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Ondansetron and seizures

Niranjan N Singh1, Ajitesh Rai, John B Selhorst

  • 1Department of Neurology, University of Missouri, Columbia, Missouri, USA. singhn@health.missouri.edu

Epilepsia
|June 4, 2009
PubMed

Insights

Ondansetron, a 5-HT(3) receptor antagonist, may trigger seizures in susceptible individuals. This case series highlights three patients experiencing seizures shortly after ondansetron administration, with no recurrence observed.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Clinical Neurology

Background:

  • 5-hydroxytryptamine (5-HT) receptors are implicated in epileptogenesis.
  • Ondansetron, a 5-HT(3) receptor antagonist, exhibits variable effects on seizures in animal models.
  • The potential for ondansetron to induce seizures in humans requires further investigation.

Purpose of the Study:

  • To report cases of seizures occurring after ondansetron administration.
  • To investigate the potential causal link between ondansetron and seizure induction.

Main Methods:

  • Case series describing three patients who experienced seizures post-ondansetron.
  • Clinical assessment including electroencephalography (EEG) and magnetic resonance imaging (MRI).
  • Evaluation of seizure recurrence after ondansetron cessation.

Main Results:

  • Three patients (2 female, 1 male; ages 38-56) developed generalized tonic-clonic seizures 12-22 minutes after intravenous ondansetron (4 mg).
  • None had prior seizure history or family history of epilepsy.
  • EEG and MRI were normal; no seizures recurred after discontinuation of ondansetron.

Conclusions:

  • The temporal association and lack of recurrence suggest ondansetron may have triggered seizures in these patients.
  • Ondansetron should be used cautiously in patients with potential seizure risk factors.
  • Further research is warranted to elucidate the mechanism of ondansetron-induced seizures.

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