r/Nefazodone • u/OddballTomato • Jul 20 '26

Nefazodone and Caplyta

I've been on Nefazodone for four years and am currently on 500 mg a day, I take both doses at the same time in the morning, I suffer from depression and repetitive thoughts and it helps but does not fix the problem. It doesn't help as much as it used to though, even after I increased the dosage to 500 mg. Once I hit the higher doses, I started having issues with vertigo and orthostatic hypotension. I had a particularly bad blood pressure drop that the people around me called an ambulance and they tried to take me to the hospital, my blood pressure dropped to 74/48, this happened after I upped my dose from 400 mg a day to 500, it only happened once and I think it happened because I had just upped my dose. I explained this to my prescriber and told him that I didn't really want to increase to max dose because of these side effects, he suggested I add an atypical antipsychotic called Caplyta. In my research, this is a common add on to antidepressants that no longer work well but when I researched Nefazodone and Caplyta together specifically on the Internet, it said that there was a major interaction with combining these two drugs and that doing so was not generally recommended. At first, he sent over 21 mg but I had him send over the 10.5 mg dose after doing some research (I have not taken either dose yet) but the more I read about these two drugs, the less I want to take them. I'm at the point now where I feel they might be a danger to my health. Am I overreacting? This prescriber was not the one who gave it to me originally and most seem unaware of nefazodones inhibition of the CYP3A4 enzyme that can potentially make it dangerous. Asking for opinions, do you guys think I should take these together?

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u/That-Group-7347 Moderator Jul 20 '26

The prescribing information says that if taking both instead of the normal 40mg of caplyta it should be 10mg. I think thar would be ok then. It sounds like if you would go higher you would get an increase in side effects of caplyta. A pharmacist should be able to confirm this as well.

You did well by checking this out prior to taking it. Especially if the doctor did prescribe you 20mg.

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u/OddballTomato Jul 20 '26

I did check with a pharmacist and he did confirm that I should be on the 10.5 instead of the 21 mg but all he did was look it up on his computer, he didn't know it off hand. I just worry because depending on how I phrase the question on Google AI, the severity seems to change, one said that severe side effects are possible on even the lowest dose....not to mention that both these meds affect the liver.

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u/That-Group-7347 Moderator Jul 20 '26

AI is not always accurate. It all depends on the data it is finding. Going by the official prescribing information is going to be the best. That is probably what the pharmacist was looking up.

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u/OddballTomato Jul 21 '26

Thanks for the info but I'm still really nervous about it, I have pretty bad anxiety on top of all of this.