References 1 Simonneau G, Gatzoulis MA, Adatia I, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol 2013; 62: D34–D41. 2 Gurtner HP. Aminorex and pulmonary hypertension. A review. Cor Vasa 1985; 27: 160–171. 3 Kay JM, Smith P, Heath D. Aminorex and the pulmonary circulation. Thorax 1971; 26: 262–270. 4 Simonneau G, Fartoukh M, Sitbon O, et al. Primary pulmonary...

Pulmonary arterial hypertension (PAH) is a rare disorder characterised by progressive obliteration of the pulmonary microvasculature resulting in elevated pulmonary vascular resistance and premature death. According to the current classification PAH can be associated with exposure to certain drugs or toxins, particularly to appetite suppressant intake drugs, such as aminorex, fenfluramine deriv...

BACKGROUND Coadministration of phentermine and fenfluramine (phen/fen) effectively treats obesity and possibly addictive disorders. The association of fenfluramine and certain other anorexic agents with serious side effects, such as cardiac valvulopathy and primary pulmonary hypertension (PPH), limits the clinical utility of these drugs. Development of new medications that produce neurochemical...

Correspondence to Dr James J DiNicolantonio; [email protected] Obesity is developing into a pandemic in countries like the USA, the UK and India. The WHO projects that by 2015, about 700 million adults will be clinically obese. Obesity is a major public health problem, beyond the disability directly related to excessive adiposity, and it also increases the risk of several chronic diseases suc...

In 1967 Kay et al postulated that some cases of unexplained pulmonary hypertension might be due to the ingestion of drugs or other toxic substances.' This concept, later termed dietary pulmonary hypertension,23 was advanced following the observation that the oral administration to rats of the pyrrolizidine alkaloid monocrotaline produced severe pulmonary hypertension.' There are no reports of p...

Increased synthesis of serotonin and/or activity of serotonin in pulmonary arteries has been implicated in the pathobiology of pulmonary arterial hypertension (PAH). The incidence of PAH associated with diet pills such as aminorex, fenfluramine, and chlorphentermine initially led to the "serotonin hypothesis of pulmonary hypertension." Over the last couple of decades there has been an accumulat...

A large body of evidence supports the hypothesis that mesolimbic dopamine (DA) mediates, in animal models, the reinforcing effects of central nervous system stimulants such as cocaine and amphetamine. The role DA plays in mediating amphetamine-type subjective effects of stimulants in humans remains to be established. Both amphetamine and cocaine increase norepinephrine (NE) via stimulation of r...

In recent years, the pace at which new psychoactive substances (NPS) have emerged has accelerated considerably. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) reported that between 2005 and 2011, 164 NPS were formally notified through the early warning system. While 49 NPS were notified in 2011 alone (1), a further increase of 73 NPS has been observed for 2012 (2). Many of...