Nefazodone shortage in the United States: analysis of drug switching and utilization

Introduction Medication shortages and manufacturer discontinuations of antidepressants place patients in vulnerable scenarios if medications become inaccessible, leaving prescribers to alter therapy without guarantee of a sustained response to the new treatment. Methods We conducted a descriptive retrospective analysis to explore changes in drug utilization and switching patterns following an FDA-declared nefazodone shortage in the United States. Using the Komodo Healthcare Map®, we analyzed prescribing patterns across the pre-shortage, shortage, and post-shortage periods. Results A total of 7891 individuals were selected for inclusion, with 2185 eligible for the switching outcomes. A majority (96.4%) switched to an alternative medication, with an average time to switch of 106.8 days (SD: 81.7). Few patients resumed nefazodone use post-shortage (7.3%). Discussion Although most patients transitioned to alternative antidepressants during the shortage, the need for treatment changes and the low rate of returning to the original medication may reflect challenges to patient-centered care. There is a need for clearer prescriber guidance to better support clinical decision-making during medication shortages.