar disorder, seizures, heart disease, glaucoma, and kidney or liver problems.
Discuss pregnancy, pregnancy plans, and breastfeeding with your provider. Treatment decisions should consider both the medication and the condition being treated.
Nefazodone generally should not be started with active liver disease or elevated baseline liver enzymes. Do not restart after liver injury attributed to it.
Medicines and interactions
Review all your medications with your provider, including over-the-counter medicines and supplements. Have new medications checked before taking them.
Nefazodone strongly inhibits CYP3A. Some statins, sedatives, heart-rhythm medicines, and other drugs may become unsafe. Carbamazepine and several other combinations are contraindicated.
Do not combine with MAOIs. Other serotonergic medicines, alcohol, and sedatives require particular review.
Everyday tips
A regular dose time and refill reminder can help prevent missed doses.
Bring a few specific observations to appointments: sleep, motivation, anxiety, and activities that have become easier or harder.
Your questions answered
Can I stop when I feel better?
Consult with your provider. Continuing treatment after improvement can reduce the chance that symptoms return. Most antidepressants should be reduced gradually to limit withdrawal symptoms.
What if I have sexual side effects?
Changes in desire, arousal, or orgasm are worth discussing. Your provider can review the dose or treatment options; do not stop or skip doses on your own.
Storage and safety
Keep medication in its labeled container, away from excess heat and moisture and out of reach of children and pets. Do not share it. Ask a pharmacy about disposal of unused medication.
Sources
About this information
Educational handout; does not replace your prescription or provider's recommendations.
Educational inclusion does not mean this medication or its indications are treated at this practice. Review the guide for your exact product with your prescriber or pharmacist.