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DATE      CITATION           DRUG                     REPORT                                      


1996 Castaņeda et al. Nefazodone Report of three cases in which NFZ had been abruptly substituted for FLX, PRX and VFX, "with the emergence of anxiety, dysphoria, affective lability, agitation, restlessness, confusion and somatic complaints such as headaches, tremors and nausea", together with intense craving for opiates or cocaine in three "otherwise stably abstinent patients".
1998 Benazzi Nefazodone Letter: thought to be the first published report (in the English- language literature) of nefazodone withdrawal problems. Patient was 27-year old male, with diagnosed "dysthymic disorder and social phobia". After three months on clomipramine and alprazolam, NFZ 250mg/day was added. One month later NFZ was abruptly withdrawn. Patient experienced similar withdrawal symptoms to those he had previous had when coming off  VFX. Symptoms spontaneous resolved after three days.
1999 Kotlyar et al Nefazodone This case report concerns a healthy 28-year old male volunteer, given up to 400mg/day NFZ (the usual therapeutic dose) for nine days. Following abrupt discontinuation, subject reported "electric shock-like symptoms, dizziness, and nausea". Symptoms began to subside 72-hours after stopping and ceased shortly thereafter.
1999 Lauber Nefazodone After four weeks of treatment at the usual therapeutic dose (400mg/day), this young woman patient abruptly stopped treatment and 48 hours later experienced "nausea, vomiting, fatigue, headache, myalgia, sweating, restlessness, dizziness, sleeping disturbances with vivid nightmares, severely depressed mood, emotional lability and anxiety" plus "brief moments of disorientation and shock-like sensations". Four days later treatment was restarted and symptoms promptly resolved. Author comments that, in view of the relatively short half-life of NFZ, it seemed surprising that the onset of the withdrawal syndrome occurred only 48 hours after discontinuation.
1999 Rajagopalan and Little Nefazodone Case report: 41 year old patient took nefazodone 100mg/day for three weeks, but her conditioned worsened and it was decided to reduce and then stop the NFZ (after 3 days on 50mg/day). Severe withdrawal symptoms began two days off drug and lasted another week ... "she became frightened by what she described as the worst feeling throughout. Although she found the experience difficult to describe, she reported that her head felt itchy inside, had racing thoughts, felt anxious and hyped up to the point that she wanted to hit her head on the wall in order to make it stop ..."
new.bmp (454 bytes) Yapp et al Nefazodone Case report involving admission of breast-fed premature baby found "drowsy, lethargic, unable to maintain normal body temperature and feeding poorly". Authors report their data "suggest a putative association between maternal nefazodone ingestion and adverse effects" in this infant.  The measured amount of drug exposure would normally be considered safe in a full-term infant; however, adverse effects in the infant resolved when breastfeeding was stopped.

The following are the recommendations and warnings relating to withdrawal reactions for SSRI antidepressants in the Data Sheet Compendium 1998/99:

Nefazodone (Dutonin/Serzone): None


Contents page
  Pencil_and_PaperE190.gif (245 bytes) References
Table: all reports of SSRI withdrawal