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Fen-phen
is the common name for the drug containing either pondimin
(fenfluramine) or redux (dexfenfluramine), and taken in combination
with phentermine (an amphetimine-like drug). Essentially,
fen-phen acts to alter the levels of serotonin in the brain
that effectively block the impulses that tell us we’re hungry. Because
of this, fen-phen was used to help people lose weight. By
affecting the serotonin levels in the brain, fen-phen can
cause primary pulmonary hypertension, heart valve problems,
and neuropsychological damage to the brain.
Heart
Valve Defects
Fen-phen
is known to cause problems with the aortic and mitral valves.
When these valves are impaired, they can cause blood to be
regurgitated into the ventricle and left atrium. The symptoms
of heart valve disease may be subtle---existent in the presence
of shortness of breath and chest pain. Treatment can include
medication, a valvoplasty, or a repair of the damaged heart
valves and/or heart valve replacement surgery. This condition
often requires long term heart monitoring and medication.
Primary
Pulmonary Hypertension
Primary
pulmonary hypertension (PPH) is a rare disease that has no
known cause that results in the progressive narrowing of the
blood vessels of the lungs. This, in turn, leads to high blood
pressure in these blood vessels and can eventually lead to
heart failure. Secondary pulmonary hypertension (SPH) is the
result of other types of lung disease, abnormal breathing
processes or heart disease.
The
use of fenfluramine (and derivatives) and dexfenfluramine
has been found to increase the risk of developing PPH, especially
when the usage lasts for more than three months. Studies estimate
that treatment with certain appetite suppressant drugs increases
the risk of developing PPH from 1 to 28 cases (per million
persons treated in one year).
Initial
symptoms of PPH may be very minor, and diagnosis can be delayed
for several years until symptoms worsen. Typical symptoms
may include:
- Shortness
of breath
- Chest
pain
- Dizziness,
fainting, and weakness
- Excessive
fatigue
- Bluish
lips and skin
- Ankle
swelling
It
is often difficult to detect PPH in a routine medical examination.
Even when the disease has progressed, the signs and symptoms
may be confused with other conditions that affect the heart
and the lungs. PPH is diagnosed only after several possible
causes of pulmonary hypertension are excluded. Typically,
additional tests are needed to positively diagnose PPH.
The
prognosis for patients with PPH can cover a wide spectrum.
Many patients report that lifestyle changes allow them to
perform many of their day-to-day affairs. The median period
of survival is three years after diagnosis, although the survival
rate is generally longer for those patients without heart
failure and for those patients diagnosed after 40.
The
condition is treated with a number of drugs that work to cure
or halt the progression of this disease, although they may
only help to relieve certain symptoms. Some patients take
vasodilators, which help to dilate the blood vessels in the
lungs and help reduce the blood pressure in them. In addition,
anticoagulants may be used to decrease the tendency of the
blood to clot in the lungs. Although medication helps certain
patients, patients with severe PPH may require and be candidates
for a lung or heart-lung transplant.
If
you have taken either fen-phen or redux for more than three
months and have any shortness of breath, chest pain or unusual
fatigue, the Federal Drug Administration and the American
Board of Cardiology recommend that individuals undergo an
echocardiogram to detect for the possibility of medical problems.
Neuropsychological
Damage
Neuropsychological
damage is difficult to determine because physicians are unable
to sample and analyze human brain cells. If there is serious
concern over neuropsychological damage for symptoms such as
cognitive disturbance, memory loss, mood swings, behavioral
changes, psychotic breakdowns, or depression, patients should
consult a neuro-specialist.
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