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December 24, 1997

Brain Serotonin Neurotoxicity and Fenfluramine and Dexfenfluramine

Author Affiliations

Princeton, NJ

JAMA. 1997;278(24):2141. doi:10.1001/jama.1997.03550240031021

To the Editor.  —In the article by Dr McCann and colleagues,1 the differences between fenfluramine and more standard psychostimulants, eg, dextroamphetamine, were not discussed in detail.Some of the mechanisms that the authors suggest might explain the serious adverse events from fenfluramine might also apply to standard psychostimulants, but is there evidence that standard psychostimulants (such as those prescribed for attention-deficit/hyperactivity disorder) can cause the same serious adverse events? If standard stimulants do not produce the same serious adverse events, the search for possible mechanisms could be narrowed to pharmacologic effects of fenfluramine that standard stimulants do not share.