Abstract
Childhood-onset refractory epilepsies (e.g., Dravet syndrome [DS]) contribute to developmental delays, impaired quality of life, and increased mortality. We lack safe and effective antiseizure medications (ASMs) for these patients. Fenfluramine, an appetite suppressant, increases serotonin activity by releasing and inhibiting the reuptake of 5-HT and stimulating all 5-HT receptors. Combining fenfluramine with phentermine (Fen-Phen) led to sustained weight loss in obese patients, but pulmonary hypertension and heart valve lesions led to withdrawal. A small open-label trial with fenfluramine and a subsequent randomized trial found significant reductions in seizures in children with DS.1,2
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