Hats off to Dr. Engler. Patients need this type of support. He ...

Hats off to Dr. Engler. Patients need this type of support. He is a unique individual willing to tell his own experiences. Singulair increases risk of Suicide? Don't just poo-poo the possibility This analysis is solely the work of the author. It has not been edited or endorsed by GLG . Analysis By:David Engler, MD Physician, The Allergy Clinic Implications: It is difficult to imagine why taking Singulair would increase the risk that someone would complete suicide. After all, what does a leukotriene receptor antagonist have to do with mental health? I don't know. But doctors, ask yourself, have you ever had a Singulair patient stop taking it because it caused headaches? I have had dozens of them stop taking it because of headaches. When they attempt to try it again, the headache comes back. But the package insert says that the risk of headache is no greater than it is in people who took placebo. Try explaining that to the patient who got the headache--it's very real to them. Analysis: The story about Singulair and suicide may be based on some cause-effect relationship. I don't know what that is, but I will tell you story of a patient I saw last week. She is a 19 year old college student, with the usual stresses of college. I have been treating her for asthma and allergies since she was 10 years old, and she had been on Singulair for about 5 years. She was treated in the town's ER for an intentional Tylenol overdose; she took 15 of them for a headache that wouldn't go away. The usual charcoal to the stomach, with Mucomyst to protect the liver from the Tylenol went fine. While under evaluation, the ER doc also noticed she had been "cutting" her wrists and arms. She said that it relieved stress. They asked her about the Singulair and she said it gave her bad dreams. Astutely, they stopped it. All this happened a week or so before the recent news headlines. Is that cause and effect? No way....but remember that MRK is the same company that still denies that Vioxx can increase the risk of heart attack. Oh yeah, Vioxx. That drug would have been great as a niche drug if given to treat pain in those already at risk of a GI bleed. But, no, MRK was encouraging dentists to give it out for toothaches, and most patients in my practice who were on it had no history of GI bleed. MRK wanted Vioxx to be a billion-dollar blockbuster; had it been marketed appropriately, it may still be on the market. So how will I change my prescribing habits? For patients who have a psychiatric history, including those who take antidepressants, I'll mention the story of this patient to those on Singulair and start asking questions to try to determine if they are brittle or fragile from a psychiatric standpoint. This may be much ado about nothing, but what if it's not? I've learned to stop drinking the drug company Kool Aid without a few grains of salt.