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Do Asthma Drugs Give You Nightmares?
Asthma can be a frightening and taxing thing to live with. This inflammatory lung disease affects some 25 million people in the United States alone, and it can be life threatening if not treated properly. Asthma constricts the airways and causes severe coughing, chest tightness, and difficulty breathing. Many treatments have been developed over the years, but one that gained a lot of publicity was Montelukast. This oral medication was recommended by many doctors, but now reports are coming out that it could have serious psychological side effects, including nightmares. Let’s explore the facts regarding this controversial medication and provide some recommendations so you can make the best decisions regarding asthma treatment.
What is Montelukast?
Montelukast is the generic name for Singulair, an oral asthma medication. Montelukast belongs to a class of drugs called selective leukotriene receptor antagonists, which block the action of a type of fatty molecule called leukotrienes. These molecules are released during an asthma attack and are actually what causes the bronchoconstriction that makes it difficult for people with asthma to breathe during an attack.
But what triggers an asthma attack in the first place? Attacks can occur as a result of exposure to allergens, airborne chemicals, smoke, or due to cardiovascular exertion (running or exercising too hard, etc). When one of these things triggers an attack, leukotrienes are released and trigger the inflammatory response which causes the airways to close. Breathing becomes rapid and shallow, and panic can set in. Taking montelukast medications like Singulair can prevent attacks by preventing the leukotrienes from triggering the inflammatory response. Dosage for montelukast will depend on the patient’s age.
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Sounds like it’s a great drug. So what’s the problem?
Well, many patients are reporting some pretty alarming neuropsychiatric side effects from montelukast. Some of these side effects include nightmares, aggressive behavior, feelings of agitation, stress and anxiety, difficulty sleeping, hallucinations, and even depression. Some montelukast users also experienced physical tremors along with these symptoms. Most disturbing are reports of increased suicidal thoughts and behavior in people taking this drug.
There have been more than 18,000 cases of such adverse side effects from montelukast, according to Vigibase, a database maintained by the World Health Organization (WHO) that tracks side effects of drugs. According to the Vigibase data, both children and adults who used Singulair were seven times more likely to develop depression than those not taking the medication. Nightmares and suicidal thinking were 22 and 20 times higher, respectively.
Merck, the company that produces Singulair, has stated that they issued warnings about these side effects when the drug was released in 2008 and that the drug was still deemed safe enough for release.
It must be pointed out that the authors of a study on Singulair (which used the data from Vigibase as well as a separate database in the Netherlands) pointed out with the exception of nightmares, it is difficult to prove a definitive cause-effect relationship. Still, these numbers are cause for concern for many people.
What should you do?
The FDA has issued warnings about these side effects and is still looking into the matter, but warns people already taking montelukast to not stop taking it unless directed by their doctor. Asthma is a serious condition, and the advice of a medical professional should always be taken seriously. Monteukast can still be beneficial for people with severe cases of asthma. But if you have not started taking it yet, it is worth having a discussion with your doctor before starting in order to see if it is the right option for you.