Nefazodone: its place among antidepressants

Area of Science:

• Pharmacology and Psychiatry
• Neuroscience

Background:

• Nefazodone is an antidepressant medication.
• It acts by blocking serotonin type 2 (5-HT2) receptors and inhibiting the reuptake of serotonin and norepinephrine.

Purpose of the Study:

• To review the pharmacology, pharmacokinetics, efficacy, adverse effects, and drug interactions of nefazodone.
• To determine nefazodone's place among currently available antidepressants.

Main Methods:

• A comprehensive search of European and American literature was conducted using EMBASE and MEDLINE.
• Only double-blind, placebo-controlled studies evaluating nefazodone's antidepressant efficacy were reviewed.

Main Results:

• Nefazodone demonstrates antidepressant activity at dosages of 400-600 mg/d in double-blind, placebo-controlled studies.
• Common adverse effects include sedation, dry mouth, nausea, and dizziness.
• Nefazodone may have fewer sexual adverse effects than other antidepressants and has not been associated with priapism.

Conclusions:

• Nefazodone shows greater efficacy than placebo and equivalent efficacy to imipramine.
• It presents a milder adverse effect profile compared to tricyclic antidepressants and fewer sexual dysfunctions than SSRIs.
• Nefazodone at dosages of at least 300 mg/d is a viable treatment option for depression.