Urgent warning over common drug prescribed to Australians that could increase the risk of suicide
Warning labels must be attached to an asthma drug commonly prescribed to children in Australia after it was linked to suicidal thoughts, hallucinations and other psychiatric conditions.
US research found that montelukast, sold under the brand name Singulair, attaches to cells in the brain that control mood, decision-making, attention, impulse control and sleep.
Over the past decade, the Therapeutic Goods Association has received approximately 200 reports of behavioral side effects associated with montelukast in Australia.
This includes 57 cases of depression, 60 cases of suicidal thoughts and 17 suicide attempts or incidents of intentional self-injury.
There were seven cases where patients taking the drug committed suicide.
Among those affected was Melbourne boy Harrison Sellick who attempted suicide at just five years old.
According to his mother Vanessa, Harrison was prescribed montelukast when he was two years old and over the next three years developed behavioral problems and suicidal thoughts.
Ms Sellick told Daily Mail Australia that her son, now 17 and off the medication, tried to take his own life at just five years old: ‘He started having really long meltdowns that would last for an hour and a half. There was general comments about death and self-loathing.’
Australia-born Harrison Sellick tried to kill himself at just five years old a couple of years after going on Singulair. His mother Vanessa said he began having ‘really long meltdowns’ starting at age two as well as ‘general comments about death and self-loathing’
Montelukast, sold under the brand name Singulair, is a commonly prescribed drug in Australia
Although the numbers affected are concerning, Nial Wheate, Professor of Pharmaceutical Chemistry at Macquarie University, said they were put in perspective by the number of Australians taking the drug.
‘Over the same time period (of side effect reports), more than 200,000 scripts for montelukast have been filled under the Pharmaceutical Benefits Scheme.
‘Overall we don’t know conclusively that montelukast causes depression and suicide, just that it seems to increase the risk for some people.’
Dr Wheate urged anyone with concerns to consult their doctor.
‘If you have asthma and take montelukast or your child does, you should not just stop taking the drug, because this could put you at risk of an attack that could be life threatening.
‘If you’re concerned, speak to your doctor who can discuss the risks and benefits of the medication for you, and, if appropriate, prescribe a different medication.’
Given as a daily pill, montelukast works by blocking chemicals released by the body that cause the airways to swell and constrict during an asthma attack.
Since the 90s, it has been typically prescribed to asthma patients whose condition can’t be controlled by the usual treatment.
Virginia-native Nicholas England fatally shot himself in the head at age 22 just weeks after going on the generic version of Singulair
Controversy surrounding the drug and its potential for prompting suicidal ideation has circulated for years.
Campaigners have repeatedly called for more to be done to make patients and parents aware of the potential risk.
These calls have now been amplified after the results of a US investigation into the drug and its impact on the brain.
Presented at the American College of Toxicology’s last year, representatives from the US Food and Drug Administration National Center for Toxicological Research confirmed there is a link between the drug and psychiatric conditions.
They said laboratory tests had shown ‘significant binding’ of montelukast to multiple receptor cells found in the brain and are highest in cells known to be involved with psychiatric effects.
However, the US authorities stopped short of removing the drug from sale, adding that studies are still ongoing, and results have not yet been finalised.
Singulair was a blockbuster performer for Merck after its launch in 1998, offering relief for asthmatics in a pill rather than carrying around an inhaler.
A 2017 analysis from Kiplinger, a business forecasting company, suggested that the drug had made Merck nearly $50billion in sales since it came on the market.
In early advertising, the company said the side effects were so benign they were ‘similar to a sugar pill,’ while the label said the effect on the brain was minimal.
However by 2019, health authorities had received thousands of reports detailing psychiatric episodes in patients prescribed the drug, including dozens of cases involving suicide.
Among them was Robert England’s 22-year old son Nick, who killed himself in 2017 less than two weeks after starting montelukast.
England recalls that his son had trouble sleeping before he died, and said he was completely healthy and had no mental health problems prior to taking the drug.
‘He was on that medication for just days, literally just days,’ England said. ‘It completely changed the trajectory of our lives.’
Organon, a Merck spinoff that now markets Singulair, said in a statement following news of the American research it is confident in the drug’s safety profile.
‘The product label for Singulair contains appropriate information regarding Singulair benefits, risks and reported adverse reactions,’ the company said.
