Over a week ago I posted on this site and sent an email newsletter
("If They Don't Kill Us They Will Drive Us Crazy")
on Singulair and psychiatric side effects; this was on the day that the FDA announced that they were
investigating an association between Singulair and increased risk of suicidality. The newsletter was
forwarded to journalists from the NJ Star Ledger and pharmawire.com who called me right
away. In the latter publication I was quoted as saying that it was unclear if there were
leukotriene receptors in the brain (which isn't true, there are). Right after talking to them
I updated my March 27 post to add that there are receptors in the brain which is an important
point in establishing a causal effect (i.e. it has to act on the brain in order to cause psychiatric side effects) .
The leukotriene receptors are involved in regulation of the inflammatory response and a link between
neural systems involved in the inflammatory response and mood is well established.
Other points related to whether a drug is shown to cause a particular side effects include
whether there are case reports of an association, whether the symptom comes on after
starting the drug, and whether the side effect goes away after stopping the drug. You can see at
medications.com a number of patients reporting all three of these. Finally, do other drugs
in the same class have the same effect, and as I posted last time the FDA is investigating psychiatric
side effects in all drugs in this class.
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