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Ondansetron, a 5-HT3 antagonist, improves cerebellar tremor
G P Rice1, J Lesaux, P Vandervoort
1Department of Clinical Neurological Sciences, London Health Sciences Centre, Ontario, Canada.
Abstract:
It has been previously shown that ondansetron, a 5-HT3 antagonist, can ameliorate vertigo in patients with acute brainstem disorders. A coincidental benefit was the improvement of cerebellar tremor in some patients with both vertigo and tremor. To further evaluate this effect, a placebo controlled, double blind, crossover study was conducted of a single dose of intravenous ondansetron in 20 patients with cerebellar tremor caused by multiple sclerosis, cerebellar degeneration, or drug toxicity. The principal outcome measures were the change in blind assessment of a writing task (spiral copying) and the timed completion of a nine hole peg test. Thirteen of 19 patients were deemed to have improved spiral copying after treatment with ondansetron when compared with baseline performance. One patient had a better response to the placebo compared with baseline performance (P = 0.00024). Patients completed the nine hole peg test in less time after ondansetron than after placebo (P = 0.08). Twelve patients thought that their tremor was functionally improved with the ondansetron treatment. None thought that the placebo gave improvement (P = 0.00098). The efficacy of orally administered ondansetron in tremor control is currently under study.
Insights
Ondansetron, a 5-HT3 antagonist, demonstrated potential in reducing cerebellar tremor in patients with multiple sclerosis and other conditions. This study suggests ondansetron may be an effective treatment for tremor symptoms.
Area of Science:
- Neuroscience
- Pharmacology
Background:
- Ondansetron, a selective 5-HT3 receptor antagonist, is known for its antiemetic properties.
- Previous observations suggested ondansetron may alleviate vertigo and improve cerebellar tremor in specific patient groups.
Purpose of the Study:
- To investigate the efficacy of a single intravenous dose of ondansetron in managing cerebellar tremor.
- To evaluate ondansetron's effect on tremor-related functional tasks.
Main Methods:
- A placebo-controlled, double-blind, crossover study involving 20 patients with cerebellar tremor.
- Assessment included blind evaluation of a spiral copying task and timed completion of the nine-hole peg test.
Main Results:
- Thirteen out of 19 patients showed improved spiral copying after ondansetron administration compared to baseline.
- Patients completed the nine-hole peg test significantly faster with ondansetron versus placebo (P=0.08).
- Twelve patients reported functional tremor improvement with ondansetron, while none reported placebo improvement (P=0.00098).
Conclusions:
- Intravenous ondansetron showed a positive effect on cerebellar tremor, improving both objective measures and patient-reported functional outcomes.
- Further research is warranted to explore the efficacy of orally administered ondansetron for tremor control.