Exploring the potential connection between asthma medication and suicidal thoughts: An examination.
In the realm of asthma management, it's essential to strike a balance between effective treatment and minimizing potential mental health risks. Some medications, such as corticosteroids, montelukast, and theophylline, have been associated with mood changes, depression, and suicidal ideation.
The U.S. Food and Drug Administration (FDA) has issued a boxed warning against prescribing montelukast (Singulair) for mild asthma due to its link with suicidal ideation. This strengthens an earlier warning from 2008, which stated that there is a connection between mental health conditions, including suicidal ideation, and montelukast.
Corticosteroids, anti-inflammatory medications with a wide range of uses including asthma treatment, have also been linked to depression and other adverse psychiatric effects. Theophylline use is less commonly linked to psychiatric side effects but has a narrow therapeutic index and problematic side-effect profiles.
However, there are alternatives. Inhaled bronchodilators and biologic therapies are available and generally do not carry a known risk of suicidal ideation or depression.
Key alternatives include inhaled short-acting beta-2 agonists (SABAs) like albuterol, inhaled long-acting beta-2 agonists (LABAs), inhaled anticholinergics, and biologic therapies such as monoclonal antibodies and dupilumab. These medications target specific inflammatory pathways in asthma and have not been reported to increase the risk of depression or suicidal ideation significantly.
Non-pharmacologic management, such as trigger avoidance, environmental control, and physical therapy, also have no direct mental health side effects.
It's crucial to work with a doctor to determine the most appropriate treatment plan based on someone's asthma symptoms, medical history, and other factors. For personalized treatment, evaluation by an asthma specialist or pulmonologist is recommended.
If a person is experiencing significant mood or behavioral changes after starting or stopping a medication, they should seek immediate medical help. In the United States, people can call or text the 988 Lifeline, text HOME to the Crisis Text Line, or find a helpline in their country with Befrienders Worldwide.
In an emergency, if a person is at immediate risk of a suicide attempt, they should follow the directions provided by emergency responders, tell them which medications they are taking, and remove weapons or substances that can cause harm if possible.
[1] Montelukast and Mental Health Concerns [2] Corticosteroids and Suicidal Ideation [3] Theophylline and Psychiatric Side Effects [5] Alternative Asthma Treatments: A Comprehensive Review
- The U.S. Food and Drug Administration (FDA) has issued a boxed warning against prescribing montelukast (Singulair) for mild asthma due to its link with suicidal ideation, strengthening an earlier warning from 2008, which stated that there is a connection between mental health conditions, including suicidal ideation, and montelukast.
- Corticosteroids, anti-inflammatory medications with a wide range of uses including asthma treatment, have also been linked to depression and other adverse psychiatric effects.
- In an emergency, if a person is at immediate risk of a suicide attempt, they should follow the directions provided by emergency responders, tell them which medications they are taking, and remove weapons or substances that can cause harm if possible.
