Extrapyramidal reactions to ondansetron: cross-reactivity between ondansetron and prochlorperazine?

摘要: ) re-ceptor antagonist perioperatively used as an an-tiemetic, has excellent safety record (1,2). Incontrast to other antiemetic drugs (droperidol,promethazine, and metoclopramide), extrapyramidalside effects were not detected in the initial clinicaltrials (3–6). Ondansetron does affect dopamine,histamine, adrenergic, or cholinergic receptor activityand is therefore “free of neurologic adverse effects(7).” However, 11 years since its approval by theFood Drug Administration, ondansetron beenassociated with several cases extrapyramidal sideeffects (8–13). We encountered two patients who de-veloped symptoms close temporalproximity their administration. Al-though these resolved no long termsequelae, presentation was dramatic resem-bled seizure activity. The first case noted espe-cially interesting because it suggests that a patientwho experienced earlier drug-induced extrapyra-midal side may experiencesimilar ondansetron.