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[Appetite depressants and pulmonary hypertension]
1Medizinische Kliniken A und B, Departement Innere Medizin, Universitätsspital Zürich.
Therapeutische Umschau. Revue Therapeutique
|October 28, 1998
Summary
Appetite suppressant drugs like fenfluramine and dexfenfluramine were linked to severe pulmonary hypertension. A case study highlights a fatal outcome in a pregnant woman, leading to the withdrawal of these medications.
Area of Science:
- Cardiology
- Pharmacology
- Pulmonology
Background:
- Appetite suppressant drugs, including fenfluramine and dexfenfluramine, were widely prescribed in the 1990s.
- Pre-existing evidence from the 1980s indicated a potential link between these medications and pulmonary hypertension.
Observation:
- A case report details a 30-year-old woman who developed severe pulmonary hypertension and right heart failure.
- These conditions emerged during late pregnancy following seven months of dexfenfluramine treatment.
Findings:
- The patient succumbed to septicemia with multiorgan failure four days post-cesarean section.
- Dexfenfluramine, like fenfluramine, is associated with pulmonary hypertension, potentially due to serotonin-mediated vasoconstriction.
- Histological findings included plexogenic pulmonary arteriopathy and valvular heart disease.
Implications:
- This case underscores the serious cardiovascular risks associated with fenfluramine and dexfenfluramine.
- The observed link between these drugs and pulmonary hypertension contributed to their eventual withdrawal from the market.
- Awareness of drug-induced cardiovascular toxicity is crucial in clinical practice.