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Story originally printed in the La Crosse Tribune or online at www.lacrossetribune.com

Published - Tuesday, April 29, 2008

Terry Rindfleisch: Singulair concerns? Chat with your doc

La Crosse allergists are surprised the Food and Drug Administration is studying a possible link between Singulair, a popular asthma drug, and suicide.

The agency is reviewing several case reports about behavior and mood changes, suicidal thoughts and suicide itself among patients who took the drug.

Dr. David Nelson, a Franciscan Skemp allergist, and Dr. Jason Knuffman, a Gundersen Lutheran allergist, said many asthma and allergy patients in the La Crosse area take the drug, and they recommend patients continue to take Singulair.

They have received calls from patients.

“If patients are concerned, they need to talk to their physician,” Knuffman said. “We haven’t seen this side effect; in fact, I have told patients in the past that the drug has no side effects.”

Knuffman said Singulair is a leukotriene receptor antagonist. It works by controlling certain chemicals that lead to an allergic reaction and inflammation, and it does not affect the central nervous system, he said.

“There have been only a few case reports, and that link has not been found in other studies,” Nelson said. “There is no definite evidence or a direct relationship, but we’re releasing information that has not been substantiated.

“We want to make sure we keep patients’ asthma under control, so we don’t want to overreact by taking people off of Singulair,” he said.

In 40 clinical trials, Merck said it had found no reported suicides among 11,000 patients, which led to the drug’s approval. The FDA recommends patients continue to take the drug, but physicians should monitor patients for mood changes and suicidal behavior.

“I think it’s important for patients diagnosed with depression to work with their physician and monitor their health,” Knuffman said. “We want people to report any side effects or symptoms.”

Singulair, a pill taken daily, has been used by millions of patients for about 10 years to treat asthma and runny noses associated with allergies.

Nelson said he has had some patients go off the medicine, and he wants to monitor those patients to make sure they have effective asthma control.

I have asthma, and I’m following my doctor’s advice to continue to take Singulair.

We won’t know for some time whether there’s any link. The problem is, data is not available on incidence of suicide in the general population versus the incidence in patients taking Singulair. So we don’t really know whether there is an increased incidence of suicide in patients receiving Singulair.

It could be one of those situations where a person who commits or attempts suicide just happened to be taking Singulair. Is anyone looking at other drugs taken by those who attempt or commit suicide?

It’s good to have the information so we can watch for signs and symptoms. I’d still rather know than not know.

Contact Terry Rindfleisch at (608) 791-8227.