Psychiatrc symptoms induced by montelukast: A case report

Abstract

Introduction Montelukast is a leukotrienes receptor antagonist, which is used, in chronic asthma, exercise induced broncoconstriction and allergic rhinitis treatment. Montelukast inhibates the proinflammatory cytokines and leukotriene is released from the specific cells. Leukotrienes cause mucus secretion, vasodilatation, broncoconstriction and eosinophilia. This case is about an asthma-diagnosed child who had acute disturbing behaviour and sleeping problems after using montelukast treatment. Case A 5 year-old boy assessed because of symptoms like breaking the rules, disturbing friends, self-harming, hyperactivity, distractability, insomnia and nightmares. In his history, when he was 9months old acute hyperactivity, yelling, naughtiness, insomnia, disturbing and self-harming behaviours occurred suddenly 24hours after intravenous montelukast treatment due to asthma crisis. While he was still using oral montelukast, his parents had cut off the treatment. After about 2months, there was decrease in the symptoms. After using montelukast, these kinds of misbehaviour occurred again in a week. The montelukast treatment was terminated controlled way under a pediatrician consultation. Turgay DSM-IV Based Distruptive Behaviour Disorders Screening and Rating Scale were completed by both of the parents in the first interview and after 2months of cutting off montelukast treatment. While comparing 2 scales and parents' anamnesis, we found that impulsivity, oppositional defiant, hyperactivity, distractability, breaking off the rules, irritability, insomnia and having nightmares reduced. Conclusion Montelukast can cause many psychiatric symptoms. In that case we found sleeping problems and disturbing behaviour caused or induced by montelukast treatment. As in that case, other drugs also can cause or enhance psychiatric symptoms. So it is important to assess the other drugs while assessing the diagnosis and the treatment.