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Brand: Serzone
Published 2025-12-23 · Last reviewed 2025-12-30 · 4 references
Content sourced from FDA labeling (DailyMed) and peer-reviewed literature.
Nefazodone (brand Serzone; generics) is an antidepressant indicated for depression (label).
Its mechanism includes serotonin uptake inhibition with 5-HT2 antagonism and α1 antagonism, contributing to sedation and orthostatic effects in some patients (mechanism/clinical).
The defining safety issue is rare but potentially life-threatening hepatic failure. Labeling highlights a reported U.S. rate of about one case of liver failure resulting in death or transplant per 250,000 to 300,000 patient-years and advises weighing this risk when selecting among alternatives (label).
Nefazodone is a strong CYP3A4 inhibitor and has a high interaction burden. Contraindications and major interactions can be clinically limiting in polypharmacy, particularly with sedative-hypnotics and other CYP3A4 substrates (label/clinical).
The compare view, nefazodone evidence feed, and print page support reviewing hepatic risk and interaction constraints alongside alternatives.
Because of hepatic failure risk and major drug–drug interactions, nefazodone is typically reserved for select cases where alternatives have failed or were poorly tolerated. When it is used, follow-up focuses on hepatic symptoms, medication reconciliation, and functional safety in sedation.
View labelExactRefer to the Glossary entry on Neurotransmitters for background on receptor systems involved in serious mental illness.
Inhibits neuronal uptake of serotonin and norepinephrine and antagonizes 5-HT2 receptors; α1 antagonism contributes to sedation and Orthostatic hypotension (label/mechanism).
Compared with SSRIs, the 5-HT2 antagonism can reduce certain serotonergic side effects, but the interaction burden often dominates clinical decision-making (clinical).
Nefazodone monitoring is dominated by hepatic safety and interaction management; these risks frequently outweigh potential benefits in polypharmacy.