Researchers at Antwerp University Hospital and University of Leuven, Belgium report 12 patients, 7 female and 5 male, age range 3-35 years, with a genetically proven diagnosis of Dravet syndrome who received fenfluramine (mean dose 0.34 (0.12-0.90) mg/kg/day) as add-on therapy. Seven (58%) patients had been seizure free for a mean of 6 (1-19) years. When fenfluramine treatment was discontinued in 7 patients, seizures recurred in 3; seizures were controlled when fenfluramine was reintroduced. Two patients developed a mild thickening of one or two cardiac valves without clinical symptoms. 
COMMENT. Fenfluramine is a substituted phenylethylamine structurally related to amphetamine. The combination “Fen-Phen” anti-obesity product was withdrawn from the market in the US in 1997 because of serious cardiac side effects. The effectiveness of fenfluramine in treatment of self-induced photosensitive epilepsy was reported in 1985  and confirmed in 1996. 
The use of stimulants in the treatment of epilepsy is not new. In 1942, Cook and Dole report the effectiveness of dl-amphetamine (Benzedrine) (Cook GH, Dole JA. Dis Nerv Syst 1942 Nov;3:366-370), and in 1955, the classic, Goodman and Gilman textbook includes reference to the control of “petit mal” and the associated EEG spike and wave discharges following d-amphetamine (Dexedrine). 
In 1972, Livingston summarized the literature on the effectiveness of d-amphetamine in the control of “petit mal” and other epilepsies. For children <6 years old, Livingston recommended initial d-amphetamine doses of 2.5 mg daily, and >6 years, 2.5 mg 2 x daily . Given the adverse publicity associated with fenfluramine, future trials of stimulants in Dravet syndrome patients might substitute d-amphetamine (l-amphetamine is found ineffective as an anticonvulsant). For the early recognition and when to suspect the diagnosis of Dravet syndrome, see a review from the Comprehensive Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago .