Two Cases of Montelukast-Associated Psychosis in Children
Jumaili WA, Gburi NA, Chaudhary N, Brown K, Jain S. Two Cases of Montelukast-Associated Psychosis in Children. Prim Care Companion CNS Disord. 2024 May 28;26(3):23cr03694. doi: 10.4088/PCC.23cr03694. PMID: 38815271.
In 2020, the FDA issued a black box warning of severe mental health complications in children associated with montelukast use.1,2 Montelukast-induced dose dependent neuropsychiatric symptoms in children include depression, anxiety, irritability, sleep disturbance, nightmares, agitation, suicidal behavior, auditory/visual hallucinations, and/or full psychosis.1 Stopping montelukast treatment abruptly can have varying effects on underlying neuropsychiatric symptoms and may increase the likelihood of recurrence after restarting montelukast.1
Montelukast treatment has been linked to an increased risk of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).5 The correlation between montelukast therapy and PANDAS is not fully understood, but many streptococcal infections have occurred after discontinuing montelukast treatment.5
