The Hidden Dangers of Singulair: Can it ruin your life?

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Singulair, the brand name for montelukast, is a medication that’s used to treat asthma and allergic rhinitis. Specifically, it’s meant to prevent symptoms of asthma and allergies before they occur rather than as a response to symptoms after they’re already happening.

While this medication can be effective in treating these conditions, there are potential concerns about it, particularly for those who use it often.

In recent years, the FDA has even published warnings about potential mental health side effects when using Singulair and is still evaluating its safety. The FDA currently recommends restricting its use for allergic rhinitis and only using it temporarily over a short amount of time.

Understanding Singulair

Singulair is known as a leukotriene receptor antagonist. That means it blocks the formation of fatty signaling molecules called leukotrienes that the body produces as a response to inflammation.

Blocking the production of these molecules reduces nasal inflammation, which can cause a stuffy nose when you have allergies or trouble breathing when you have asthma.

Typically, Singulair would be prescribed on a long-term basis to treat chronic asthma symptoms. Rather than something like an inhaler that you’d use after an asthma attack starts, Singulair is more of a preventative option. You would take a specific dose at the same time each day to prevent asthma symptoms from occurring.

In some cases, Singulair may also be prescribed to prevent exercise-induced asthma symptoms. So, you’d take a dose two hours before participating in intense physical activities.

In the short term, it may also be prescribed to treat mucus buildup and nasal inflammation caused by seasonal allergies. Since this is only short-term use, it’s why the FDA still says that using Singulair for allergic rhinitis is lower risk.

Potential Risks and Adverse Effects of Singulair

One of the biggest risks of long-term Singulair use is potential behavioral, mood, and mental health changes that can be dangerous.

Studies have shown that Singulair may cause suicidal thoughts, depression, and hallucinations. These effects can cause someone to take risky actions that endanger themselves or others.

Other potential side effects associated with Singulair include:

Coughing
Diarrhea and stomach pain
Ear and sinus infections
Sore throat
Upper respiratory infections
Rash and hives
Bruising
Muscle weakness
Agitation
Insomnia
Tremors
Sleepwalking
Vivid and unpleasant dreams

If you or someone you care about is taking Singulair and experiences any of these side effects, seeking medical attention is important, especially if the symptoms are severe.

Personal Experiences or How Singulair Can Ruin Your Life

There are many stories and medical cases where patients taking Singulair experienced negative side effects. Let’s review a few to better understand how it could affect someone’s health and well-being.

FDA Analysis

The U.S. Food and Drug Administration (FDA) reviewed 82 cases of completed suicide associated with montelukast use. Many of these cases were preceded by new-onset neuropsychiatric symptoms such as:

Agitation
Aggression
Anxiousness
Depression
Disorientation
Hallucinations
Insomnia
Irritability
Restlessness
Tremors

Observational Study on Neuropsychiatric Diagnoses

A cohort study in May of 2022 analyzed electronic health records of 72,490 patients with asthma and 82,456 patients with allergic rhinitis. The study found that patients initiating montelukast had higher odds of developing neuropsychiatric outcomes, including anxiety disorders and insomnia, within a year of starting the medication.

Medical Analysis

In March 2020, the U.S. Food and Drug Administration (FDA) issued a boxed warning—their most prominent caution—regarding serious mental health side effects associated with Singulair.

This action was taken after reviewing reports of neuropsychiatric events, including agitation, depression, sleep disturbances, and, in rare cases, suicidal thoughts and actions.

The exact mechanism by which montelukast may lead to these neuropsychiatric effects remains unclear. However, some healthcare professionals have offered insights into potential pathways. Dr. Florence van Hunsel, a pharmacist and epidemiologist, noted that “montelukast given orally reaches the brain in rats,” suggesting that the drug can cross the blood-brain barrier and potentially affect central nervous system functions.

Given these concerns, the FDA advises that montelukast should be reserved for patients who have not responded adequately to other treatments or cannot tolerate alternative therapies.

Healthcare providers are encouraged to discuss these potential risks with patients and caregivers, ensuring they are informed about the signs of neuropsychiatric side effects and the importance of promptly reporting any unusual changes in mood or behavior.

Guidance for Patients and Caregivers

If you or someone you care about is prescribed Singulair, it’s important to watch for mental health and physical side effects that can occur on this medication. You should seek immediate medical attention if any severe side effects start happening, such as hallucinations, increased aggression, or suicidal thoughts.

When someone stops taking Singulair, it’s also important for medical professionals to be aware of potential withdrawal symptoms that could occur. Research from the FDA has shown that withdrawal from Singular can cause:

Flu-like symptoms
Depression
Anxiety
Psychosis
Insomnia
Suicidal thoughts and actions

Seeking medical support at a drug treatment center during withdrawal can be a good idea to stay safe and make the process as comfortable as possible.

Alternative Treatment Options

Those who want to avoid the potential adverse effects of Singulair or who have experienced negative reactions to it before can still opt for many alternative treatment options for asthma and allergies.

The most common alternative for asthma is inhaled corticosteroids (ICS), which is what’s commonly in an inhaler. Long-acting beta-agonists may also be prescribed alongside ICS to help relax airway muscles and make breathing easier.

For allergies, antihistamines are the most common medication used. You can often find options over the counter, such as Zyrtec. That said, it never hurts to discuss options with your doctor before taking anything.

Other lifestyle changes like regular exercise, eating a well-balanced diet, managing stress, and getting enough sleep will also help you improve health, well-being, and symptoms associated with conditions like asthma and allergies.

Conclusion

Taking Singulair over an extended period can cause adverse side effects, especially on mental health. It’s always important to discuss potential risks with your doctor whenever you’re prescribed something new.

If you or someone you care about decides to stop taking Singulair after being on it for a long time, it’s important to be aware that withdrawal symptoms can occur. Our treatment center provides medical detox services that can help, giving you around-the-clock medical care to manage symptoms and make the process as comfortable as possible.

References

Research, Center for Drug Evaluation and. “FDA Requires Boxed Warning about Serious Mental Health Side Effects for Asthma and Allergy Drug Montelukast (Singulair); Advises Restricting Use for Allergic Rhinitis.” FDA, 13 Mar. 2020, https://www.fda.gov/drugs/drug-safety-and-availability/fda-requires-boxed-warning-about-serious-mental-health-side-effects-asthma-and-allergy-drug
Choi, Jaehwa, and Chaudhary Ehtsham Azmat. “Leukotriene Receptor Antagonists.” PubMed, StatPearls Publishing, 4 June 2023, https://www.ncbi.nlm.nih.gov/books/NBK554445/
Aldea Perona, Ana, et al. “Psychiatric Disorders and Montelukast in Children: A Disproportionality Analysis of the VigiBase®.” Drug Safety, vol. 39, no. 1, 30 Nov. 2015, pp. 69–78, https://pubmed.ncbi.nlm.nih.gov/26620206/
“In Brief: Neuropsychiatric Events with Montelukast | the Medical Letter Inc.” Medicalletter.org, https://secure.medicalletter.org/TML-article-1597a
Paljarvi, Tapio, et al. “Analysis of Neuropsychiatric Diagnoses after Montelukast Initiation.” JAMA Network Open, vol. 5, no. 5, 24 May 2022, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2792596
“Montelukast (Singulair): Reminder of the Risk of Neuropsychiatric Reactions.” GOV.UK, https://www.gov.uk/drug-safety-update/montelukast-singulair-reminder-of-the-risk-of-neuropsychiatric-reactions
Badri, Talel, and Veronica Takov. “Montelukast.” Nih.gov, StatPearls Publishing, 22 Mar. 2023, https://www.ncbi.nlm.nih.gov/books/NBK459301/
Commissioner, Office of the. “FDA Requires Stronger Warning about Risk of Neuropsychiatric Events Associated with Asthma and Allergy Medication Singulair and Generic Montelukast.” FDA, 24 Mar. 2020, https://www.fda.gov/news-events/press-announcements/fda-requires-stronger-warning-about-risk-neuropsychiatric-events-associated-asthma-and-allergy
“Administrators of the Montelukast (Singulair) Side Effects Support and Discussion Group.” FDA, 16 May 2022, https://www.fda.gov/media/158486/download