Innes J A, Watson M L, Ford M J, Munro J F, Stoddart M E, Campbell D B
Br Med J. 1977 Nov 19;2(6098):1322-5. doi: 10.1136/bmj.2.6098.1322.
Fifty women with refractory obesity received fenfluramine for 20 weeks. Every two weeks details of weight change, drug dose, degree of anorexia, and any side effects were recorded and plasma was obtained for fenfluramine and norfenfluramine measurements. Of the 41 patients available for final analysis 26 achieved a maximum plateau dose of 160 mg/day. Plasma fenfluramine concentrations did not correlate with the degree of anorexia or with the incidence of side effects other than the severity of dream disturbance. There was a highly significant relation between weight loss and plasma fenfluramine and norfenfluramine concentrations and also between weight loss and the presence of sustained anorexia. Women who achieved mean plateau concentrations over 200 ng/ml lost a mean 8.8 kg while those with concentrations less than 100 ng/ml lost a mean of only 2.1 kg. When fenfluramine is prescribed in refractory obesity the dose should be increased stepwise until either satisfactory weight loss is achieved or troublesome side effects appear.
五十名顽固性肥胖女性服用芬氟拉明20周。每两周记录体重变化、药物剂量、厌食程度及任何副作用的详情，并采集血浆用于检测芬氟拉明和去甲芬氟拉明。在可供最终分析的41名患者中，26名达到了160毫克/天的最大稳定剂量。血浆芬氟拉明浓度与厌食程度或除梦境紊乱严重程度之外的副作用发生率均无相关性。体重减轻与血浆芬氟拉明和去甲芬氟拉明浓度之间以及体重减轻与持续性厌食的存在之间存在高度显著的关系。平均稳定浓度超过200纳克/毫升的女性平均减重8.8千克，而浓度低于100纳克/毫升的女性平均仅减重2.1千克。在顽固性肥胖患者中开具芬氟拉明处方时，应逐步增加剂量，直至达到满意的体重减轻或出现令人困扰的副作用。
