In 2007, there were some concerns that suicide may be a complication of montelukast (Singulair) therapy.Montelukast has been prescribed for more than a decade for the treatment of asthma and seasonal allergic rhinitis.
A retrospective study sponsored by the American Lung Association has found no evidence of depression or suicide linked to montelukast.
Among the 569 patients randomly assigned to take montelukast, there was no evidence of any deterioration of emotional well being in either adults or children. On the contrary, the researchers found a positive effect on emotional outlook.
The study findings will be published in an upcoming issue of the Journal of Allergy and Clinical Immunology.
Singulair was Merck's biggest product last year and the most-prescribed respiratory drug in the U.S., with worldwide sales of $ 4.27 billion. In 2007, included reports of tremors, depression, suicide and anxiousness in the drug's prescribing information.
Leukotriene Receptor Antagonists (LTRA)
Antagonists of the CysLT1 receptor (LTRA) are efficacious as controller therapy in asthma and montelukast is FDA-approved for treatment of seasonal allergic rhinitis.
Mast cells quickly generate different mediators from the metabolism of arachidonic acid: leukotrienes and prostglandins (LTC4, LTB4, PGD2). These substances are produced within minutes of IgE-receptor crosslinking on the surface of mast cells.
Eicosanoids are signaling molecules made by oxygenation of 20-carbon essential fatty acids. There are 4 families of eicosanoids (PP-LT): prostaglandins (PG), prostacyclins (PGI), leukotrienes (LT) and thromboxanes (TX).
Mast cell mediators including (PP-LT): prostaglandins (PG), prostacyclins (PGI), leukotrienes (LT) and thromboxanes (TX). See more Allergy and Immunology mind maps here.
References:
American Lung Association Study Finds No Evidence of Depression or Suicide Linked to Asthma and Allergy Drug Montelukast. MarketWatch, 09/2008.
Singulair (montelukast) and Suicide Risk
Urinary leukotriene E(4)/exhaled nitric oxide ratio predicts montelukast response in childhood asthma http://goo.gl/i5cG
Image source: Montelukast, from Wikipedia, the free encyclopedia, public domain.
Image source: Montelukast, from Wikipedia, the free encyclopedia, public domain.
