Prescribing montelukast for asthma treatment

In light of recent media attention, it is important to consider the risks and benefits associated with prescribing and taking montelukast for asthma treatment. While montelukast remains a valuable asthma treatment, for some, it is key to be aware of potential neuropsychiatric reactions. These have been reported in patients of all ages and include sleep disturbances, behaviour changes, depression, agitation, and, albeit rarely, hallucinations and suicidal behavior.

As healthcare professionals, we should ensure that patients and parents are made aware of these potential side effects and seek medical advice promptly if they occur. If neuropsychiatric reactions arise, assess the need for continued treatment. Additionally, report any suspected adverse drug reactions associated with montelukast to the Yellow Card Scheme. 

The MHRA is currently conducting an additional review to assess new data concerning the risks associated with montelukast and is nearing its conclusion. For more detailed information, please refer to the latest MHRA statement. These recommendations were released in 2019 in response to clinician's concerns and offer appropriate advice on clinical considerations and care when prescribing Montelukast.