THERAPEUTIC DOSE RANGE OF NEFAZODONE IN THE TREATMENT OF MAJOR DEPRESSION

The therapeutic dose range of nefazodone for treatment of major depres sion was examined in a series of placebo-controlled efficacy studies c arried out during phase 2 and 3 premarketing clinical evaluation. Nefa zodone is a new antidepressant drug with pharmacologic effects on both serotonin and norepinephrine neurotransmitters. The usual starting do se of nefazodone for depressed patients, unless they are being switche d from a serotonin selective reuptake inhibitor (SSRI), is 100 mg. b.i .d. A lower starting dose is recommended for elderly patients or patie nts being treated with an SSRI. Following assessment of the patient's clinical response after the first week of therapy, the daily dose shou ld be adjusted upward for most patients. In the efficacy studies, the majority of patients were being maintained on a dose of 300 to 500 mg daily at the end of the acute treatment period. The side effects of ne fazodone most often related to dosage were sedation, nausea, and visua l symptoms. Imipramine-treated patients, on the other hand, had a high incidence of dry mouth, constipation, and asthenia. In these studies, nefazodone was found to be effective and well tolerated by patients, the majority of whom were being maintained at a 300- to 500-mg/day dos e, following an initial starting dose of 100 mg b.i.d.