Nefazodone: An update

Nefazodone is an antidepressant with some novel characteristics in regard to its putative mechanism of action. Although the clinical significance of these properties is not clear, nefazodone is unique in that it is associated with minimal effects on sleep architecture and sexual functioning. Use of nefazodone to treat anxiety disorders appears to have promise, although placebo-controlled studies are still needed. Nefazodone is a potent inhibitor of CYP3A4, and thus numerous potential drug interactions must be carefully considered in order to avoid potential therapeutic misadventures. Recent reports indicate that nefazodone can cause severe hepatic toxicity. Evaluation of hepatic function before, and periodically after, therapy with nefazodone is initiated would be prudent. Nefazodone may be an appropriate antidepressant when potential anxiolytic activity would be beneficial and there is a need to avoid adverse effects on sexual functioning or sleep architecture.