Risk of suicide attempt in asthmatic children and young adults prescribed leukotriene-modifying agents: A nested case-control study

Schumock, Glen T.; Stayner, Leslie T.; Valuck, Robert J.; Joo, Min J.; Gibbons, Robert D.; Lee, Todd A.

doi:10.1016/j.jaci.2012.04.035

Cited by 53 publications

(53 citation statements)

References 37 publications

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“…First, to date, there is no definitive evidence of an association between LTIs and suicide based on FDA’s review of adverse event data from manufacturer-conducted placebo-controlled clinical trials 4 or observational studies. 21,22 In the case of LTIs, the intent of the label change was to provide clinicians and patients with updated information necessary to make rational treatment decisions. Minimal changes in LTI use and mental health visits are likely appropriate responses.…”

Section: Discussionmentioning

confidence: 99%

Asthma Treatments and Mental Health Visits After a Food and Drug Administration Label Change for Leukotriene Inhibitors

Zhang²,

Lakoma³

et al. 2015

Clinical Therapeutics

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Purpose In 2009, the US Food and Drug Administration (FDA) mandated a label change for leukotriene inhibitors (LTIs) to include neuropsychiatric adverse events (eg, depression and suicidality) as a precaution. This study investigated how this label change affected the use of LTIs and other asthma controller medications, mental health visits, and suicide attempts. Methods We analyzed data (2005–2010) from 5 large health plans in the US Population-Based Effectiveness in Asthma and Lung Diseases (PEAL) Network. The study cohort included children and adolescents (n = 30,000), young adults (n = 20,000), and adults (n = 90,000) with asthma. We used interrupted time series to examine changes in rates of LTI dispensings, non-LTI dispensings, mental health visits, and suicide attempts (using a validated algorithm based on a combination of diagnoses of injury or poisoning and psychiatric conditions). Findings The label change was associated with abrupt reductions in LTI use among all age groups (relative reductions of 8.3%, 15.1%, and 6.0% among adolescents, young adults, and adults, respectively, compared with expected rates at 1 year after the warnings). Although we detected immediate offset increases in non-LTI asthma medication use, these increases were not sustained among adolescents and young adults. There were small increases in mental health visits among LTI users. Implications The FDA label change for LTIs communicated possible risk of neuropsychiatric events. Communication and enhanced awareness may have increased reporting of mental health symptoms among young adults and adults. It is important to assess intended and unintended consequences of FDA warnings and label changes.

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Section: Discussionmentioning

confidence: 99%

Asthma Treatments and Mental Health Visits After a Food and Drug Administration Label Change for Leukotriene Inhibitors

Zhang²,

Lakoma³

et al. 2015

Clinical Therapeutics

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“…However, the research pertaining to the use of asthma medications and suicide risk has returned very mixed findings, with a number of studies failing to find an increased risk in individuals using these medications [39][40][41]. One study indicated that risk associated with asthma medications may be higher than certain types of medications for other conditions (selective serotonin reuptake inhibitors), but that risk may depend on the type of asthma medication used [42].…”

Section: Discussionmentioning

confidence: 99%

The relationship between asthma and suicidal behaviours: a systematic literature review

2015

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Asthma is a highly prevalent chronic condition worldwide, and is particularly common in younger people compared to other chronic conditions. Asthma can result in a number of symptoms that are detrimental to the quality of life of sufferers. The aim of the present systematic literature review was to analyse the existing literature on the relationship between asthma and fatal and nonfatal suicidal behaviours.Articles were retrieved from Scopus, PubMed, ProQuest and Web of Knowledge. We searched for the terms (suicid* OR self-harm) AND (asthma* OR "bronchial hyperreactivity") published in Englishlanguage peer-reviewed journals between 1990 and December 2014. Original research papers providing empirical evidence about the potential link between asthma and suicidal behaviours were included.The initial search identified 746 articles. Specific limiting criteria reduced the number of articles to the 19 articles that were finally included in the systematic review.The review found a potential link between asthma and suicide mortality, ideation and attempts across the age groups. Limitations of the review include the restriction to English-language papers published within the chosen time period, the limited number of papers involving suicide mortality, and the fact that the majority of papers originated from the USA. @ERSpublications Systematic literature review suggests potential link between asthma and suicide mortality, ideation and attempts http://ow.ly/Jowfs

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“…A survey among 20,000 adults and children receiving this treatment showed no reports of completed suicide, and possible suicidality-related AEs were rare; furthermore, the events were similar to those seen in the control subjects [41]. Interestingly, Schumock et al [42] conducted a regression analysis showing that the relationship between montelukast and suicidality could actually be in the opposite direction (i.e. there is a reduced risk).…”

Section: Psychiatric and Nervous System Disordersmentioning

confidence: 99%

Montelukast-Induced Adverse Drug Reactions: A Review of Case Reports in the Literature

Calapai¹,

Casciaro²,

Miroddi³

et al. 2014

Pharmacology

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Background: Montelukast, a leucotriene receptor antagonist, binds the cysteinyl leucotriene type 1 receptor. Montelukast is commonly prescribed to asthma patients as add-on therapy to inhaled corticosteroids. Several clinical trials emphasized that montelukast can be considered a safe drug. However, recent evidence reconsidered the benefit/risk ratio of the use of montelukast for both paediatric and adult patients. Summary: The present review analyzed the previous published case reports regarding montelukast-induced adverse drug reactions (ADRs). They included agitation, anxiety, depression, sleep disturbance, hallucinations, suicidal thinking and suicidality, tremor, dizziness, drowsiness, neuropathies and seizures. The immune system can be involved, in particular, cases of Churg-Strauss syndrome have been published. Furthermore, it can induce hypersensitivity reactions, including anaphylaxis and eosinophilic infiltration. In addition, hepatobiliary, pancreatic and uropoietic disorders have been observed. Some of these cases are characterized by severe prognosis (i.e. neurological deficit and fatal hepatotoxicity). Key Message: The use of montelukast can be burdened by several ADRs, of which physicians should be aware in their clinical practice. A better understanding of the mechanisms causing ADRs after using montelukast could help researchers and clinicians in defining a risk-reduction strategy aimed to lessen montelukast toxicity. More accurate epidemiological studies, in order to discover risk factors favouring montelukast-associated ADRs, are demanded.

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Risk of suicide attempt in asthmatic children and young adults prescribed leukotriene-modifying agents: A nested case-control study

Cited by 53 publications

References 37 publications

Asthma Treatments and Mental Health Visits After a Food and Drug Administration Label Change for Leukotriene Inhibitors

Asthma Treatments and Mental Health Visits After a Food and Drug Administration Label Change for Leukotriene Inhibitors

The relationship between asthma and suicidal behaviours: a systematic literature review

Montelukast-Induced Adverse Drug Reactions: A Review of Case Reports in the Literature

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