Breathe Deep, Reconsider Your Singulair Rx

Amy Rothenberg ND
3 min readJan 11, 2024

Potential Mental Health Side Effects of Common Asthma and Allergy Medication

Recent information, underscoring the potential mental health risks of the common asthma medication, Singulair is essential information to share. About 8% of Americans are diagnosed with asthma which translates to about 20 million adults and 6 million children. Like many chronic ailments, people of color and those with lower income, as well as seniors bear the most burden with higher incidence, more ER visits, and more fatal asthma attacks.

There are many approaches to asthma from both a conventional and more natural, integrative perspective. That said, in 2022, over 12 million Americans took Singular or its generic, Montelukast, for allergies and/or asthma including 1.2 million children. And though the Food and Drug Administration issued a clear black box warning about this medication in 2020, the number of prescriptions for this drug has remained steady. Many patients continue to take the medicine and are uninformed about its potential to lead to serious mental health and neuropsychological issues including anxiety, hallucinations, nightmares, hostility, agitation, depression, and suicidal ideation.

The black box alert is not shared widely with physicians or is not taken seriously enough. And if you have received any prescription medication recently, you know that the many pages of drug information are often folded into teensy squares of extremely small print; it would be difficult to absorb all of it or to even understand every bit of information shared.

This is an example of poor regulation, lapses in communication to both doctors and patients and systemic gaps in the FDA approach, especially for drugs approved some time ago. The drug company that produces Singulair, Merck’s resistance to conducting further research even when reports of side-effects were pouring in, reflects poorly on the entire industry. Even back in 1998 when Singular was approved, there was evidence that these issues could arise, but further elucidation took 20+ years. For many impacted individuals and families, it was citizen action through a Facebook support group that helped shine light on this serious potential issue. Merck withholding relevant and essential information from consumers is unacceptable.

For most, symptoms decrease or reverse when the medication is stopped, for others, symptoms persist. For yet others, issues did not arise during treatment with Singulair at all, but rather after the medicine was stopped. And it is not only those who had previous mental health issues who are impacted. Some of those suffering have no history of mental health symptoms or diagnoses.

If you or a loved one is taking Singular or Montelukast, speak with the person who prescribed it about your concerns. This drug should never be used as a first line treatment for allergies or asthma. Consider adding a naturopathic doctor to your health care team. They will look at you or your child’s chief complaint in the context of overall health, aim to treat the root cause of your asthma or allergies and orchestrate the gentlest, most effective approaches for enduring relief. To find a naturopathic doctor near you see here or here.

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Amy Rothenberg ND

American Association of Naturopathic Physician’s 2017 Physician of the Year. Teacher, writer and advocate for healthy living. www.nhcmed.com