Nefazodone and Imipramine in Major Depression: A Placebo-Controlled Trial

Abstract

Nefazodone is a phenylpiperazine antidepressant with 5-HT2 antagonism and 5-HT reuptake inhibition. Two hundred and eighty-three out-patients with a diagnosis of DSM-III-R major depression of at least one-month duration (65% ill for over 6 months), and a mean score of 24 on the 17-item Hamilton Rating Scale for Depression (HRSD), were randomised to treatment with nefazodone, imipramine, or placebo. The double-blind treatment period was 8 weeks in duration. Nefazodone's antidepressant efficacy was comparable with imipramine's, with both drug treatments significantly better than placebo in a variety of outcome measures. For example, after 8 weeks of therapy, 78% of nefazodone and 83% of imipramine but only 55% of placebo patients (P < 0.01) were globally much or very much improved. Nefazodone was better tolerated than imipramine, with fewer drop-outs and a lower incidence of side-effects during treatment.

Nefazodone in Psychotic Unipolar and Bipolar Depression: A Retrospective Chart Analysis and Open Prospective Study on Its Efficacy and Safety versus Combined Treatment with Amitriptyline and Haloperidol

“…Several studies comparing NEF with imipramine found equal efficacy [9][10][11][12]; the same holds true for another study versus AMI [13].…”

Effects of Selective Serotonin Reuptake Inhibitors on Objective and Subjective Sleep Quality

“…However, antidepressants such as nefazodone or trazodone, which are potent drugs to reduce clinical symptoms in depression [32,60,62,[75][76][77], but increase REM sleep (nefazodone) or have only little effect on REM sleep variables (trazodone), cast doubts on this theory. Whether or not nefazodone as well as trazodone, which are both associated with a more pronounced improvement in objective and subjective sleep variables compared to SSRIs, are able to provide clinical antidepressant benefits without objective sleep disturbances, has to be explored in further studies.…”

Advances in psychopharmacology: mood disorder and dementia

“…Like trazodone it has modest 5-HT reuptake blocking properties (Table 1) and is metabolised to the 5-HT receptor agonist, m-CPP. Controlled trials in patients with major depression have shown that in doses of 400 mg and greater nefazodone are more effective than placebo and generally equal in therapeutic activity to comparator drugs 6 ; these studies, however, have focused on outpatients with moderate depressive disorders. Nefazodone is usually given in two divided doses starting at 200 mg daily with titration to 400 mg daily after about a week.…”

“…Nefazodone is generally well tolerated with the most common side effects being headache, loss of energy, dizziness, dry mouth, nausea and somnolence 6 . It appears less cardiotoxic than tricyclic antidepressants and is probably safer in overdose.…”