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− | '''Nefazodone''' hydrochloride (trade name '''Serzone''') is an [[antidepressant]] drug marketed by |
+ | '''Nefazodone''' hydrochloride (trade name '''Serzone''') is an [[antidepressant]] drug marketed by Bristol-Myers Squibb. Its sale was discontinued in 2003 in some countries, due to the small possibility of hepatic (liver) injury, which could lead to the need for a liver transplant, or even death. The incidence of severe liver damage is approximately 1 in 250,000 to 300,000 patient-years.<ref name="pi">[http://www.rxlist.com/cgi/generic/nefaz.htm Rxlist.com: "Nefazodone Prescribing Information"], accessed 8 January 2007.]</ref> On May 20, 2004, Bristol-Myers Squibb discontinued the sale of Serzone in the United States. Several generic formulations of nefazodone are still available.<ref name="fdaob">[http://www.accessdata.fda.gov/scripts/cder/ob/docs/obdetail.cfm?Appl_No=020152&TABLE1=OB_Disc ''FDA Orange Book''], accessed 15 January 2006.</ref><ref name="about">[http://mentalhealth.about.com/od/psychopharmacology/a/serzone504.htm About.com: "Serzone Pulled from U.S. Market", accessed 15 January 2006.]</ref> |
==Structure and mode of action== |
==Structure and mode of action== |
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− | Nefazodone is most closely related to [[trazodone]] (trade name '''Desyrel'''). Nefazodone is not considered to be an [[SSRI]], [[MAOI]] or [[tricyclic |
+ | Nefazodone is most closely related to [[trazodone]] (trade name '''Desyrel'''). Nefazodone is not considered to be an [[SSRI]], [[MAOI]] or [[tricyclic antidepressant]]. It is not chemically related to either [[bupropion]]/amfebutamone or [[venlafaxine]]. |
It operates by blocking post-synaptic [[serotonin]] [[5-HT2A receptor|type-2<sub>A</sub>]] [[serotonin receptor|receptor]]s and, to a lesser extent, by inhibiting pre-synaptic serotonin and [[norepinephrine]] (noradrenaline) reuptake. Nefazodone is also a relatively potent alpha-1 [[adrenergic receptor|adrenoceptor]] [[antagonist]].<ref>{{cite journal | last = Sanchez| first = C | coauthors = J. Hyttel | title = Comparison of the Effects of Antidepressants and Their Metabolites on Reuptake of Biogenic Amines and on Receptor Binding | journal = Celular and Molecular Neurobiology | volume = 19 | issue = 4 | pages = 467-89 | date = 1999 }}</ref> |
It operates by blocking post-synaptic [[serotonin]] [[5-HT2A receptor|type-2<sub>A</sub>]] [[serotonin receptor|receptor]]s and, to a lesser extent, by inhibiting pre-synaptic serotonin and [[norepinephrine]] (noradrenaline) reuptake. Nefazodone is also a relatively potent alpha-1 [[adrenergic receptor|adrenoceptor]] [[antagonist]].<ref>{{cite journal | last = Sanchez| first = C | coauthors = J. Hyttel | title = Comparison of the Effects of Antidepressants and Their Metabolites on Reuptake of Biogenic Amines and on Receptor Binding | journal = Celular and Molecular Neurobiology | volume = 19 | issue = 4 | pages = 467-89 | date = 1999 }}</ref> |
Latest revision as of 10:14, 5 May 2009
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Nefazodone chemical structure | |
2-[[3-[4-(3-chlorophenyl)-1-piperazinyl]]propyl]-5-ethyl-2,4-dihydro-4-(2-phenoxyethyl)-3H-1,2,4-triazol-3-one IUPAC name | |
CAS number 83366-66-9 |
ATC code |
PubChem 4449 |
DrugBank APRD00402 |
Chemical formula | {{{chemical_formula}}} |
Molecular weight | 506.5 g/mol |
Bioavailability | 20% (IV only) |
Metabolism | Hepatic (active metabolites) |
Elimination half-life | 2–4 hours |
Excretion | 55% urine 20-30% feces |
Pregnancy category | {{{pregnancy_category}}} |
Legal status | Rx-only |
Routes of administration | oral |
Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. Its sale was discontinued in 2003 in some countries, due to the small possibility of hepatic (liver) injury, which could lead to the need for a liver transplant, or even death. The incidence of severe liver damage is approximately 1 in 250,000 to 300,000 patient-years.[1] On May 20, 2004, Bristol-Myers Squibb discontinued the sale of Serzone in the United States. Several generic formulations of nefazodone are still available.[2][3]
Structure and mode of action
Nefazodone is most closely related to trazodone (trade name Desyrel). Nefazodone is not considered to be an SSRI, MAOI or tricyclic antidepressant. It is not chemically related to either bupropion/amfebutamone or venlafaxine.
It operates by blocking post-synaptic serotonin type-2A receptors and, to a lesser extent, by inhibiting pre-synaptic serotonin and norepinephrine (noradrenaline) reuptake. Nefazodone is also a relatively potent alpha-1 adrenoceptor antagonist.[4]
Dosing
Nefazodone doses for adults typically start at 50 mg twice daily uptitrated by 100 mg/day per week to a maximum of 600 mg (300 mg twice daily), according to Food and Drug Administration (FDA) regulations. Some patients with severe depression were treated with more than 600 mg/day. Most patients were treated with 300 mg–600 mg daily.
Side effects
Nefazodone and other SNRIs and SSRIs have been shown to cause sexual side effects in some patients, both males and females. Although usually reversible, these sexual side effects can sometimes last for months, years or possibly indefinitely even after the drug has been completely withdrawn. This disorder is known as Post SSRI Sexual Dysfunction. However, nefazodone is associated with a very low incidence of sexual side effects. Indeed, nefazodone is sometimes used as an antidote to SSRI induced impotence and anorgasmia in men.[5]
Advantages
Nefazodone's claimed advantages over other antidepressants available at the time included reduced possibility of disturbed sleep or sexual dysfunction, and ability to treat some patients who did not respond to other antidepressant drugs.
Notes
- ↑ Rxlist.com: "Nefazodone Prescribing Information", accessed 8 January 2007.]
- ↑ FDA Orange Book, accessed 15 January 2006.
- ↑ About.com: "Serzone Pulled from U.S. Market", accessed 15 January 2006.
- ↑ Sanchez, C, J. Hyttel (1999). Comparison of the Effects of Antidepressants and Their Metabolites on Reuptake of Biogenic Amines and on Receptor Binding. Celular and Molecular Neurobiology 19 (4): 467-89.
- ↑ [1]
- de:Nefazodon
- it:Nefazodone
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