ST LOUIS (MD Consult) - On June 12, 2009, the US Food and Drug Administration (FDA) issued an update after completing its safety review of the class of asthma drugs known as leukotriene modifiers. The drugs mentioned in the FDA communication include montelukast (marketed as Singulair), zafirlukast (marketed as Accolate), and zileuton (marketed as Zyflo and Zyflo CR). Neuropsychiatric events have been reported in some patients who have taken these medications, and the FDA is now requesting that manufacturers include a precaution in the drug prescribing information.
The post-market reports from patients receiving these leukotrienes include cases of neuropsychiatric events. Some of these reports include clinical details consistent with a drug-induced effect. The neuropsychiatric events that have been reported include agitation, aggression, anxiousness, tremor, hallucinations, depression, dream abnormalities, insomnia, irritability, and restlessness, as well as suicidal thinking and behavior (including suicide). In the clinical trial data submitted by manufacturers, neuropsychiatric events were not commonly observed. However, the available data were limited because the trials were not designed to specifically gather information on neuropsychiatric events.