Release of neurotransmitters downstream with theoretical antidepressant and anxiolytic effect
➔ powerful disinhibitor of glutamate release
Potential improvement of negative symptoms of schizophrenia
Potential Improvement of OCD
Theoretical mitigation of SRI-induced bipolar destabilization (El-Mallakh and Aydin, 2024)
↓ seizure threshold
5-HT3 antagonist (2/2)
An effect of metoclopramide, mirtazapine, vortioxetine, clozapine, olanzapine, and loxapine Christmas colors reference the ondansetron mascot, with green suggestive of antipsychotic spectrum – “little green men”
Drugs with this mechanism (9)
Alosetron — 5-HT3 antagonist restricted to severe refractory IBS-D because of ischemic-colitis risk.
Dolasetron — 5-HT3 antiemetic largely displaced because IV use carries marked QT risk.
Granisetron — 5-HT3 antagonist antiemetic available as a multi-day transdermal patch.
Memantine — NMDA antagonist for moderate-to-severe Alzheimer dementia; well tolerated.
Metoclopramide — D2-antagonist prokinetic/antiemetic; tardive dyskinesia limits long use.
Memantine XR — Extended-release NMDA antagonist for moderate-to-severe Alzheimer disease.
Ondansetron — 5-HT3 antagonist antiemetic; QT prolongation at high dose.
Palonosetron — Long-acting second-generation setron that covers delayed chemo nausea.
Vortioxetine — Multimodal serotonergic antidepressant; cognitive benefits and less sexual dysfunction, but dose-related nausea.