|US brand name: Serzone|
|Generic name: nefazodone|
side effects, dosage, how to take & discontinue, uses, pros & cons, and more
Table of Contents (hide)
- 1. FDA Approved Uses of nefazodone
- 2. Off-Label Uses of nefazodone
- 3. Nefazodone’s pros and cons
- 4. Serzone’s Side Effects
- 5. Interesting Stuff Your Doctor Probably Won’t Tell You about Serzone
- 6. Serzone’s (nefazodone) Dosage and How to Take Nefazodone
- 7. How Long Serzone Takes to Work
- 8. How to Stop Taking Nefazodone
- 9. Serzone’s (nefazodone’s) Half-Life & Average Time to Clear Out of Your System
- 10. Days to Reach a Steady State
- 11. How Nefazodone Works
- 12. Comments
- 13. Serzone Ratings, Reviews, & Other Sites of Interest
- 14. References
2. Off-Label Uses of nefazodone
- Combat PTSD
- Social phobia
- bipolar depression
- postpartum depression
- sexual dysfunction caused by other antidepressants (especially with women)
- insomnia and other sleep disorders.
Good luck getting any doctor to prescribe nefazodone for depression, let alone an off-label application.
Highly effective, especially in preventing relapses. Low instances of sexual side effects.
Doctors are afraid to prescribe it, which is probably just as well because it will probably get pulled from the market completely any day now. Lots and lots of drug-drug interactions.
The usual anticholinergic-like side effects one gets with meds that have a positive effect on both serotonin and norepinephrine: headache, nausea, dry mouth, sweating, dizziness, blurred vision, sleepiness or insomnia, and constipation. Because nefazodone isn’t much of an anticholinergic none of these sticks around very much. Except for the sleepiness.
Urinary retention or hesitancy, which is something that either sticks around or strikes at random. A variety of vision weirdness - go ahead and get your eyes checked, but if an eye doctor doesn’t find anything on a cursory examination, it’s not your eyes, it’s the Serzone. Priapism. Liver problems severe enough that you have to immediately stop taking it, which is why nefazodone has been yanked from the market most everywhere.
The inability to produce clear speech. 3-day long clitoral priapism
They don’t know if you should take nefazodone with food or not. With most drugs they can tell if it’s a good idea, a bad idea, or, as is usually the case, it doesn’t make any difference. The bioavailability of Serzone is bad enough to start (20% or less), or maybe not. The data are all over the map with this med. You don’t want to make it worse, but the data are conflicting! The obvious things to do are:
1. Ask your pharmacist. My money is on the answer being to take it on an empty stomach, because the PI sheet states:
Food delays the absorption of nefazodone and decreases the bioavailability of nefazodone by approximately 20%. — Serzone PI sheet
2. If you’re taking nefazodone on an empty stomach and it makes you want to puke, try taking it with food.
Nefazodone is structurally related to Abilify, even though the two don’t even come close to doing the same thing.
Apparently nefazodone has a discontinuation syndrome that is almost Effexor-like in severity. Which is just fabulous for anyone who lives somewhere it becomes suddenly unavailable.
The official recommendation:
The recommended starting dose for nefazodone HCl is 200 mg/day, administered in 2 divided doses (bid). In the controlled clinical trials establishing the antidepressant efficacy of nefazodone HCl, the effective dose range was generally 300–600 mg/day. — Serzone PI sheet
What we suggest: Start with 100mg at night, then gradually add 50–100mg, dividing it into however much in the morning and night works best for you, until your symptoms stop. We also suggest not taking more than 500mg a day.
Pretty much like trazodone, except with a higher dosage. 50–100mg at night.
Like trazodone, if you’re taking nefazodone for sleep it can start working in one or two days. Otherwise anywhere from one to six weeks.
Unless your liver has imploded, slowly and carefully. As in reducing your dosage by 50mg a day every five to seven days. You can try for a faster discontinuation, but if you start to feel the symptoms of withdrawal, consider my suggestion.
Nefazodone discontinuation syndrome
switching to an SSRI may not help
Nefazodone itself has a half-life of 2–4 hours. Nefazodone has three active metabolites with half-lives that range from 3–18 hours. With its really shitty bioavailability and protein binding (both around 20%) I’m surprised it hasn’t cleared your system five minutes after you take it. Nefazodone is probably gone in three to five days, and that’s both plasma and tissue clearance.
These short half-lives and crappy bioavailability are similar to Effexor’s, and help to explain why Serzone has a similarly nasty discontinuation syndrome. Although sometimes it seems to have a bioavailability and protein binding above 90%.
Usually two to three days. Maybe. As nefazodone’s pharmacokinetics are non-linear, and apparently fungible, and all three of its active metabolites contribute to what it does, your guess is as good as mine.
Like trazodone Serzone is a serotonin reuptake inhibitor that also blocks action at the serotonin 5HT2A and 5HT2C receptors, although one of its metabolites may also be an agonist at 5HT2C, thus counteracting what would normally suppress serotonin reuptake inhibitor side effects like weight gain and anxiety. It is also a moderate antagonist at 5HT1A, and norepinephrine alpha-1. The data are conflicting about how much of an antihistamine it is, but my money is on it being a decent one, otherwise it wouldn’t be as good for sleep as it is. At its higher dosages it is also enough of a norepinephrine and perhaps even dopamine reuptake inhibitor to make a difference.
Poor Serzone. I bet if the problems it can cause with your liver came to light today instead of at the height of anti-antidepressant hysteria in the early 2000s it would still be on the market. It has the pharmacodynamic profile (how it works) of a nearly perfect antidepressant. Too bad its pharmacokinetics (half-life and such) suck so hard that even if it one of its metabolites didn’t hose everything with 5HT2C agonism, the short half-lives and general unpredictability that lead to a discontinuation syndrome, and lots of drug-drug interactions would rule it out.
|Shirts to swipe from|
Crazymeds’ Clothes Line.
|See more ways to let my |
ADs express your feelings
|at Straitjacket T-shirts.||Shirts, hoodies & more.|
Medicated for Your Protection
Don’t worry about buying one. Windows shop and share the designs you’d like to buy. Do you have anything better to do right now?
Give your overall impression of Serzone on a scale of 0 to 5. Detailed ratings and reviews are available on the Serzone Ratings & Reviews Page.
Get all critical about Serzone
Rating 4.3 out of 5 from 47 criticisms.
Vote Distribution: 3 – 1 – 3 – 1 – 5 – 34
If you’re still feeling judgmental as well as just mental1, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
Get all judgmental about the Serzone (nefazodone) Synopsis
Rates 3.4 out of 5 from 17 value judgments.
Vote Distribution: 3 – 1 – 0 – 3 – 3 – 7
Medicine Is The Best Medicine
I <3 Wellbutrin
13.3 Full US PI sheet, Global SPCs & PILs, Other Consumer Review & Rating Sites, check for drug-drug interactions
It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
Medicine Is The Best Medicine stickers
Fuck Depression stickers
PTSD Sucks! stickers
Fuck Bipolar bumper stickers
You don’t have to buy anything. Look around the store. Tweet what you like to your Pinbook Circle. Do you have anything better to do right now?
If you have any questions not answered here, please see the Crazymeds Serzone discussion board.
||Keep Crazymeds on the air.
Donate some spare electronic currency
you have floating around The Cloud
|Display your mad pride. ||Tell your imaginary friends about Crazymeds. |
Totes & Other Bags
Physicians’ Desk Reference Edition 53 © 1999. Published by Medical Economics Company.
Consumer’s Guide to Psychiatric Drugs by John D. Preston Psy.D., John H. O’Neal, M.D. & Mary C. Talaga R.Ph., M.A. © 2000. Published by New Harbinger Publications.
Psychopharmacology of Antidepressants Stephen M. Stahl, M.D., Ph. D. © 1997. Published by Martin Dunitz
Clinical Handbook of Psychotropic Drugs 18th edition Adil S. Virani, K. Bezchlibnyk-Butler, J. Jeffries © 2009 Published by Hogrefe & Huber Publishers.
Totes & Other Bags
If you have any questions not answered here, please see the Crazymeds Serzone discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)
|Last modified on Monday, 20 January, 2014 at 15:31:50 by SomeMedCritic||Page Author Jerod Poore||Date created|
|“Serzone (nefazodone): a Synopsis for the Educated Consumer.” by Jerod Poore is copyright © Jerod Poore||Published online 2011/03/26|
|Citation options to copy & paste into your article:|
|Plain text:||Poore, Jerod. “Serzone (nefazodone): a Synopsis for the Educated Consumer.” Crazymeds (crazymeds.us). ().|
Serzone, and all other drug names on this page and used throughout the site, are a trademark of someone else. Serzone’s PI Sheet will probably have the name of the manufacturer and trademark owner (they’re not always the same company) at or near the very bottom. Or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing. It may of changed hands by the time you finished reading this article.
Page design and explanatory material by Jerod Poore, copyright © 2004 - 2014. All rights reserved.
Keep up with Crazymeds and and/or my
slow descent into irreparable madness boring life. Pick your preferred social media target(s):
Follow me for site updates,
and research & pharm news.
|Wear my Straitjacket||Batshit Crazy Blog|
Crazymeds | Promote Your Page Too||
Follow for site updates and
retweets to cheer you the hell up.
|Play Dress-Up with your Imaginary Friends||Crazymeds: The Blog|
Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
No neurologists, psychiatrists, therapists or pharmacists were harmed in the production of this website. Use only as directed. Void where prohibited. Contains nuts. Certain restrictions may apply. All data are subject to availability. Not available on all mobile devices, in the 12 Galaxies Guiltied to a Zegnatronic Rocket Society, or in all dimensions of reality. Hail Xenu!
‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas? I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.