(+)-Fenfluramine and its major metabolite, (+)-norfenfluramine, are potent substrates for norepinephrine transporters

J Pharmacol Exp Ther. 2003 Jun;305(3):1191-9. doi: 10.1124/jpet.103.049684. Epub 2003 Mar 20.

Abstract

(+/-)-Fenfluramine is an amphetamine analog that was once widely prescribed as an appetite suppressant. Although (+/-)-fenfluramine is no longer clinically available, the mechanisms underlying its anorectic properties are still of interest. Upon peripheral administration, stereoisomers of (+/-)-fenfluramine are N-deethylated to form the metabolites, (+)- and (-)-norfenfluramine. It is well accepted that isomers of (+/-)-fenfluramine and (+/-)-norfenfluramine interact with 5-hydroxytryptamine (serotonin, 5-HT) transporters to release 5-HT from neurons. However, the effects of these drugs on other monoamine transporters are not well characterized. In this study, we examined the interaction of stereoisomers of (+/-)-fenfluramine and (+/-)-norfenfluramine with transporters for 5-HT, norepinephrine (NE), and dopamine (DA). Results from in vitro assays confirmed these drugs are potent substrates for 5-HT transporters: (+)-fenfluramine, (-)-fenfluramine, (+)-norfenfluramine, and (-)-norfenfluramine released [3H]5-HT from synaptosomes with EC50 values of 52, 147, 59, and 287 nM, respectively. Importantly, (+)-fenfluramine and (+)-norfenfluramine released [3H]NE with EC50 values of 302 and 73 nM. Results from in vivo microdialysis experiments showed that intravenous injection of (+)-norfenfluramine elevates extracellular levels of 5-HT, NE, and DA in rat frontal cortex. The effects of (+)-norfenfluramine on NE and DA were antagonized by pretreatment with the NE uptake blocker nisoxetine. In summary, administration of fenfluramines can increase synaptic levels of 5-HT, NE, and DA in the cortex, and (+)-norfenfluramine likely contributes to these effects. Release of NE and DA evoked by (+)-norfenfluramine is at least partly mediated via NE transporters. Our results emphasize the potential involvement of noradrenergic mechanisms in the actions of fenfluramines.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biogenic Monoamines / analysis
  • Fenfluramine / pharmacology*
  • Male
  • Norepinephrine Plasma Membrane Transport Proteins
  • Norfenfluramine / pharmacology*
  • Rats
  • Rats, Sprague-Dawley
  • Serotonin / metabolism
  • Symporters / drug effects
  • Symporters / metabolism*
  • Tritium

Substances

  • Biogenic Monoamines
  • Norepinephrine Plasma Membrane Transport Proteins
  • Slc6a2 protein, rat
  • Symporters
  • Tritium
  • Norfenfluramine
  • Fenfluramine
  • Serotonin