Singulair has been shown to encourage suicidal ideation in people who are already prone to it. Having certain mental health conditions can raise this risk.
While people can experience suicidal thoughts for a variety of reasons, sometimes medications can make this situation more likely to occur. Most people wouldn’t associate asthma or regulating the condition through medication with a risk of suicide or even suicidal ideation (the action of thinking about suicide).
However, over the years, one popular asthma medication has been linked with an increase in suicidal ideation in adults. If you have asthma, it’s important to understand the risks as well as safer alternatives that you can take.
If you have asthma as well as depression or other mental health concerns that can increase your risk of suicidal ideation, you need to know that medication could be causing these thoughts and that help is available.
You’re not alone
If you’re experiencing suicidal thoughts, know that you’re not alone.
In the United States, you can dial or text 988 to be connected to someone from the Suicide & Crisis Lifeline who can talk or chat with you and provide help. This is a free service that’s available 24 hours a day, 7 days a week, as part of the Substance Abuse and Mental Health Services Administration (SAMHSA).
Alternatively, you can also visit 988lifeline.org to chat with trained professionals and research additional support options.
The short answer is, yes. There’s a medication that has been linked with an increase in mental health side effects.
However, research has suggested that the increased risk is most prevalent in people who were already experiencing mental health concerns. It’s also important to note that the severity of a person’s asthma can also influence the intensity of mental health side effects.
A 2020 study looked at the link between depression, suicidal motivation (SM), and suicidal ideation (SI) in people with asthma. The cross-sectional study that followed 1,358 adults consisted of people with asthma — but with a mix of well controlled and poorly controlled cases. Some of the study’s findings are:
- Of all participants, 222 had depression, 331 had SM, and 73 had SI.
- Meanwhile, 138 people had mild depression with SM, and just 14 with mild depression and SI.
- When the researchers adjusted the participant figures to solely look at people who also had severe asthma (SA), they found that the chance of depression increased by 53%.
The study also found that people who felt they had low social support for their condition or that their asthma was poorly managed with few resources to treat it had a higher chance of experiencing depression.
But, even people with mild asthma could be at risk of experiencing depression, SM, and SI.
What asthma medications can cause suicidal ideation?
In March 2020, the Food and Drug Administration (FDA) issued a warning for the asthma and allergy drug montelukast, which is marketed under the brand name Singulair as well as in generic form.
Specifically, the FDA noted that it had received continued reports of increases in depression, agitation, sleeping problems, and even suicidal thoughts in people who were taking the medication.
While montelukast already contained a warning about potential mental health-related side effects, the FDA now requires a black box warning on the packaging.
If you’re experiencing suicidal ideation and are on Singulair or a similar medication, you should know that your medications could be influencing your train of thought. You should call your doctor as soon as you can to let them know what you’re going through and ask if you should discontinue your medication.
Remember to treat yourself with compassion, and reach out to your support system. While mental health conditions can sometimes have a stigma attached to them, they’re also common. Reach out to a friend, family member, trusted religious leader, or seek counseling to help you work through these feelings.
Wherever you’re coming from, there’s a crisis line to talk you through it:
- 988 Suicide & Crisis Lifeline: You can reach the 988 Suicide & Crisis Lifeline in the United States by dialing or texting 988. There’s support in English and Spanish, and for people who are deaf or hard of hearing.
- DeafLEAD: DeafLEAD is a 24-hour crisis intervention through videophone for those that use ASL or by calling 573-303-5598.
- Crisis Text Line: You can reach the Crisis Text Line by texting “HOME” to 741-741.
- Substance Abuse and Mental Health Services Administration: You can reach the Substance Abuse and Mental Health Services Administration(SMHSA) by calling 1-800-622-HELP (4357). Help is available in English and Spanish.
- National Alliance on Mental Illness: You can reach the National Alliance on Mental Illness by calling 1-800-950-NAMI (6264) or texting 62640.
- National Domestic Violence Hotline: You can reach the National Domestic Violence Hotline by chatting online, calling 1-800-799-SAFE (7233), or texting “START” to 88788.
- National Sexual Assault Hotline: You can chat online with the National Sexual Assault Hotline or call them at 1-800-656-HOPE (4673).
- Call Blackline: People of Color can reach Call Blackline by calling 1-800-604-5841.
- SAGE National LGBTQ+ Elder Hotline: You can call the SAGE National LGBTQ+ Elder Hotline at 1-877-360-LGBT (5428).
- Trans Lifeline: You can call Trans Lifeline at 1-877-565-8860 in the United States or 1-877-330-6366 in Canada.
- Veterans Crisis Line: You can chat online with the Veterans Crisis Line, dial 988 then press 1 (in the United States), or text 838255.
Suicidal ideation can happen to anyone. While a history of mental health conditions can be a warning sign, not every person who experiences suicidal thoughts fits that description. Paying attention to your loved ones, and looking for significant behavioral changes can be a sign that something is wrong.
Common warning signs include:
- becoming withdrawn or isolated
- extreme anger or discussing revenge
- an increase in drug or alcohol use
- feeling helpless, trapped, or being a burden to others
- excessive or minimal sleep
- extreme changes in mood, agitation, or anxiousness
Note that if you think an adult is experiencing suicidal thoughts and is currently taking Singulair, you should encourage them to stop taking the medication and talk with their doctor. If they’re your child, stop giving them the medication and reach out to your clinician to determine alternative prescriptions.
If someone you know is having suicidal thoughts, the first thing to do is remain calm. Make sure they’ve had a good meal and try to engage them with a favorite hobby or comfort movie. Listen to how they feel without judgment, and help them see that they have people around to support them. Remind them that many people go through this and grow past it.
Encourage them to get professional help, go with them to a hospital or sit with them while they call a crisis line. You can also call the line yourself to get more advice.
Most directives encouraging clinicians to offer alternative medications to Singulair tend to focus on alternate over-the-counter (OTC) allergy medications. This is because Singulair treats both asthma and allergies.
If Singulair is no longer a viable option for people with asthma, a few prescription alternatives exist.
One option can be zafirlukast, which is marketed as Accolate and can be prescribed for those ages 5 and up.
Other proven alternatives to Singulair include:
Not every person with asthma who takes Singulair will experience suicidal thoughts. But for people with a history of mental health concerns, or who experience changes in mood when taking this medication, knowing why it’s happening is important.
Remember that your physician is there to help you and can provide an alternative medication if you experience problems.
More importantly, if you’re experiencing suicidal thoughts, know that you’re not alone. Call or text 988 or visit 988lifeline.org to get immediate help. Remember, this resource is always free, and help is available 24 hours a day, 7 days a week.