SAFETY AND TOLERABILITY PROFILE OF NEFAZODONE

Nefazodone has a very favourable side-effect profile in comparison wit h other antidepressants; it does not cause psychic activation, sexual dysfunction, weight change or cardiotoxicity. The majority of side eff ects are mild in severity and often transient. Most patients will expe rience a significant degree of adaptation to nefazodone's side effects over the first few weeks of treatment. The adverse experience profile in elderly patients, including those effects related to the cardiovas cular system, is similar to that observed in patients aged under 65 ye ars. The drop-out rates for adverse experiences in clinical trials hav e been comparable with fluoxetine and lower than with imipramine. The safety of nefazodone in long-term use is supported by data from more t han 250 patients treated for at least 1 year with no evidence of new a dverse experiences emerging with chronic exposure. With hepatic impair ment, doses should be somewhat lower, but renal impairment requires no reduction; starting doses in the elderly should also be reduced. Drug -drug interactions may occur with drugs metabolised by the cytochrome P-450 IIIA(4) isozyme but not with drugs metabolised by cytochrome P-4 50 IID6 isozyme or IA(2). Overdoses have caused no serious complicatio ns, and no deaths have occurred so far. Nefazodone is a safe and well- tolerated antidepressant with some important advantages over existing antidepressants.