A young male is treated with Nefadar (nefazodone) because of depression. The physician has noted a

Fråga: A young male is treated with Nefadar (nefazodone) because of depression. The physician has noted a low value of haemoglobin, 104 g/l (reference value > 130 g/l) and an electrolyte disorder with sodium 105 mmol/l (reference value 133-146 mmol/l). Because of these findings a further investigation has started. Could this be a side effect of Nefadar treatment?

Sammanfattning: No documentation was found concerning treatment with nefazodone and anaemia and/or sodium depletion as a side-effect. In this case other possible causes should be excluded for the symptoms. However, since this is a new drug, the documentation of side-effects is limited. A discontinuation of treatment could be considered if no other causes are found.

Svar: Nefazodone (Nefadar) is a new antidepressant classified as a serotonin norepinephrine reuptake inhibitor. Its use in treatment of depression is so far well tolerated because of less side effects compared to tricyclic antidepressants (1). According to FASS (Swedish physician desk reference) treatment with tricyclic antidepressants has been reported to cause an inappropriate secretion of antidiuretic hormone (SIADH), which could include hyponatremia.

A literature search including Drugline, Medline and common pharmacological handbooks did not provide any data concerning anaemia or a sodium depletion during treatment with nefazodone. No case reports were found in the register of SADRAC (Swedish Adverse Drug Reactions Advisory Committee). Personal communication with the manufacturer gave no further information concerning this question.

We recommend this case be reported to SADRAC. 1 Robinson DS, Roberts DL, Smith JM, Stringfellow JC, Kaplita SB, Seminara JA, Marcus RN: The safety profile of nefazodone. J Clin Psychiatry 1996; 57(suppl 2): 31-38