Suicidality symptoms and conditions

My son started taking Singulair in Sept 08 when he was 22 months old. I never really gave it to him consistently, since it was just to help with his reoccurring ear infections. I noticed a little change in his behavior, but I thought it was the "terrible two's". I started giving it to him religiously at the beginning of Nov 08. He had his first meltdown on Nov 15. He was totally uncontrollable. I call it the "Exorcist" tantrum. I took him to the ER, but they told me nothing was wrong. (I did tell the ER all of the medications he was taking.) He started waking up in the middle of the night screaming. Each day, he got a little worse. Defiant, hateful, destructive, etc. He still isn't talking much, so he can't tell me what is going on. Christmas and New Year were horrible. We had NO idea that it could cause mood changes (that is putting it mildly). The pediatrician had no idea what could be causing the behavioral changes. He also started biting his fingernails and obsessing over little things, like the strings hanging off of his blanket.

We decided to take him off Singulair after double checking the side effects. We stopped a week ago, and the change is amazing. He is back to my great little boy. I am sooooo glad that we discovered this after only a few months. I cannot imagine living like that for years.

Two days after stopping the Singluair, I found this website: ******

As I read the different cases, I thought that it was exactly like my son. I was convinced it was the medicine. Each day that he gets better and better-like his normal self- I keep getting madder and madder that no one informed me about the possible side effect. The Dr. did not know nor the pharmacist.

Yesterday, I went to the FDA site to complain about the side effects. It just so happens that the FDA released a statement yesterday that they are still investigating the link between suicidality and Singulair.

We need to let everyone know, that if you are using Singulair, please pay attention to their child's behavior. Some people may be just fine, but others (like my son) are not fine.

I just came across an article on the online "Huffington Post" by Dr. Doug Bremner, who researched the connection between accutane and depression, called "If Prescription Meds Don't Kill You They Might Drive You Crazy" He explains the link between Singulair, Leukotrienes in the brain and depression. There are numerous articles by him as well that are definitely worth reading.

Jenna M.
Parents United for Pharmaceutical Safety and Accountability

I read that many of you blame Singulair for your side effects when you are also taking multiple drugs. As a public service, I put together a list of side effects from some of the other drugs mentioned on this site. These are by no means all the side effects listed for each drug. The first group is from allergy medications people have mentioned.
Zyrtec & Zyzol -
suicidal ideation, suicide, aggressive reaction, anaphylaxis, cholestasis, convulsions, glomerulonephritis, hallucinations, hemolytic anemia, hepatitis, orofacial dyskinesia, severe hypotension, stillbirth, thrombocytopenia.
abnormal thinking, agitation, amnesia, anxiety, decreased libido, depersonalization, depression, emotional liability, euphoria, impaired concentration, insomnia, nervousness, paroniria, sleep disorder.
accidental injury, asthenia, back pain, chest pain, enlarged abdomen, face edema, fever, generalized edema, hot flashes, increased weight, leg edema, malaise, nasal polyp, pain, pallor, periorbital edema, peripheral edema, rigors.

Benadryl-
Sedation, sleepiness, dizziness, disturbed coordination, fatigue, confusion, restlessness, excitation, nervousness, tremor, irritability, insomnia, euphoria, paresthesia, blurred vision, diplopia, vertigo, tinnitus, acute labyrinthitis, neuritis, convulsions. Epigastric distress, anorexia, nausea, vomiting, diarrhea, constipation, Urinary frequency, difficult urination, urinary retention, early menses

Allegra -
insomnia, nervousness, sleep disorders or paroniria, and hypersensitivity reactions (including anaphylaxis, urticaria, angioedema, chest tightness, dyspnea, flushing, pruritus, and rash). Back Pain, Stomach discomfort, Pan in extremity, Headache, Vomiting, Somnolence/Fatigue, diarrhea,

Claritin -
Hypotension; hypertension; palpitations; tachycardia; syncope, Headache; somnolence; fatigue, nervousness; hyperkinesia; paresthesia; dizziness; migraine; tremor; vertigo; impaired concentration; depression; agitation; anxiety;

Here's a way out theory about my unique and to me mystifying medical situation....

I recently read where Singulair, an asthma medicine, is suspected of causing suicides, obviously an effect on the brain function. The FDA notes that over the past year, Merck has updated Singulair's prescribing information and patient information to include the following post marketing adverse events: TREMOR (March 2007), (April 2007), suicidally (October 2007), and anxiousness (February 2008). (the tremor highlight is mine since this is a major symptom of Parkinson's )

Well, I took Singulair from 1998 to 2004 and I wonder if maybe, just maybe Singulair could be a contributing factor to my strange Parkinson's but not Parkinson's problems that is
gait,
balance,
freezing of gait problems

Any thoughts or ideas on how I might follow up on my hypothesis?

Update about my post about the Chinese researchers who reported leukoteine receptors in the brain. There were a few people who misunderstood what I was trying to say to you. I was trying to say that yes it is possible or at least not impossible that Singulair does interfere with brain function in some people because at least one group of researchers found leukoteine receptors in the brain.

I located an article where a professor at Emory was quoted as saying that psychiatric side effects could be possible if leukoteine receptors exist in the brain. That is what I was trying to say without getting myself in trouble for giving misinformation. There is quite a bit more that I would like to say but I cannot find proof as of yet but I am working on it.

Merck’s Singulair likely to see prescription drop-off only in high-risk populations
By Beth Herskovits and Gayatri Iyer in New York

Published: March 28 2008 19:52 | Last updated: March 28 2008 19:52

This article is provided to FT.com readers by Pharmawire—a news service focused on providing insight into the most price sensitive issues in the global pharmaceutical market. www.pharmawire.com
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Merck’s asthma and allergy drug Singulair may see a decline in prescriptions due to recent concerns about suicidality, but the drop will not be precipitous, physicians told Pharmawire.

The warning will likely cause the biggest prescription fall-off among patients with a personal or family history of depression, or patients with mild disease, they add. The drug is taken daily to prevent asthma attacks and allergies, or as needed for exercise-induced asthma.

”Both my kids are on Singulair - and I’m not going to take them off it,” said Dr Lawrence Ciesemier, an allergist and immunologist who practices Kirksville, Missouri. ”It was a surprise to me that this data came out.”

Dr Gregg Santilli, an allergist and immunologist in private practice at AirCare in Plano, Texas, noted that he has prescribed Singulair - a drug he helped launch - for 10 years without seeing any suicides. ”Apparently this is an extremely rare event,” he said. ”This drug has certainly not been linked in a causative way to this.”

”The real question is whether the is greater than what’s seen in the general population,” said Dr Jay Portnoy, president of the American College of Allergy, Asthma and Immunology. ”It’s still an extremely safe and effective medication.”

The FDA announced yesterday that it is ”considering” regulatory action after post-marketing reports seemed to link the asthma and allergy blockbuster to suicidal thoughts and action. Officials said in a statement that they are undertaking a nine-month review of Singulair and three other leukotriene modifying medications: AstraZeneca’s Accolate and Dey’s Zyflo and Zyflo CR.

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HERE IS THE PART ABOUT THE LEUKOTRIENE RECEPTORS IN THE BRAIN

Dr Douglas Bremner, director of Emory’s Clinical Neuroscience Research Unit, noted that drugs can cause psychiatric effects when the targeted receptor also exists in the brain. But he added that it’s unclear whether the brain has leukotriene receptors.

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He noted that despite the updated label, the side effects ”sort of flew below the radar.” However, he painted a grimmer picture of the effect on the market, saying this would affect Singular sales badly. People are likely to stop taking it, he added.

Over the past year, Merck has updated its safety label to include reports of tremors, depression, suicidality, and anxiousness, the FDA said.

But Dr George Philip, senior director in clinical research for Merck, noted that none of the reports of suicidality came out of clinical studies. He added that post-marketing reports can be ”sketchy” and ”not well-defined” - making it more difficult to determine whether the drug caused the change in behavior.

Asked about whether certain high-risk patients should avoid Singulair, he said, ”It may be part of the dialogue moving forward. These are still unanswered questions.”

He added that other allergy drugs have also been linked to suicide, including Pfizer’s Zyrtec.

Santilli noted that he would consider each patient’s individual risk factors - and the severity of their asthma - before making any treatment changes. GlaxoSmithKline’s Advair has a black box warning linking it to an increased risk of asthma-related death, he said, and Zyflo patients must be monitored for liver toxicity.

”Every drug has risks and benefits,” he said. ”Singulair seemed to be a very clean, very safe drug.”

Ciesemier agreed. ”I prescribe Singulair daily,” he said, but conceded that ”maybe this wouldn’t be the first choice” for patients with a history of suicidality.

Patients who are taking the drug for allergies, a less serious condition, might be more likely to switch to an antihistamine, Santilli noted.

Singulair earned USD 4.3bn last year, growing 19%, and is the bestselling respiratory product on the US market, according to the company. Merck has a market cap of USD 96.57bn.

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As a pediatrician I write for Singulair every day.
The medication is for allergies.
Allergies cause a cascade of event that I will describe:
adenoidal swelling, leads to snoring + sleep disturbances. Poor sleep makes the child tired the next day leading to less attentiveness, hyperactivity and eventually acting out.
Almost 4 out of five kids with allergies have those subsequent symptoms, and more.
Over the years the child poor behavior his parents, teachers and peers respond of criticism/ ridicule, and punishments, cause the child to feel inadequate, embarrassed, frustrated and eventually depressed and suicidal.

Yes, Singulair does cause behavioral change but they appear within the first couple of pills, the rest is due to allergies and lack of medical care, i.e. sleep, Singulair, and Zyrtec deficiency.
Allergy shots cause 4 times the incidence of suicidally than Singulair, and Ritalin 10 times more.
Check it, it's true.

As a pediatrician I write for singulair every day.
The medication is for allergies.
Allergies cause adenoidal swelling, which cause sleep disturbances which makes the child tired the next day with makes him over weight, less attentive, hyper and eventually act out.
This in turn makes the child experience parental, peers and teachers criticism/ abuse, with leads to the child feel inadequate, embarrassed, frustrated and eventually depressed and suicidal.

Yes, singulair does cause behavioral change but they appear within the first couple of peels, the rest is due to allergies, lack of medical care, i.e. sleep, singulair, and zyrtec deficiency.
Allergy shots cause 4 times the incidence of suicidally than singulair, and Ritalin 10 times more.
They say in hebrew "once a stone is thrown into a well, thousands of smart people won't find it".
Check it, it's true.