Singulair and Suicidal Thoughts; FDA Investigates While I Take Cymbalta

Singulair is now under investigation by the FDA into a possible link between the allergy and asthma medication and suicidal thoughts or other mood changes. Meanwhile, Merck has already revised the label of the drug while it is under investigation.

As found on YouTube, CBS conducted a heart-wrenching interview with Kate Miller, a mother who lost her 15-year-old son to suicide last August, apparently after recently switching from Allegra to Singulair. No pre-existing behavioral or mental problems were noted prior to the incident. Following this tragedy, three additional reports concerning suicide and Singulair were sent to the FDA and subsequently an investigation was launched.

Singulair is now prompting many concerns and questions from patients and parents, understandably.

A Personal Account of Singulair, Depression and Suicidal Thoughts

Given that I take three medications for sinusitis and allergies, Singulair, Claritin and Flonase, I can appreciate both the conditions and the drugs. Yet, I did not take Singulair on a regular basis until recently, when I relocated and found my allergy battles increasing ten-fold. Worse yet, Cymbalta, an antidepressant, is now added to the pharmacological cocktail--goji berries just weren't cutting it. Is there a correlation here between the new depression and Singulair?

As for mood changes, the truth be told, I rarely experience serious depression, let alone suicidal ideation. But it doesn't take a Beck Depression Inventory to quantify my semi-recent changes in mood, coincidently or not, while on a regular dose of Singulair.

When I lose interest in and feel hopeless about writing-and we're not talking mere discouragement or burnout-there is a serious problem. This includes uncharacteristically losing myself for two weeks in a recently purchased used Xbox. This may be normal for some people, but not for me--such is why I didn't own the gaming console prior. And, it was especially unhealthy when I turned down writing jobs in the process, feeling unmotivated and incapable.

Further, to better quantify the depression, writing is not a job for me, it is my life. Given that so-called disabilities keep me from living a "normal life," - a bit of a homebody at times -- I find writing more than an accurate substitute. However, without the passion I'm admittedly lost, despite having other hobbies. Even on days when I find writing difficult, and no amount of Singulair clears my head, it is a joy.

So while I was not suicidal on Singulair, it is fair to say I experienced the precursor, hopelessness. What makes the mood change all the more puzzling is that life is recently running at a B+, or better than usual.

Does Singulair Lead to Depression and Suicidal Thoughts?

If the FDA were to analyze my situation, as with most people, at first blush the answer would be "No." Plenty of other physiological causes could explain the changes in mood and in my case it is probably secondary to an immune condition which also prompts my need for Singulair. But I will be re-investigating whether a better alternative for allergy medicine exists in my case.

As such, I question the correlation of not only Singulair to suicidal thoughts but the health of the individual who needs allergy medication in the first place.

Questions About Singulair, The Immune System and Suicide

Given the fact that it is wise and necessary to investigate a potential link between suicidal thoughts and Singulair and that the new label warnings are prudent, the following comes to mind in reducing these tragedies in general.

The immune system, especially when dysfunctional, affects mental well-being. Is it probable that some individuals who need allergy or asthma medication have an immune-related cause to their depression and would benefit from immune enhancement? Further, would more tragedies be avoided if psychoneuroimmunology (PNI) were more readily used, a field that better understands the body-mind connection.

As medications and herbal supplements affect individuals differently, and not fully discovered in clinical studies, would it not save more lives to increase awareness about medication risks and the possibility of suicidal thoughts in general, albeit a downer on pharmaceutical sales?

One solution is to emphasize to parents and patients what warning signs to look for and to make patients and children more comfortable discussing thoughts of suicide, without fear of inadequacy, retribution or serious mental illness. Remove the guilt factor and encourage more discussion in the doctor's office and at home.

Closing Thoughts on Singulair and Suicide

While Singulair is under investigation by the FDA, many doctors are reassuring patients that the drug is safe. Given that more than 30 million prescriptions were written last year alone, and few problems noted, this is relatively comforting. However, if the patient is a child or adolescent or if mood changes are suspected, the physician should be notified and perhaps an alternative treatment sought.

It is hoped that victims such as Kate Miller will soon find both answers and peace.

The FDA is also asking health providers and consumers to report on any negative experiences with Singulair by phone (1-800-332-1088), mail or via the online adverse event reporting system.

Sources:
FDA CBER, Early Communication About an Ongoing Safety Review of Montelukast (Singulair)
CBS, FDA Probing Allergy Drug Suicide Risks