Neuropsychiatric Disease and Treatment (Sep 2023)
Reintroducing Fenfluramine as a Treatment for Seizures: Current Knowledge, Recommendations and Gaps in Understanding
Abstract
Gianluca Dini,1 Giuseppe Di Cara,1 Pietro Ferrara,2 Pasquale Striano,3 Alberto Verrotti1 1Department of Pediatrics, University of Perugia, Perugia, Italy; 2Department of Pediatrics, Campus Bio-Medico University, Rome, Italy; 3Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto “G. Gaslini”, Genoa, ItalyCorrespondence: Gianluca Dini, Department of Pediatrics, University of Perugia, Piazzale Giorgio Menghini 1, Perugia, 06129, Italy, Tel +39 3337797213, Email [email protected]: Despite the introduction of new anti-seizure medications in recent years, approximately one-third of the epileptic population continues to experience seizures. Recently, the anti-obesity medication fenfluramine (FFA) has been successfully repurposed, and it has received approval from various regulatory agencies for the treatment of seizures associated with Dravet syndrome and Lennox-Gastaut syndrome. The potential antiseizure effects of FFA were initially observed in patients with photosensitive epilepsy in the 1980s but it was not rigorously explored as a treatment option until 30 years later. This narrative review aims to provide an overview of the historical progression of FFA’s use, starting from initial clinical observations to preclinical studies and, ultimately, successful clinical trials in the field of epilepsy.Keywords: fenfluramine, seizures, Dravet syndrome, drug-resistant epilepsy, serotonin
