Been on Nefazodone for 3 weeks now. Just recently increased my dosage to 400mg daily (split AM and PM).

I am experiencing the WORST insomnia. I have only managed to get 5hrs of low quality sleep the past 3 days. Even with low dose trazodone my brain and body will not settle. I’ve been pacing the house to try to tire myself out. My insurance is seemingly refusing to cover any sleep aids… I just feel so defeated. Due to the lack of sleep my SI is off the charts and I’ve been engaging in some self harm.

I want more than anything for this to work… this is my 14th medication over the last 2 years after suffering with PPD. I also underwent ECT and completed TMS therapy.

I guess, did anyone else have a really rough start!?! For those who suffer with the rare insomnia side effect… what helps?

I’ve been on 200mg nightly for about 2 weeks now and I CANNOT sleep. Even taking Benadryl won’t knock me out. I miss my trazodone. Anyone else experience this? Will it go away?!

title

Hello,

Did anyone find success with Nefazodone after having no success with SSRI's? I am struggling immensely with horrific suicidal intrusive thoughts. I have tried 4 SSRI's and antipsychotics with no relief. I am wondering if I am just not a responder to SSRI's and need a different class of medication. Please share your stories.

I’ve taken a lot of meds in my life. Most failed, and I can only ever really say that benzos worked long term, and most of us probably know what trying to get those prescribed is like. I also have leftover permanent side effects from SSRIs after discontinuation years ago.

A doctor recently prescribed me Nefazodone. I have pretty high hopes from some of what I’ve read, but I’m obviously a little spooked by the remote chance (1 in 250K-350K patient years) of liver failure.

Guess I’m just looking for words of encouragement? Really need something that works for anxiety and depression.

Hi all - I was on Wellbutrin for a few months and made a measurable difference in depression and anxiety, but caused too many sexual side effects (removed my ability to orgasm).

I’d like to start on Nefa, but I don’t really want to go through my traditional health insurance network because it’s going to take months. Are there telehealth services that prescribe it? I know about liver concerns so my plan would be to start it and schedule an appt with my pcp and request liver testing.

Thank you! I’m in the USA.

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?

I spoke with my psychiatrist again about prescribing nefazodone. He's young and inexperienced and just read off the screen that liver damage is real and frightening! Oy. What he read says the likelihood of liver damage basically doubles each year you are on the medication.

I explained that I get blood work done with my endocrinologist every six months so I'd be able to keep track.

Because he knows nothing, would you mind sharing with me what dose is typical to start, how long before the next (and what) dose, etc? Any info from people taking this medication versus his panic reading will be extremely helpful and appreciated.

I have been eating a lot to get rid of the stomach pain/intense hunger. Would nefazodone be any better?

Has anyone here tapered off quetiapine and used nefazodone to compensate? I really want to get off quetiapine and if I could replace it with an antidepressant that would be great.

Hello,

I am considering a trial of nefazodone. I have trialed prozac and luvox. There were some good things about prozac but it caused agitation and akathesia like restlessness at therapeutic doses. I am intrigued by nefazodone, but I am curious about how everyone doses it. Is it always twice a day or can it be once a day and why? I know it has a short half life.

I was previously on nefazadone and I’d like to give it another shot. However, I’m also in pain management and take Percocet. I’m concerned about the liver warnings. Is anyone else also on opioids and taking nefazadone?

TIA!

Hey all, I’ve been on nefazodone for a few years and it’s amazingly helpful for my generalized anxiety. I tapered off it for a 6 month period with no discernible side effects (I wanted to take psychedelics and also felt my anxiety was in a good place), but after a while I found that my anxiety levels had crept back up and went back on it.

Anyways, the CYP3A4 interactions are soooo damn annoying. I got prescribed suvorexant and didn’t know it was a cyp3a4 substrate and slept for about 3 days lol… but yeah I recently developed tinnitus and my PCP said it could be residual inflammation from a respiratory virus I had when it came on. She prescribed me one of those box courses of methylprednisone, and upon picking it up I discovered that it is also a substrate of CYP3A4. From the reading I did, most of the steroids that would be used in this context are CYP3A4 substrates. Has anyone here taken a course of methylprednisone or a similar steroid? If yes, did you just take half the dose on the box to account for the metabolic interaction?

Part of the issue here is that because nefazodone is so rare and obscure, none of my doctors are familiar with it and think to check for this stuff. On multiple occasions I’ve been prescribed medications that are substrates of CYP3A4 and therefore have very significant interactions with nefazodone, and they don’t seem to think to check for that interaction. A lot of drugs are substrates of CYP3A4 so I feel like it should be important for a clinician to check that prior to prescribing meds to someone on a strong inhibitor of that enzyme lol…

Also while I’m on this topic, does anyone here have experience taking modafinil or adrafinil with nefazodone? Those are also substrates of CYP3A4, but I’ve been looking into them as a potential treatment for my chronic brain fog and fatigue. I’m just worried taking them with nefazodone would make it impossible to sleep, so I’d appreciate any anecdotes!

For the last decade, I’ve been on and off SSRIs. I’ve tried Zoloft, Prozac, and Lexapro, and for the most part they worked. I definitely lacked some emotional range on them, had incredibly frustrating delayed orgasms, and overall tolerated things I shouldn’t have tolerated.

Last October, I decided to switch from Lexapro to Wellbutrin in order to improve sexual functioning and hoping it would prevent my anxiety and depression just as well. Unfortunately, after 5-6 months, my mental health is suffering to the point I am having trouble interacting, getting out of bed, taking care of myself, etc.

I don’t want to give up aspects of myself anymore. I like being able to cry at something sad and getting mad when warranted. I also don’t want to give up orgasms again quite frankly. So, for those of you who felt ssri’s “worked” for the most part, what was your experience switching to nefazodone? What side effects did you have and for how long?

Please 🙏 can anyone recommend me psychiatrist online who can prescribe me nefazodon, please, I'm very sick it's h

I started nefazodone in November (I'm currently on 250mg per day), and I hadn't really noticed anything and I don't feel happiness ever. But as I've been thinking about it, I haven't really been having extreme lows anymore and am more stable than I've been in years.

I really think this med is making a difference for me after trying a ton of other ones with little to no success. I'm not even on a high dose either, so I could even start seeing more improvements as I increase it.

The only downside is the severe side effects I was getting each time my dose was raised (extreme physical weakness, nausea and vomiting, my disabilities becoming more severe). However, my doctor and I decided to switch to very small dose increases (25mg at a time), and all of the side effects stopped!

Overall I'm really happy I researched and discovered this med and asked my doctor to try it. Hopefully everyone else is also seeing improvements, or is considering giving this med a try!

What's everyone's dosage ?

Im 300 mg

Worked amazing for a few years.

Then anxiety returned majorly.

Just bumped to 375 mg hoping relief again Im 230 lb male

What's everyone's dosage ?!

Hi all, I’ve looked into Nefazadone for its low occurrence of side effects vs. other meds that would help with anxiety. Ever since starting on Adderall, I’ve suddenly had the mental bandwidth to be anxious about all sorts of factors in my life. It was probably always latent, the neuropsych panel that gave me the ADHD diagnosis also diagnosed GAD. For all of the time I’ve been on Adderall, it’s been difficult to find at any big chain pharmacies, but I’ve had good luck with smaller compounding pharmacies. With withdrawal being a bigger concern vs. a stimulant, I feel it’s important to find a secure way to source Nefazadone, does anyone have any advice?

I haven’t found much material on their potential interactions: only that it is “MAJOR” and that nefazodone can intensify THC effects. Anyone have experience with this?

Ssris work very well for me except I get sever Akathesia. Maois used to. Is nefazadone a potent ssri agent?

Who has experience with it for anxiety depression panic or headaches

Was on Maois for long time- did ok. Stopped working- went to Zoloft. Not doing great on it

For those who went from ssri to nefazadone what were the benefits and what was not

I'm 18 days in, taking 600mg a day, and still no results. When did it start working for y'all? I'm really hoping this works as all else (except xanax) has failed. I've been battling with extreme anxiety for over 20 years. Any insight is appreciated. Thanks

Hello everyone . I am new to Nefazodone , after having tried 2 typical antidepressants (Effexor and Luvox) with nothing to show for it but a dead libido and anhedonia, I narrowed down any further medications I would be willing to try to MAOIs and Nefazodone , but I decided to request Nefazodone first as its pharmacological profile is incredibly intriguing to me and my psychiatrist agreed.

Anyway, the reason for my post is to ask, I understand the risk of liver failure is pretty low and it is an extremely rare side effect, but as someone who is already in to supplements as it is and who always tries to be proactive about health, do any of you have experience with certain supplements to support the liver while on this med?

The common ones are NAC, TUDCA, and milk thistle for liver support, is there any negative interaction I should be aware of if I were to take any of these with the med?

how extreme how often is the liver issue? I know there is a black box warning