Although nefazodone (Serzone) is structurally related to trazodone, it is less sedating. It does not block a1-adrenoreceptors, and its use is not associated with pri-apism. Nefazodone inhibits the neuronal reuptake of serotonin and blocks 5HT2A receptors. Its short half-life requires dosing twice a day (Table 33.1). Nefazodone is not associated with weight gain or sexual dysfunction. It inhibits the cytochrome P450 3A4 isoenzyme that is responsible for 50% of known oxidative metabolism, and therefore, nefazodone can elevate levels of drugs dependent on this pathway for metabolism.

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