Serotonergic agents in the treatment of hypothalamic obesity syndrome: a case report

The hypothalamic obesity syndrome is characterized by hyperphagia and excessive weight gain in the presence of demonstrable hypothalamic injury. There have been no previous reports describing the use of serotonergic agents in this condition. We report on a patient with severe hyperphagia and obesity secondary to a hypothalamic lesion, who was treated with consecutive courses of fluoxetine and fenfluramine. Neither treatment resulted in a reduction in food intake or weight. Treatment of hypothalamic obesity with serotonergic agents appears to be of little value, probably because they exert their effect via intact serotonergic-sensitive hypothalamic nuclei.