d-fenfluramine, but not d-norfenfluramine, uses calcium to increase extracellular serotonin.

Microdialysis in the hippocampus of freely moving rats was used to assess extracellular serotonin (5-HT) in response to local infusion of d-fenfluramine and its metabolite d-norfenfluramine with and without local calcium depletion. Verapamil (1 mM) in calcium-free Ringer infused via the microdialysis probe increased extracellular 5-HT and prevented the full increase in extracellular 5-HT normally caused by 1 mM d-fenfluramine. The results suggest d-fenfluramine might act in part as a calcium channel agonist favoring a calcium influx that in turn would trigger the exocytotic process in 5-HT terminals. d-norfenfluramine, on the other hand, was capable of releasing 5-HT, in vivo, in spite of depleted Ca levels.