Hidden amphetamines: from smoking cessation to diabetes.

(1) Amphetamine-like drugs are not only authorised for use as appetite suppressants. (2) Bupropion, otherwise known as amfebutamone, is licensed as an aid to smoking withdrawal. It has amphetamine-like adverse effects, such as seizures; in addition it causes hypersensitivity reactions. (3) Benfluorex is sold in France as an adjunctive treatment for hypertriglyceridemia and diabetes with overweight. The lack of data on its adverse effects is hardly reassuring. A case of severe cardiac valve disease has been published. (4) The ephedrine derivatives norephedrine (phenylpropanolamine) and pseudoephedrine are used in ENT as decongestants because of their vasoconstrictive properties. They expose patients to serious cardiovascular risks. Ephedrine and plants belonging to the genus Ephedra (used in freshly prepared appetite suppressant mixtures) have negative risk-benefit ratios. (5) Methylphenidate is used as a psychostimulant in patients with narcolepsy and children with attention-deficit disorder. It can lead to serious mental and physical dependence.