Ondansetron and seizures.
Experimental studies suggest that 5-hydroxytryptamine (5-HT) receptors play a role in epileptogenesis and seizure propagation. Ondansetron, a 5-HT(3) receptor antagonist, has been reported to have proconvulsant and anticonvulsant effects in animals. We describe three patients who developed seizures after receiving ondansetron. There were two females and one male. Ages ranged from 38-56 years. None had a previous or family history of seizures. Four milligrams (mg) of ondansetron was given intravenously for severe nausea and vomiting in association with migraine, gastritis, and diabetic ketoacidosis. A generalized tonic-clonic seizure occurred in each patient--12, 15, and 22 min after injection. Brain magnetic resonance imaging (MRI) and electroencephalography (EEG) were normal in all patients. Although no antiepileptic drugs were given, none had seizure recurrence subsequently. The temporal relationship between ondansetron administration and seizures, lack of EEG or MRI abnormalities, and absence of seizure recurrence suggest that the seizures were causally related to ondansetron in our patients.
Singh
Niranjan N
NN
Department of Neurology, University of Missouri, Columbia, Missouri, USA. singhn@health.missouri.edu
Rai
Ajitesh
A
Selhorst
John B
JB
Acharya
Jayant N
JN
D000328:Adult; D004569:Electroencephalography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy; D009325:Nausea / Q000188:drug therapy; D017294:Ondansetron / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D011985:Receptors, Serotonin / Q000187:drug effects / Q000502:physiology; D012008:Recurrence; D012640:Seizures / Q000139:chemically induced* / Q000503:physiopathology; D012701:Serotonin / Q000502:physiology; D012702:Serotonin Antagonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D014839:Vomiting / Q000188:drug therapy
D011985:Receptors, Serotonin; D012702:Serotonin Antagonists; D012701:Serotonin; D017294:Ondansetron