Nefazodone overdose
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overdosage topics
Human experience
Pre-marketing clinical studies
In premarketing clinical studies, there were seven reports of Nefazodone overdose alone or in combination with other pharmacological agents. The amount of Nefazodone ingested ranged from 1000 mg to 11,200 mg. Commonly reported symptoms from overdose of Nefazodone included nausea, vomiting, and somnolence. One nonstudy participant took 2000 to 3000 mg of Nefazodone with methocarbamol and alcohol; this person reportedly experienced a convulsion (type not documented). None of these patients died. Return to top
Post-marketing experience
In postmarketing experience, overdose with Nefazodone alone and in combination with alcohol and/or other substances has been reported. Commonly reported symptoms were similar to those reported from overdose in premarketing experience. While there have been rare reports of fatalities in patients taking overdoses of Nefazodone, predominantly in combination with alcohol and/or other substances, no causal relationship to Nefazodone has been established. Return to top
Overdose management
Treatment should consist of those general measures employed in the management of overdosage with any antidepressant. Return to top
Monitoring patient
Ensure an adequate airway, oxygenation, and ventilation. Monitor cardiac rhythm and vital signs. General supportive and symptomatic measures are also recommended. Induction of emesis is not recommended. Gastric lavage with a large-bore orogastric tube with appropriate airway protection, if needed, may be indicated if performed soon after ingestion, or in symptomatic patients. Return to top
Treatment
Activated charcoal should be administered. Due to the wide distribution of Nefazodone in body tissues, forced diuresis, dialysis, hemoperfusion, and exchange transfusion are unlikely to be of benefit. No specific antidotes for Nefazodone are known. Return to top
Other considerations
In managing overdosage, consider the possibility of multiple drug involvement. The physician should consider contacting a poison control center for additional information on the treatment of any overdose. Telephone numbers for certified poison control centers are listed in the Physicians’ Desk Reference (PDR). Return to top
Adapted from the FDA Package Insert.