Other Brand Names: Dutonin (UK), Menfazona, Nefadar, Nefirel, Reseril, Rulivan (other Forn Parts)

Generic Name: nefazodone hydrochloride

Other Forms:

FDA Approved Uses: Depression

Off-Label Uses: Panic/Anxiety, Bipolar Depression, Chronic Fatigue, Fibromyalgia, Arthritis, Lupus, Irritable Bowel Syndrome, Eating Disorders

Pros: The mildest of the serotonin & norepinephrine reuptake inhibitors, so discontinuation syndrome isn't as harsh. Works on serotonin & norepinephrine equally and at a consistent rate, not in a funky way like Effexor.

Cons: So mild that it was proven ineffectual on people hospitalized with severe depression. Oh, it could destroy your liver. They won't even prescribe it in Canada anymore because of that.

Not So Common Side Effects: 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. Plus edema and lowered blood pressure and excessive sleepiness. Serzone is chemically related to Desyrel (trazodone), and it targets specific serotonin receptors, so that probably accounts for the sleepiness.

 These may or may not happen to you don't, so don't be surprised one way or the other.

 You aren't going to get these. I promise.

Interesting Stuff Your Doctor Probably Won't Tell You: Your doctor had better tell you about the liver thing, because I have never seen more black box warnings on a PI sheet than on the latest edition of Serzone's. Literally in a black box right on top, just like in the good old days. Once you've tried Serzone you can never go back again. It's a jealous and unforgiving drug. If you put it aside to try others, too bad. You must pledge your devotion to it from the start, otherwise it will get you where it can hurt you the most - right in the liver.

Be careful when mixing benzos and Serzone. Some of them, like Xanax, may suddenly get a lot stronger. Surprise! It's spelled out in the PI sheet, but always check for drug-drug interactions yourself, online and with your pharmacist.

Don't take it with food, as you'll be getting less out of it. The bioavailability of Serzone is bad enough to start, which is why it destroys your liver from the inside out, taking it with food just makes it worse.

Dosage: The initial dose is 200mg a day, divided into two 100mg doses. If there's no improvement after a month that may be increased by 100-200mg a day per week to a maximum of 600mg a day.

Days to Reach a Steady State: Four to five days.

When you're fully saturated with the medication and less prone to peaks and valleys of effects. You still might have peaks of effect after taking many meds, but with a lot of the meds you'll have fewer valleys after this point. In theory anyway.

How Long it Takes to Work: As with any reuptake inhibitor, it can take up to a month.

Half-Life & Average Time to Clear Out of Your System: Like Effexor, Serzone has to do a double metabolism. Like Wellbutrin it has to break down into three different metabolites. So Serzone itself has a half-life of 2-4 hours, and its component metabolites have half-lives that range from 1.5-18 hours. Fortunately the good people at Bristol-Myers Squibb R&D did some heavy research and found the mean total half-life of all components to be 11-24 hours. Allow five days to step down by 100-200mg a day to discontinue. I just stopped cold turkey because it put me in such a foul mood, and I couldn't tell the difference for a few days. But I don't get along with serotenergic drugs at all, so don't go by me!

If you've worked your way up to a particular dosage, it's usually best to spend this many days at the next lowest dosage before going down the next lowest dosage before that and so forth. This is the least sucky way to avoid problems when stopping any psychiatric medication. Presuming you have the option of slowly tapering off them.

Comments: Supposedly the weakest of all official antidepressants on the market, the combination of serotonin and norepinephrine reuptake was just the thing to send me into a rage that destroyed an innocent computer monitor. Bear in mind that I am especially sensitive to any adjustment to my serotonin levels. Serzone has been pulled from the market in Europe by Bristol-Myers-Squibb (allegedly for poor sales) and Canada's national health system has warned Canadian doctors about the potential liver problems. There is, of course, a lawsuit here in the US over just that. Is Serzone any worse for your liver than other hepatically metabolized drugs? I honestly have no idea, but I have never seen so many warnings on a PI sheet for the same damn thing. However I'd really question taking Serzone in combination with any other medication or taking it if you have any concerns about the status of your liver until the whole liver question is settled, preferably by scientists and not lawyers. Lawyers are needed only if there really has been corporate malfeasance. A regular liver panel probably isn't a bad idea.

Sample US Cost: About $115 for 60 tablets of whatever size you want: 50mg, 100mg, 150mg, 200mg, or 250mg for brand name Serzone. About $65 for 60 tablets of the generic nefazodone in any size.

As of 11/11/2003. Full retail for the uninsured. Go ahead and gloat, citizens of civilized countries and all of you with full medical coverage.

Sample Canadian Cost: Doesn't look like the Canadians even sell this med anymore. I don't blame them.

As of 11/11/2003. In US dollars, for re-importation to the US. Does not include shipping charges or currency conversion charges you might incur on your credit card. Currency fluctuations will alter the price on a daily basis.

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If you still have unanswered questions about this or other medications, including which one is, or combination of meds are the best for you, your best bet is to ask on Crazy Meds Talk.  Better yet, if you want to let the world know how they worked out for you and want to help out others in their quest for the correct meds, join the party.
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Another problem is that you may not get a response even if I wanted to send you one.  You see, so many dickweeds with malicious intents and too much time on their hands have appropriated the crazymeds.org domain name to use for their spam, viruses and the like.  Subsequently some lazy-ass e-mail protection software authors just go by the domain name, and not the IP address.  So I've been blacklisted because of the actions of others.  Or the software just doesn't like the domain name because of the "crazy" and/or "meds."  Or your question about a particular medication will set off spam flags.  So the e-mail just wouldn't go through regardless.  Sorry.

 

 

 

 

 

 

 

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All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and pharmacists before taking, or changing how you take any psychiatric medication. Your mileage may vary. What happened to us won't necessarily happen to you. I am neither a doctor nor a pharmacist. I don't portray either here or on TV. Only a doctor can diagnose and treat an illness. Some doctors tend to 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 medication. All information on this site has been obtained through personal experience, the experiences of my friends, the experiences of people reported on online support groups, and from sources that are referenced throughout the site. As such the information presented here is not a substitute for real medical advice from your real doctor, just a compliment to it. All brand names of the drugs listed in this site are the trademarks of the companies listed after them in the pages about the drugs, even though those companies may or may not have been acquired by other companies who may or may not be listed in this site by the time you read this. Always read the PI sheet that comes with your medications and never ever throw them away. No information about visitors to this site is collected or saved. Although from time to time I do look at search terms used to find it in an effort to make the information I present more relevant. Use only as directed. Void where prohibited.