Published: 7 September 2017


Montelukast — Reminder about Neuropsychiatric Reactions

Prescriber Update 38(3): 40
September 2017

Key Messages

  • Neuropsychiatric reactions have been reported in patients taking montelukast.
  • Healthcare professionals should advise patients that neuropsychiatric reactions can occur.
  • Patients and/or family members should be instructed to contact a healthcare professional should any neuropsychiatric reaction occur.


Montelukast is a leukotriene receptor agonist used for the treatment of asthma and rhinitis. Neuropsychiatric reactions have been reported in patients taking montelukast.

The Centre for Adverse Reactions Monitoring (CARM) has received 22 reports of suspected adverse reactions to montelukast to date. More than half of these reports (12) describe neuropsychiatric events. The most commonly reported neuropsychiatric reactions were abnormal dreaming, insomnia and aggression. In some reports, it was noted that the patient was also taking corticosteroids. However, in some cases montelukast was the only reported medicine.

The data sheets for montelukast products note that the following neuropsychiatric reactions have been reported: agitation including aggressive behaviour or hostility, anxiousness, depression, disorientation, disturbance in attention, dream abnormalities, hallucinations, insomnia, memory impairment, psychomotor hyperactivity (including irritability, restlessness, and tremor), somnambulism, suicidal thinking and behaviour (suicidality), and tic1,2.

It is recommended that physicians discuss these adverse experiences with their patients and/or caregivers. Patients and/or caregivers should be instructed to notify their physician if these changes occur.

  1. Merck Sharp & Dohme (NZ) Ltd. 2016 Singulair Data Sheet. 3 June 2016. URL: (accessed 4 July 2017).
  2. Apotex NZ Ltd. 2016. Apo-montelukast Data Sheet. 9 December 2016. URL: (accessed 4 July 2017).
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