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A part of the phenylpiperazine compound chemical group, nefazodone is typically sold and prescribed as a generic and is used to treat depression and nerve-based pain symptoms.  Nefazodone inhibits serotonin and norepinephrine uptake within the brain and nervous system, increasing the activity levels of these neurotransmitters and reducing the symptoms of depression.  The same chemical interaction can also reduce pain associated with spinal column disorders.  Nefazodone is available in tablet form only and is typically taken twice a day.  In most cases, patients begin with a low dose of nefazodone and gradually increase their dosage to the full prescribed strength.  A similar process is necessary when discontinuing use of this powerful antidepressant and pain relief medication.

Uses for Nefazodone

Nefazodone was first introduced for clinical use in the U.S. in 1994.  Developed as an alternative for trazodone, the new medication offered significant advantages for patients due to its reduced sedative effect at full dosage.  Nefazodone is generally used to control depression.  It can also be helpful in treating a number of other conditions:

•             Migraine

•             Chronic pain, especially due to spinal disorders

•             Post traumatic stress disorders

•             Generalized anxiety

•             Social anxiety disorder

•             Panic disorders

•             Premenstrual dysphoric disorder

The pain relief mechanism of nefazodone is not well understood; it may have to do with the role of serotonin and norepinephrine in managing pain within the nervous system.  Nefazodone does produce significant pain relief for patients suffering from spinal column disorders; it appears to inhibit the transmission of pain signals through the nervous system and to block the reception of those signals by neural cells in the brain.

Contraindications for Nefazodone use

Nefazodone is not recommended for use in children and adolescents due to an increased risk of suicidal thoughts among these vulnerable populations.  Additionally, patients with liver disease should avoid the use of nefazodone; this medication can worsen the condition or accelerate its progress.  Patients allergic to trazodone or other medications in the piperazine compound family should not take nefazodone.

Drug Interactions with Nefazodone

Nefazodone can react with a number of other medications, herbal supplements and vitamins to cause serious complications.  Known interactions include the following:


•             MAO inhibitors, including furazolidone, phenelzine and procarbazine

•             Carbamazepine

•             Eletriptan

•             Statin cholesterol medications, including lovastatin and atorvastatin

•             Digoxin

•             Alpha blockers

•             High blood pressure medications

•             Trazodone

•             Anticoagulants, including warfarin and heparin

•             Muscle relaxants

•             Narcotic-based pain relievers, including codeine and oxycontin

•             Anti-seizure medications

Other drugs not on this list may also cause interactions.  Patients should provide their physicians with a complete list of medications, supplements and vitamins currently taken in order to prevent serious and potentially fatal interactions with nefazodone.

Side effects of Nefazodone

Minor side effects of nefazodone are common and typically improve over time.  These side effects include some or all of the following symptoms:


•             Headache

•             Difficulty in focusing attention

•             Heartburn

•             Unexplained warmth, numbness or tingling in the extremities

•             Constipation

•             Dry mouth


Serious side effects are less common.  These side effects include the following conditions:

•             Seizures

•             Slowed heartbeat

•             Jaundice

•             Memory loss

•             Confusion

•             Skin irritation including rash, hives and itching

•             Visual disturbances

•             An erection lasting over four hours

Patients should report any serious side effects of nefazodone to their physician immediately.  Nefazodone has been linked with liver damage in rare cases; as a result, patients should be monitored for any signs of this disorder on a regular basis.

Nefazodone should be used only under the supervision of a physician.  It can provide significant benefits for patients but requires constant monitoring to achieve the most effective relief for pain and depression.  As with all prescription medications, patients should take nefazodone only as prescribed.