ReviewDrug safety2011
Association between leukotriene-modifying agents and suicide: what is the evidence?
Review in Drug safety, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Association between leukotriene receptor antagonists and neuropsychiatric disorders: a systematic review and meta-analysis.Frontiers in pharmacology · 2026Pooled it
- Neuropsychiatric events associated with montelukast in patients with asthma: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Anti-asthma drug montelukast induces autistic behaviors via disrupting neuronal retinoic acid signaling.Signal transduction and targeted therapy · 2026Article
- A real-world data analysis of montelukast in FDA Adverse Event Reporting System (FAERS) database.BMC pharmacology & toxicology · 2025Article
- Montelukast deprescribing in outpatient specialty clinics: A single center cross-sectional study.Exploratory research in clinical and social pharmacy · 2024Article
- Increased Risk of Tourette Syndrome with Leukotriene Modifier Use in Children with Allergic Diseases and Asthma: A Nationwide Population-Based Study.Children (Basel, Switzerland) · 2022Article
- Article
- Analysis of Neuropsychiatric Diagnoses After Montelukast Initiation.JAMA network open · 2022Article
- Identifying Acute Neuropsychiatric Events in Children and Adolescents.Hospital pediatrics · 2022Article
- Montelukast induces beneficial behavioral outcomes and reduces inflammation in male and female rats.Frontiers in immunology · 2022Article
- The role of leukotriene modifying agent treatment in neuropsychiatric events of elderly asthma patients: a nested case control study.Asthma research and practice · 2021Article
- Asthma in Cystic Fibrosis: Definitions and Implications of This Overlap Syndrome.Current allergy and asthma reports · 2021Review
- Neuropsychiatric Adverse Events of Montelukast: An Analysis of Real-World Datasets and drug-gene Interaction Network.Frontiers in pharmacology · 2021Article
- Signals of adverse drug reactions communicated by pharmacovigilance stakeholders: protocol for a scoping review of the global literature.Systematic reviews · 2020Article
- Chronic medical conditions and suicidal behaviors in a nationally representative sample of American adolescents.Social psychiatry and psychiatric epidemiology · 2020Article
- Depression symptoms and quality of life among individuals with aspirin-exacerbated respiratory disease.The Journal of asthma : official journal of the Association for the Care of Asthma · 2019Article
- The involvement of 5-lipoxygenase activating protein in anxiety-like behavior.Journal of psychiatric research · 2013Article
- Association of plasma ω-3 and ω-6 lipids with burden of disease measures in bipolar subjects.Journal of psychiatric research · 2012Article
- Methods for identifying suicide or suicidal ideation in EHRs.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2012Article
- Achieving symptom control in patients with moderate asthma.Clinical medicine insights. Circulatory, respiratory and pulmonary medicine · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.