nefazodone

Adjunctive therapy • Brands: Serzone

Last reviewed: 2025-12-30

General information

Class: Adjunctive therapy
Common US brands: Serzone
Typical dose range: Label initiation is typically 200 mg/day divided BID, with titration toward 300–600 mg/day as tolerated; dose increases are commonly spaced at one-week intervals in labeling (label).
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-30

Dosing & forms

Forms/strengths: Oral tablets (label): 50 mg, 100 mg, 150 mg, 200 mg, 250 mg.
Frequency: Label initiation is typically 200 mg/day divided BID, with titration toward 300–600 mg/day as tolerated; dose increases are commonly spaced at one-week intervals in labeling (label).
Typical range: Label initiation is typically 200 mg/day divided BID, with titration toward 300–600 mg/day as tolerated; dose increases are commonly spaced at one-week intervals in labeling (label).

Mechanism (brief)

Serotonin antagonist and reuptake inhibitor (SARI-like): inhibits serotonin/norepinephrine uptake with 5-HT2 and α1 antagonism; notable for rare but life-threatening hepatic failure and strong CYP3A4 inhibition.

Metabolism & Half‑life

Metabolism: CYP3A4
Half‑life: Single-dose range 2–4 h

Therapeutic Drug Monitoring (TDM)

Recommended: No

View labelExact

Monitoring highlights

Baseline assessment for liver disease and review of hepatic warning signs/symptoms at follow-up (label/clinical).
Medication reconciliation focused on CYP3A4 interactions, including sedative-hypnotics and common non-psychiatric drugs (label/clinical).
Orthostatic vitals and functional safety (falls risk), especially in older adults and polypharmacy (clinical).
Suicidality and mood switching surveillance early in treatment and after dose changes (label/clinical).

Sources

Nefazodone hydrochloride tablets prescribing information — DailyMed (2025)
Consensus Guidelines for Therapeutic Drug Monitoring in Neuropsychopharmacology: Update 2017 — Pharmacopsychiatry (2018)
APA Clinical Practice Guideline for the Treatment of Depression — American Psychiatric Association (2023)
CANMAT 2024 Clinical Guidelines for Major Depressive Disorder — Canadian Journal of Psychiatry (2024)

General information

Class: Adjunctive therapy

Common US brands: Serzone

Typical dose range: Label initiation is typically 200 mg/day divided BID, with titration toward 300–600 mg/day as tolerated; dose increases are commonly spaced at one-week intervals in labeling (label).

Therapeutic drug monitoring not routinely recommended.

Last reviewed: 2025-12-30

Dosing & forms

Forms/strengths: Oral tablets (label): 50 mg, 100 mg, 150 mg, 200 mg, 250 mg.

Frequency: Label initiation is typically 200 mg/day divided BID, with titration toward 300–600 mg/day as tolerated; dose increases are commonly spaced at one-week intervals in labeling (label).

Typical range: Label initiation is typically 200 mg/day divided BID, with titration toward 300–600 mg/day as tolerated; dose increases are commonly spaced at one-week intervals in labeling (label).

Monitoring highlights

Baseline assessment for liver disease and review of hepatic warning signs/symptoms at follow-up (label/clinical).

Medication reconciliation focused on CYP3A4 interactions, including sedative-hypnotics and common non-psychiatric drugs (label/clinical).

Orthostatic vitals and functional safety (falls risk), especially in older adults and polypharmacy (clinical).

Suicidality and mood switching surveillance early in treatment and after dose changes (label/clinical).