Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-07T20:20:09.314Z Has data issue: false hasContentIssue false

Delayed Onset of Neuropsychiatric Effects Associated with Montelukast

Published online by Cambridge University Press:  13 June 2014

Fintan Byrne*
Affiliation:
University Hospital Galwayand National University of Ireland Galway, Ireland
Bolarinwa Oluwole
Affiliation:
London Health Sciences Centre, London, Ontario, Canada
Vanessa Whyte
Affiliation:
Castle St Surgery, Roscommon Town, Co. Roscommon, Ireland
Sabina Fahy
Affiliation:
St. Brigids Hospital, Ballinasloe, Co. Galway, Ireland
Delia McGuinness
Affiliation:
CAMHS, Ballard House, Galway, Ireland
*
*Correspondence Email: [email protected]

Abstract

Montelukast (a leukotriene receptor antagonist) is a commonly prescribed medication used in the management of asthma in both children and adults. It has been associated with a possible increased risk of various neuropsychiatric events in post-marketing analyses of clinical trial data and surveillance studies. When establishing a link between a medication and side effects, it is usual to establish and enquire whether there is a chronological relationship between the commencement of the medication and the onset of the symptoms.

We report a case where a number of unusual neuropsychiatric events were reported several years after commencement of montelukast in a young boy who may have a genetic predisposition and a likely psychological trigger. There was complete resolution of these symptoms upon the withdrawal of montelukast.

Type
Case Report
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Global Strategy for Asthma Management and Prevention 2009 (Update)Google Scholar
2. Full Drug Prescribing information, MERCK & CO., INC. available at www.singulair.com/montelukast_sodium/hcp/asthma/prescribing-information.jsp accessed 17/09/10Google Scholar
3. Canadian Drug Bank available at http://www.drugbank.ca/drugs/DB00471 accessed 17/09/10Google Scholar
4.Cohen, S, Taitz, J, and Jaffé, A. Paediatric prescribing of asthma drugs in the UK: are we sticking to the guideline? Arch Dis Child 2007; 92:847849.CrossRefGoogle ScholarPubMed
5.Wallerstedt, SMet al.Montelukast and psychiatric disorders in children. Pharmacoepidemiol Drug Saf. 2009 09;18(9):858–64CrossRefGoogle ScholarPubMed
6.Leukotriene inhibitors: montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR). Healthcare Professional Sheet, Washington (DC): US Food and Drug Administration; 2009.Google Scholar
7.Philip, G, Hustad, C, Noonan, G, Malice, M-P, Ezekowitz, A, Reiss, TF, et al.Reports of suicidality in clinical trials of montelukast. J Allergy Clin Immunol 2009;124:691–6CrossRefGoogle ScholarPubMed
8.Philip, G, Hustad, CM, Malice, M-P, Noonan, G, Ezekowitz, A, Reiss, TF, et al.Analysis of behaviour-related adverse experiences in clinical trials of montelukast. J Allergy Clin Immunol 2009;124:699706CrossRefGoogle Scholar
9.Kelsay, K. Assessing risk: Data from montelukast clinical trials. J Allergy Clin Immunol 2009;124:697–8CrossRefGoogle ScholarPubMed
10.Goodwin, R, Eaton, W. Asthma, suicidal ideation, and suicide attempts: findings from the Baltimore epidemiological catchment area follow-up. Am J Public Health 2005; 95:717–22.CrossRefGoogle ScholarPubMed
11.McQuaid, E, Kopel, S, Nassau, J. Behavioral adjustment in children with asthma. J Dev Behav Pediatr 2001; 22:430–9.CrossRefGoogle ScholarPubMed
12.Skillman, K, Stumpf, J. Montelukast-induced anxiety in two pediatric patients. Pharmacotherapy 2011; 31:524.CrossRefGoogle Scholar
13.Naranjo, CA, Busto, U, Sellers, EM, Sandor, P, Ruiz, I, et al.A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239245.CrossRefGoogle ScholarPubMed