Fenfluramine symptom effects

A 44-year-old woman who had previously taken appetite suppressants, developed valvular disease consistent with the effects of fen-phen. She had an identical twin who, despite having been treated with the same medication, remained symptom-free and without abnormal echocardiography. Both the patient and her sister took fen-phen for 2 years. However, the patient took a daily dose of fenfluramine of 60-120 mg (and often as much as 240 mg) and phentermine 90 mg (at times 180 mg), whereas her twin sister adhered to the daily amount prescribed (fenfluramine 60 mg and phentermine 24 mg). 

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