Skip to main content
Log in

Clinical effects of fenfluramine on children with autism: A review of the research

  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

A review of research studies published to data on the effects of fenfluramine on children with autism is presented. The current status of the fenfluramine research on children with autism is assessed. The review analyzed the methodological aspects of the research, the toxicity of fenfluramine, and the relationship between fenfluramine, neurotransmitter activity, cognitive ability, and subsequent behavioral change. The review of published data indicated that fenfluramine had positive effects on the reduction of hyperactivity and stereotypic behaviors in 33% of the subjects. The best responders were children with the highest baseline IQs. The conclusions address the need for appropriate subgrouping of autistic syndromes, which may lead to identification of responders to pharmacological treatments. The need for further study of the possible long-term adverse side effects of flenfluramine is noted. Further experimental research on the effects of fenfluramine on children with autism is endorsed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Psychiatric Association. (1980).Diagnostic and statistical manual of mental disorders (3rd ed.). Washington DC: Author.

    Google Scholar 

  • August, G. J., Raz, N., & Baird, T. D. (1985). Effects of fenfluramine on behavioral, cognitive, and affective disturbances in autistic children.Journal of Autism and Developmental Disorders, 15, 97–106.

    PubMed  Google Scholar 

  • August, G. J., Raz, N., Papanicolaou, A. C., Baird, T. D., Hirsh, S. L., & Hsu, L. L. (1984). Fenfluramine treatment in infantile autism. Neurochemical, electrophysiological, and behavioral effects.Journal of Nervous and Mental Disease, 172, 604–612.

    PubMed  Google Scholar 

  • Boullin, D. J., Coleman, M., O'Brien, R. A. (1971). Laboratory predictions of infantile autism based on 5-hydroxytryptamine efflux from blood platelets and their correlation with the Rimland E-2 score.Journal of Autism and Childhood Schizophrenia, 1, 63–71.

    PubMed  Google Scholar 

  • Campbell, M., Deutsch, S. I., Perry, R., Wolsky, B. B., & Palij, M. (1986). Short-term efficacy and safety of fenfluramine in hospitalized preschool-age autistic children: an open study.Psychopharmacology Bulletin, 22, 141–147.

    PubMed  Google Scholar 

  • Clineschmidt, B. V., Zacchei, A. G., Tataro, J. A. (1978). Fenfluramine and brain serotonin.Annals of the New York Academy of Sciences, 305, 222–241.

    PubMed  Google Scholar 

  • Cohen, D. J., Caparulo, B. K., Shaytwitz, B. A., & Bowers, M. B. (1977). Dopamine and serotonin metabolism in neuropsychiatrically disturbed children.Archives of General Psychiatry, 34, 545–550.

    PubMed  Google Scholar 

  • Coleman, M., & Gillberg, C. (1985).The biology of the autistic syndromes, New York: Prager Press.

    Google Scholar 

  • Deutsch, S. I., Campbell, M., Green, W. H., Small, A. M., Perry, R., & Wolsky, B. B. (1984). Efficacy and safety of fenfluramine in hospital preschool-age autistic children: A pilot study.Proceedings of American Academy of Child Psychiatry.

  • Donnelly, M., Rapoport, J. L., & Ismond, D. R. (1986). Fenfluramine treatment of childhood attention deficit disorder with hyperactivity: A preliminary report.Psychopharmacology Bulletin, 22, 152–154.

    PubMed  Google Scholar 

  • Geller, E., Ritvo, E. R., Freeman, B. J., & Yuwiler, A. (1982). Prelininary observations on the effect of fenfluramine on blood serotonin and symptoms in three autistic boys.New England Journal of Medicine, 307, 165–169.

    PubMed  Google Scholar 

  • Gualtieri, C. T. (1986). Fenfluramine and autism: Careful reappraisal is in order.Journal of Pediatrics, 108, 417–419.

    PubMed  Google Scholar 

  • Hanley, H. G., Stahl, S. M., & Freedman, D. X. (1977). Hyperserotonemia and amine metabolites in autistic and retarded children.Archives of General Psychiatry, 34, 521–531.

    PubMed  Google Scholar 

  • Harvey, J. A., & McMaster, S. E. (1975). Fenfluramine: Evidence for a neurotoxic action on midbrain and a long-term depletion of serotonin.Psychopharmacology Communications, 1, 217–228.

    PubMed  Google Scholar 

  • Harvey, J. A., & McMaster, S. E. (1977). Fenfluramine: cumulative neurotoxicity after chronic treatment with low dosages in the rat.Communications in Psychopharmacology, 1, 3–17.

    PubMed  Google Scholar 

  • Harvey, J. A., McMaster, S. E., & Fuller, R. A. (1977). Comparison between the neurotoxic and serotonin-depleting effects of various halogenated derivatives of amphetamine in the rat.Journal of Pharmacology and Experimental Therapeutics, 202, 581–589.

    PubMed  Google Scholar 

  • Ho, H. H., Lockitch, G., O'ves, L., & Jacobson, B. (1986). Blood serotonin concentrations and fenfluramine therapy in autistic children.Pediatric Pharmacology and Therapeutics, 108, 465–469.

    Google Scholar 

  • Klykylo, W. M., Feldis, D., O'Grady, D., Ross, D. L., & Halloran, C. (1985). Clinical effects of fenfluramine in ten autistic subjects.Journal of Autism and Developmental Disorders, 15, 417–423.

    PubMed  Google Scholar 

  • Meltzer, H. Y., & Stahl, S. M. (1976). The dopamine hypothesis of schizophrenia: A review.Schizophrenia Bulletin, 2, 19–76.

    PubMed  Google Scholar 

  • Piggott, L. R., Gdowski, C. L., Villanueva, D., Fischoff, J., & Frohman, C. F. (1986). Side effects of fenfluramine in autistic children.Journal of the American Academy of Child Psychiatry, 25, 287–289.

    PubMed  Google Scholar 

  • Powers, J. M., Mann, G. T., Jones, R., Ward, J. W., Elsea, J. R., & Smith, H. M. (1979). A reassessment of the significance of dark neurons in serotonergic cell groups.Neuropharmacology, 18, 383–389.

    PubMed  Google Scholar 

  • Raleigh, M. J., Brammer, G. L., Ritvo, E. R., Geller, E., McGuire, M. T., & Yuwiler, A. (1986). Effects of chronic fenfluramine on blood serotonin, cerebrospinal fluid metabolites, and behavior in monkeys.Psychopharmacology, 90, 503–508.

    PubMed  Google Scholar 

  • Realmuto, G. M., Jensen, J., Klykylo, W., Piggott, L., Stubbs, G., Yuwiler, A., Geller, E., Freeman, B. J., & Ritvo, E. (1986). Untoward effects of fenfluramine in autistic children.Journal of Clinical Psychopharmacology, 6, 350–355.

    PubMed  Google Scholar 

  • Ritvo, E. R., Freeman, B. J., Yuwiler, A., Geller, E., Yokata, A., Schroth, P., & Novak, P. (1984). Study of fenfluramine in outpatients with the syndrome of autism.Journal of Pediatrics, 105, 823–828.

    PubMed  Google Scholar 

  • Ritvo, E. R., Freeman, B. J., Yuwiler, A., Geller, E., Schroth, P., Yokota, A., Mason-Brothers, A., August, G. J., Klykylo, W., Leventhal, B., Lewis, K., Piggott, L., Realmuto, G., Stubbs, E. G., & Umansky, R. (1986). Fenfluramine treatment of autism: UCLA-collaborative study of 81 patients at nine medical centers.Psychopharmacology Bulletin, 22, 133–140.

    PubMed  Google Scholar 

  • Rutter, M., & Schopler, E. (1978).Autism: A reappraisal of concepts and treatment. New York: Plenum Press.

    Google Scholar 

  • Sandyk, R., & Gillman, M. A. (1986). Infantile autism: A dysfunction of the opioids?Medical Hypotheses, 19, 41–45.

    PubMed  Google Scholar 

  • Shoulson, I., & Chase, T. N. (1975). Fenfluramine in man: Hypophagia associated with diminished serotonin turnover.Clinical Pharmacology Therapy, 17, 616.

    Google Scholar 

  • Schuster, C. R., Lewis, M., & Seiden, S. S. (1986). Fenfluramine: neurotoxicity.Psychopharmacology Bulletin, 22, 148–151.

    PubMed  Google Scholar 

  • Stahl, S. M. (1977). The human platelet.Archives of General Psychiatry, 34, 509–516.

    PubMed  Google Scholar 

  • Stubbs, E., Budden, S., Jackson, R., Terdal, L., & Ritvo, E. (1986). Effects of fenfluramine on eight outpatients with the syndrome of autism.Developmental Medicine and Child Neurology, 28, 229–235.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

du Verglas, G., Banks, S.R. & Guyer, K.E. Clinical effects of fenfluramine on children with autism: A review of the research. J Autism Dev Disord 18, 297–308 (1988). https://doi.org/10.1007/BF02211954

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02211954

Keywords

Navigation