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Too much serotonin damages blood vessels, particularly in the lungs, and may also harm heart valves. Such damage may have led to primary pulmonary hypertension and heart valve lesions in a small number of the millions of Americans who took the anti-obesity drug combination from 1992 until 1997, when one of the drugs, fen-fluramine, was voluntarily withdrawn by its manufacturer. The other drug, phentermine, is still used to treat obesity. Because the two drugs were never in one pill, their use in combination didn't require US Food and Drug Administration approval. The two drugs should never have been prescribed together, say researchers Timothy J. Maher, the Sawyer Professor of Pharmaceutical Sciences and director of the Division of Pharmaceutical Sciences at MCP and a lecturer in MIT's Department of Brain and Cognitive Sciences; MIT visiting scientist Dr. Ismail H. Ulus, professor of pharmacology at the University of Uludag in Bursa, Turkey; and Dr. Richard J. Wurtman, the C.H. Green Distinguished Professor at MIT and director of the Clinical Research Center. Because of omissions on drug labels, similarly dangerous side effects may result from pairing antidepressants such as Prozac with phentermine, as well as with over-the-counter cold remedies that contain ingredients such as pseudoephedrine (found in Sudafed), phenylpropanolamine (found in Accutrim) and ephedrine, the researchers found.

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