Re: Antileukotrienes and suicidal thoughts

[Guest guest]

I find this really interesting...why would a drug 'make' someone want to kill themself? Does it make people depressed, or feel hopeless or actually take away ones will to live? I take montelukast and am not exactly feeling on top of the world...could this drug be making me feel this way?

Becky

From: asfy <asfyso@...>samters Sent: Sun, 19 June, 2011 16:42:02Subject: Antileukotrienes and suicidal thoughts

Drug Saf. 2011 Jul 1;34(7):533-44. doi: 10.2165/11587260-000000000-00000.

Association between Leukotriene-Modifying Agents and Suicide: What is the Evidence?

Schumock GT, Lee TA, Joo MJ, Valuck RJ, Stayner LT, Gibbons RD.

Source

Center for Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA.

Abstract

The US FDA has issued safety alerts and required manufacturers of leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and zileuton, to include suicide and neuropsychiatric events as a precaution in the drug label. This paper reviews the existing evidence on the potential association between the LTMAs and suicidal behaviour. We conducted a literature search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from 1995 to 2010 (inclusive) to identify pertinent studies and reports. We also examined data obtained from the FDA adverse event reporting system.

To date, there are no well conducted, comparative, observational studies of this association, and the safety alerts are based primarily on case reports.

While the FDA safety alerts apply to all three LTMAs, montelukast (known by its trade name Singulair®) is by far the most widely used of these drugs and most of the reports to date regarding suicide pertain to montelukast.

From 1998 to 2009 there were 838 suicide-related adverse events associated with leukotrienes reported to the FDA, of which all but five involved montelukast.

Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA warnings.

LTMAs are approved for use in asthma and allergic rhinitis, and are effective drugs. Both of these diseases are also associated with suicide, making confirmation of the association more difficult.

Given the lack of good evidence, we recommend that a large observational cohort or case-control study be conducted to quantify the association between LTMAs and suicide. Until then, when prescribing LTMAs, clinicians should consider the potential for suicide and monitor patients who may be at elevated risk carefully for suicidal ideation or psychiatric symptoms associated with suicidal behaviour.

[Guest guest]

I have found that steroids, even half a vial of budesonide in the nasal rinse, can significantly negatively affect my mood. I found this out when I stopped using it; even though I was up against the same difficult challenges, I had far less despair. On Jun 19, 2011, at 12:52 PM, Bannister wrote:

I find this really interesting...why would a drug 'make' someone want to kill themself? Does it make people depressed, or feel hopeless or actually take away ones will to live? I take montelukast and am not exactly feeling on top of the world...could this drug be making me feel this way?

Becky

From: asfy <asfyso@...>samters Sent: Sun, 19 June, 2011 16:42:02Subject: Antileukotrienes and suicidal thoughts

Drug Saf. 2011 Jul 1;34(7):533-44. doi: 10.2165/11587260-000000000-00000.

Association between Leukotriene-Modifying Agents and Suicide: What is the Evidence?

Schumock GT, Lee TA, Joo MJ, Valuck RJ, Stayner LT, Gibbons RD.

SourceCenter for Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA.

AbstractThe US FDA has issued safety alerts and required manufacturers of leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and zileuton, to include suicide and neuropsychiatric events as a precaution in the drug label. This paper reviews the existing evidence on the potential association between the LTMAs and suicidal behaviour. We conducted a literature search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from 1995 to 2010 (inclusive) to identify pertinent studies and reports. We also examined data obtained from the FDA adverse event reporting system. To date, there are no well conducted, comparative, observational studies of this association, and the safety alerts are based primarily on case reports. While the FDA safety alerts apply to all three LTMAs, montelukast (known by its trade name Singulair®) is by far the most widely used of these drugs and most of the reports to date regarding suicide pertain to montelukast. From 1998 to 2009 there were 838 suicide-related adverse events associated with leukotrienes reported to the FDA, of which all but five involved montelukast. Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA warnings. LTMAs are approved for use in asthma and allergic rhinitis, and are effective drugs. Both of these diseases are also associated with suicide, making confirmation of the association more difficult. Given the lack of good evidence, we recommend that a large observational cohort or case-control study be conducted to quantify the association between LTMAs and suicide. Until then, when prescribing LTMAs, clinicians should consider the potential for suicide and monitor patients who may be at elevated risk carefully for suicidal ideation or psychiatric symptoms associated with suicidal behaviour.

[Guest guest]

A good number of drugs affect brain chemistry, and obviously those that create

depressive thoughts affect the wrong neurotransmitters or brain areas. This

being said, they can be of value to the brain in some circumstances, like when

the brain is inflamed because of a local ischemia or infarct. It may just be

that it is not good to chronically depress leukotrienes in a brain where they

are not initially high.

---------

J Pharm Pharmacol. 2011 Apr;63(4):550-7. doi: 10.1111/j.2042-7158.2010.01238.x.

Epub 2011 Mar 1.

Montelukast, a cysteinyl leukotriene receptor-1 antagonist, attenuates chronic

brain injury after focal cerebral ischaemia in mice and rats.

Zhao R, Shi WZ, Zhang YM, Fang SH, Wei EQ.

Source

Department of Pharmacology, School of Medicine, Zhejiang University Department

of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University,

Hangzhou Department of Physiology and Department of Neurobiology, Xuzhou Medical

College, Xuzhou, Jiangsu, China.

Abstract

OBJECTIVES:

Previously we demonstrated the neuroprotective effect of montelukast, a

cysteinyl leukotriene receptor-1 (CysLT(1) ) antagonist, on acute brain injury

after focal cerebral ischaemia in mice. In this study, we have determined its

effect on chronic brain injury after focal cerebral ischaemia in mice and rats.

METHODS:

After transient focal cerebral ischaemia was induced by middle cerebral artery

occlusion, montelukast was intraperitoneally injected in mice or orally

administered to rats for five days. Behavioural dysfunction, brain infarct

volume, brain atrophy and neuron loss were determined to evaluate brain lesions.

KEY FINDINGS:

Montelukast (0.1 & #8195;mg/kg) attenuated behavioural dysfunction, brain infarct

volume, brain atrophy and neuron loss in mice, which was similar to pranlukast,

another CysLT(1) receptor antagonist. Oral montelukast (0.5 & #8195;mg/kg) was

effective in rats and was more effective than edaravone, a free radical

scavenger.

CONCLUSION:

Montelukast protected mice and rats against chronic brain injury after focal

cerebral ischaemia, supporting the therapeutic potential of CysLT(1) receptor

antagonists.

>

> I find this really interesting...why would a drug 'make' someone want to kill

> themself? Does it make people depressed, or feel hopeless or actually take

away

> ones will to live? I take montelukast and am not exactly feeling on top of the

> world...could this drug be making me feel this way?

> Becky

>

>

>

>

> ________________________________

> From: asfy <asfyso@...>

> samters

> Sent: Sun, 19 June, 2011 16:42:02

> Subject: Antileukotrienes and suicidal thoughts

>

>  

>

>

> Drug Saf. 2011 Jul 1;34(7):533-44. doi: 10.2165/11587260-000000000-00000.

> Association between Leukotriene-Modifying Agents and Suicide: What is the

> Evidence?

> Schumock GT, Lee TA, Joo MJ, Valuck RJ, Stayner LT, Gibbons RD.

> Source

> Center for Pharmacoeconomic Research, University of Illinois at Chicago,

> Chicago, IL, USA.

> Abstract

> The US FDA has issued safety alerts and required manufacturers of

> leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and

> zileuton, to include suicide and neuropsychiatric events as a precaution in

the

> drug label. This paper reviews the existing evidence on the potential

> association between the LTMAs and suicidal behaviour. We conducted a

literature

> search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from 1995

> to 2010 (inclusive) to identify pertinent studies and reports. We also

examined

> data obtained from the FDA adverse event reporting system. 

> To date, there are no well conducted, comparative, observational studies of

this

> association, and the safety alerts are based primarily on case reports. 

> While the FDA safety alerts apply to all three LTMAs, montelukast (known by

its

> trade name Singulair®) is by far the most widely used of these drugs and most

of

> the reports to date regarding suicide pertain to montelukast. 

> From 1998 to 2009 there were 838 suicide-related adverse events associated

with

> leukotrienes reported to the FDA, of which all but five involved

montelukast. 

> Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA

warnings. 

> LTMAs are approved for use in asthma and allergic rhinitis, and are effective

> drugs. Both of these diseases are also associated with suicide, making

> confirmation of the association more difficult.

>  Given the lack of good evidence, we recommend that a large observational

cohort

> or case-control study be conducted to quantify the association between LTMAs

and

> suicide. Until then, when prescribing LTMAs, clinicians should consider the

> potential for suicide and monitor patients who may be at elevated risk

carefully

> for suicidal ideation or psychiatric symptoms associated with suicidal

> behaviour.

>

[Guest guest]

Apparently there are a LOT of drugs that have the possibility of causing

suicidal thoughts in some patients. The next time ANY drug is advertised on a TV

ad, listen closely to the precautions. Suicidal thoughts is right up there with

being very common.

That said, this would obviously be one of the side affects that should cause a

patient to want to switch to another medicine, as would ANY side affect that is

worse than the condition that is being treated.

> >

> > I find this really interesting...why would a drug 'make' someone want to

kill

> > themself? Does it make people depressed, or feel hopeless or actually take

away

> > ones will to live? I take montelukast and am not exactly feeling on top of

the

> > world...could this drug be making me feel this way?

> > Becky

> >

> >

> >

> >

> > ________________________________

> > From: asfy <asfyso@>

> > samters

> > Sent: Sun, 19 June, 2011 16:42:02

> > Subject: Antileukotrienes and suicidal thoughts

> >

> >  

> >

> >

> > Drug Saf. 2011 Jul 1;34(7):533-44. doi: 10.2165/11587260-000000000-00000.

> > Association between Leukotriene-Modifying Agents and Suicide: What is the

> > Evidence?

> > Schumock GT, Lee TA, Joo MJ, Valuck RJ, Stayner LT, Gibbons RD.

> > Source

> > Center for Pharmacoeconomic Research, University of Illinois at Chicago,

> > Chicago, IL, USA.

> > Abstract

> > The US FDA has issued safety alerts and required manufacturers of

> > leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and

> > zileuton, to include suicide and neuropsychiatric events as a precaution in

the

> > drug label. This paper reviews the existing evidence on the potential

> > association between the LTMAs and suicidal behaviour. We conducted a

literature

> > search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from

1995

> > to 2010 (inclusive) to identify pertinent studies and reports. We also

examined

> > data obtained from the FDA adverse event reporting system. 

> > To date, there are no well conducted, comparative, observational studies of

this

> > association, and the safety alerts are based primarily on case reports. 

> > While the FDA safety alerts apply to all three LTMAs, montelukast (known by

its

> > trade name Singulair®) is by far the most widely used of these drugs and

most of

> > the reports to date regarding suicide pertain to montelukast. 

> > From 1998 to 2009 there were 838 suicide-related adverse events associated

with

> > leukotrienes reported to the FDA, of which all but five involved

montelukast. 

> > Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA

warnings. 

> > LTMAs are approved for use in asthma and allergic rhinitis, and are

effective

> > drugs. Both of these diseases are also associated with suicide, making

> > confirmation of the association more difficult.

> >  Given the lack of good evidence, we recommend that a large observational

cohort

> > or case-control study be conducted to quantify the association between LTMAs

and

> > suicide. Until then, when prescribing LTMAs, clinicians should consider the

> > potential for suicide and monitor patients who may be at elevated risk

carefully

> > for suicidal ideation or psychiatric symptoms associated with suicidal

> > behaviour.

> >

>

[Guest guest]

Omg!!!!!! This is nuts. I think depression has been another factor in this disease as it is. And to know singulair may cause depreasion and suicidal thoughts as a side effect too. Damn! I have both on occassion. Depression is kind of "always there" but suicidal thoughts have cone and go over the years. Bianca On Jun 21, 2011, at 8:36 AM, "rpg4444" <rg@...> wrote:

Apparently there are a LOT of drugs that have the possibility of causing suicidal thoughts in some patients. The next time ANY drug is advertised on a TV ad, listen closely to the precautions. Suicidal thoughts is right up there with being very common.

That said, this would obviously be one of the side affects that should cause a patient to want to switch to another medicine, as would ANY side affect that is worse than the condition that is being treated.

> >

> > I find this really interesting...why would a drug 'make' someone want to kill

> > themself? Does it make people depressed, or feel hopeless or actually take away

> > ones will to live? I take montelukast and am not exactly feeling on top of the

> > world...could this drug be making me feel this way?

> > Becky

> >

> >

> >

> >

> > ________________________________

> > From: asfy <asfyso@>

> > samters

> > Sent: Sun, 19 June, 2011 16:42:02

> > Subject: Antileukotrienes and suicidal thoughts

> >

> > Â

> >

> >

> > Drug Saf. 2011 Jul 1;34(7):533-44. doi: 10.2165/11587260-000000000-00000.

> > Association between Leukotriene-Modifying Agents and Suicide: What is the

> > Evidence?

> > Schumock GT, Lee TA, Joo MJ, Valuck RJ, Stayner LT, Gibbons RD.

> > Source

> > Center for Pharmacoeconomic Research, University of Illinois at Chicago,

> > Chicago, IL, USA.

> > Abstract

> > The US FDA has issued safety alerts and required manufacturers of

> > leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and

> > zileuton, to include suicide and neuropsychiatric events as a precaution in the

> > drug label. This paper reviews the existing evidence on the potential

> > association between the LTMAs and suicidal behaviour. We conducted a literature

> > search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from 1995

> > to 2010 (inclusive) to identify pertinent studies and reports. We also examined

> > data obtained from the FDA adverse event reporting system.Â

> > To date, there are no well conducted, comparative, observational studies of this

> > association, and the safety alerts are based primarily on case reports.Â

> > While the FDA safety alerts apply to all three LTMAs, montelukast (known by its

> > trade name Singulair®) is by far the most widely used of these drugs and most of

> > the reports to date regarding suicide pertain to montelukast.Â

> > From 1998 to 2009 there were 838 suicide-related adverse events associated with

> > leukotrienes reported to the FDA, of which all but five involved montelukast.Â

> > Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA warnings.Â

> > LTMAs are approved for use in asthma and allergic rhinitis, and are effective

> > drugs. Both of these diseases are also associated with suicide, making

> > confirmation of the association more difficult.

> > Â Given the lack of good evidence, we recommend that a large observational cohort

> > or case-control study be conducted to quantify the association between LTMAs and

> > suicide. Until then, when prescribing LTMAs, clinicians should consider the

> > potential for suicide and monitor patients who may be at elevated risk carefully

> > for suicidal ideation or psychiatric symptoms associated with suicidal

> > behaviour.

> >

>

[Guest guest]

I was taking Singulair and although not suicidal, I was not happy and not myself. My relationships suffered etc. But my doctor changed me to Accolate which is in the same family of drugs - also a zafirlukast - and I am 'fine' with this one. I do agree, however, that this illness does make us miserable whatever we try to do to relieve it. Bit like the British weather, and its not knowing how you are going to feel the next day that is unsettling and depressing!

Apparently there are a LOT of drugs that have the possibility of causing suicidal thoughts in some patients. The next time ANY drug is advertised on a TV ad, listen closely to the precautions. Suicidal thoughts is right up there with being very common. That said, this would obviously be one of the side affects that should cause a patient to want to switch to another medicine, as would ANY side affect that is worse than the condition that is being treated. > >> > I find this really interesting...why would a drug 'make' someone want to kill > > themself? Does it make people depressed, or feel hopeless or actually take away > > ones will to live? I take montelukast and am not exactly feeling

on top of the > > world...could this drug be making me feel this way?> > Becky> > > > > > > > > > ________________________________> > From: asfy <asfyso@>> > samters > > Sent: Sun, 19 June, 2011 16:42:02> > Subject: Antileukotrienes and suicidal thoughts> > > >  > > > > > > Drug Saf. 2011 Jul 1;34(7):533-44. doi: 10.2165/11587260-000000000-00000.> > Association between Leukotriene-Modifying Agents and Suicide: What is the > >

Evidence?> > Schumock GT, Lee TA, Joo MJ, Valuck RJ, Stayner LT, Gibbons RD.> > Source> > Center for Pharmacoeconomic Research, University of Illinois at Chicago, > > Chicago, IL, USA.> > Abstract> > The US FDA has issued safety alerts and required manufacturers of > > leukotriene-modifying agents (LTMAs), including montelukast, zafirlukast and > > zileuton, to include suicide and neuropsychiatric events as a precaution in the > > drug label. This paper reviews the existing evidence on the potential > > association between the LTMAs and suicidal behaviour. We conducted a literature > > search of MEDLINE, EMBASE and International Pharmaceutical Abstracts from 1995 > > to 2010 (inclusive) to identify pertinent studies and reports. We also examined > > data obtained from the FDA adverse event

reporting system. > > To date, there are no well conducted, comparative, observational studies of this > > association, and the safety alerts are based primarily on case reports. > > While the FDA safety alerts apply to all three LTMAs, montelukast (known by its > > trade name Singulair®) is by far the most widely used of these drugs and most of > > the reports to date regarding suicide pertain to montelukast. > > From 1998 to 2009 there were 838 suicide-related adverse events associated with > > leukotrienes reported to the FDA, of which all but five involved montelukast. > > Nearly all cases were reported in 2008 and 2009 (96.1%) after the FDA warnings. > > LTMAs are approved for use in asthma and allergic rhinitis, and are effective > > drugs. Both of these diseases are also associated with suicide, making >

> confirmation of the association more difficult.> > Â Given the lack of good evidence, we recommend that a large observational cohort > > or case-control study be conducted to quantify the association between LTMAs and > > suicide. Until then, when prescribing LTMAs, clinicians should consider the > > potential for suicide and monitor patients who may be at elevated risk carefully > > for suicidal ideation or psychiatric symptoms associated with suicidal > > behaviour.> >>