Classification Antidepressant

Action/Kinetics: Exact antidepress-ant mechanism not known. Inhibits n neuronal uptake of serotonin and norepinephrine and antagonizes central 5-HT2 receptors and alpha-1-adrenergic receptors (which may cause postural hypotension). Produces none to slight anticholinergic effects, moderate sedation, and slight or-thostatic hypotension. Peak plasma levels: 1 hr. tV2: 2-4 hr. Time to reach steady state: 4-5 days. Extensively metabolized by the liver with less than 1% excreted unchanged in the urine. Food delays the absorption of nefazodone and decreases the bioavailability by approximately 20%. Uses: Treatment of depression. Contraindications: Use with ter-fenadine or astemizole; in combination with an MAO inhibitor or within 14 days of discontinuing MAO inhibitor therapy. Clients hypersensitive to nefazodone or other phenylpiper-azine antidepressants. Special Concerns: Use with caution in clients with a recent history of MI, unstable heart disease and taking digoxin, or a history of mania. Use with caution during lactation. Safety and efficacy have not been determined in individuals below 18 years of age. There is a possibility of a suicide attempt in depression that may persist until significant remission occurs.

Side Effects: CNS: Dizziness, insomnia, agitation, somnolence, light-headedness, activation of mania or hypomania, confusion, memory impairment, paresthesia, abnormal dreams, decreased concentration, ataxia, incoordination, psychomotor retardation, tremor, hypertonia, decreased libido, vertigo, twitching, depersonalization, hallucinations, suicide thoughts/attempt, apathy, euphoria, hostility, abnormal gait, abnormal thinking, derealization, paranoid reaction, dysarthria, myoclo-nus, neuroleptic malignant syndrome (rare). CV: Postural hypotension, hypotension, sinus bradycardia, tachycardia, hypertension, syncope, ventricular extrasystoles, angina pectoris, CVA (rare). Oral: Dry mouth, perio-dontal abscess, gingivitis, mouth ulceration, stomatitis. GI: Nausea, constipation, dyspepsia, diarrhea, increased appetite, vomiting, eructation, colitis, gastritis, esophagitis, peptic ulcer, rectal hemorrhage. Dermatologie: Pruritus, dry skin, acne, alopecia, urticaria, maculopapular rash, vesicu-lobullous rash, eczema. Musculoskeletal: Asthenia, arthralgia, arthritis, tenosynovitis, muscle stiffness, bursitis. Respiratory: Pharyngitis, increased cough, dyspnea, bronchitis, asthma, pneumonia, laryngitis, voice alteration, epistaxis, hiccups. Hematologic: Ecchymosis, anemia, leukopenia, lymphadenopathy. Ophthalmologic: Blurred vision, abnormal vision, visual field defect, dry eye, eye pain, abnormal accommodation, diplopia, conjunctivitis, mydriasis, keratoconjunctivitis, photophobia, night blindness. Body as a whole: Headache, infection, flu syndrome, chills, fever, neck rigidity, allergic reaction, malaise, photosensitivity, facial edema, hangover effect, enlarged abdomen, hernia, pelvic pain, halitosis, cellulitis, weight loss, gout, dehydration. GU:

Urinary frequency, UTI, urinary retention, vaginitis, breast pain, cystitis, urinary urgency, metrorrhagia, amenorrhea, polyuria, vaginal hemorrhage, breast enlargement, menor-rhagia, urinary incontinence, abnormal ejaculation, hematuria, nocturia, kidney calculus. Miscellaneous: Peripheral edema, thirst, abnormal LFTs, ear pain, hyperacusis, deafness, taste loss.

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