Reactions 452 - 22 May 1993

SAmfepramone

Psychosis: case reportA 46-year-old woman developed frank psychosis after

stopping amfepramone 75 mg/day, an amphetamine-likeanorexiant, which had been prescribed to aid weight loss. Twoyears previously, she had used amfepramone for 90 days withno ill effects. Ten days after starting amfepramone, shebecame moody, withdrawn and uncommunicative.Amitriptyline 50mg was introduced, but the patient stoppedboth drugs after taking only 1 amitriptyline tablet. Over thenext 5 days, her condition deteriorated and she becamepsychotic. Compulsory admission was required. She wasgiven haloperidol, and within 5 days, her symptoms hadsettled.

Author comment: The 2-year delay to re-exposure suggestsa permanent change in this patient’s neuroresponsiveness.This supports the notion of ‘kindling’ whereby ‘repeatedelectrical stimulation of the brain, with a current originallyinsufficient to produce overt behaviour effects, results inpermanent responses to subsequent subthreshold stimuli’Little JD, et al. Psychosis following readministration of diethyl propion: a possiblerole for kindling? International Clinical Psychopharmacology 8: 67-70, No. 1, 1993- New Zealand 800194954

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Reactions 22 May 1993 No. 4520114-9954/10/0452-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved