Asthma Drug Montelukast: Brain Receptor Links to Mental Health Issues

A commonly prescribed asthma drug, montelukast, sold as Singulair or in generic forms, has been found to attach to multiple brain receptors crucial for mental health. This discovery comes from a recent scientific presentation by US researchers. The drug, originally marketed by Merck & Co, has seen thousands of reports linking it to serious mental health issues, including suicidal thoughts and actions, especially in children. Despite initial claims of minimal brain distribution, the FDA added a "black box" warning in 2020 to highlight these risks. In 2019, numerous reports of neuropsychiatric episodes and suicides among patients taking montelukast surfaced online and in the FDA's tracking system. Although these reports don't prove a direct link, they prompted the FDA to investigate further. The agency found that montelukast behaves similarly to other drugs known to affect mental health, like the antipsychotic risperidone. Researchers Julia Marschallinger and Ludwig Aigner from Austria discovered significant quantities of montelukast in the brain, attaching to receptors that govern mood, impulse control, and sleep. However, it's unclear who is at particular risk or if the drug directly causes these effects. Nick England, a 22-year-old, took his own life just days after starting montelukast in 2017. His father, Robert, recalls Nick having no prior mental health issues. Lawsuits against Merck allege the company knew about potential brain impacts and downplayed psychiatric risks. The FDA has not updated the drug label based on the latest presentation. Organon, a Merck spinoff, maintains confidence in the drug's safety profile.