Migraine-type headaches in children receiving chemotherapy and ondansetron

Six children developed severe daily migraine-type headaches during cancer treatment. In addition to chemotherapy drugs, all received daily doses of ondansetron, a 5-hydroxytryptamine type 3 receptor antagonist. 5-Hydroxytryptamine is considered to play a central role in migraine pathogenesis, and ondansetron may have caused headaches by producing 5-hydroxytryptamine dysfunction in the brain. All six children had either a personal or a family history of migraine, and this may be a risk factor for developing ondansetron-associated migraine-type headaches. Ondansetron-induced headaches respond to withholding the drug and to standard antimigraine medications, but further study of a larger group of patients is required to confirm this impression.