THE MOOD MOLECULE

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For example, says Solomon Snyder, the Johns Hopkins neuroscientist who discovered several of the brain's serotonin receptors, while antidepressants are reasonably effective against chronic pain, it is easy to imagine a serotonin drug that could target chronic pain more directly than today's antidepressants do. It is also possible that pharmacologists could build a serotonin sleeping pill, a serotonin jet-lag pill, or even an appetite suppressant that doesn't have Redux's dangerous side effects. Just as the first antidepressants were refined into safer, more effective and relatively side effect-free drugs like Prozac, so might Redux or fenfluramine yield to similar but safer alternatives.

As neurophysiologists continue to unravel the secrets of serotonin, they will also be looking at other neurotransmitters that influence mood and emotion. Already psychiatrists are buzzing with news of reboxetine, which totally ignores serotonin and goes after norepinephrine, the neurotransmitter Prozac left behind. Approved in England just this past summer, it works quickly, has relatively mild side effects (constipation, dry mouth, low blood pressure) and might eventually be the therapy of choice for people with especially severe depression. However, the new drug has so far gone through clinical trials on only a few hundred people; fenfluramine was used in Europe for more than 20 years before any heart problems showed up.

Advanced mood-enhancing medicines such as reboxetine and the next generation of serotonin boosters may eventually revolutionize psychiatry, self-improvement and health care in general. But in the wake of the Redux-fenfluramine debacle, it could be many years before the FDA is ready to approve the new drugs. Or before the rest of us are ready to swallow them.

--Reported by Elaine Lafferty/Los Angeles, J. Madeleine Nash/Chicago, Alice Park/New York and Dick Thompson/Washington