Search

Montelukast prescribing information includes a Boxed Warning issued in March 2020 regarding neuropsychiatric adverse events. A previous Sentinel System study of asthma patients from 2000 to 2015 did not demonstrate an increased risk of intentional self-harm measured using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes, with montelukast compared to inhaled corticosteroids (ICS). Using a new user cohort study design, we examined intentional self-harm events in patients aged 10 years and older who were incident users of either montelukast or ICS as monotherapy, with a diagnosis of asthma, between October 1, 2015, to June 30, 2022, in the Sentinel System. We measured intentional self-harm using ICD-10-CM codes, which may have better accuracy for capturing suicide attempts than ICD-9-CM codes. We used inverse probability of treatment weighting to balance baseline covariates. We performed subgroup analyses by age group, sex, psychiatric history, and pre/post Boxed Warning era and conducted sensitivity analyses varying type of care setting of the outcome and exposure episode gaps. Among 752,230 and 724,855 patients in the montelukast and ICS exposure groups respectively, we found no association between montelukast use and self-harm compared to ICS use [Hazard Ratio (95% Confidence Interval): 0.96 (0.85, 1.08)]. This finding was consistent across all subgroups, and sensitivity analyses. Our results cannot exclude other neuropsychiatric idiosyncratic reactions to montelukast. Compared to the previous Sentinel study, this study identified about double the rate of self-harm events, suggesting a greater sensitivity of ICD-10 codes for measuring self-harm than ICD-9. [ABSTRACT FROM AUTHOR]

Interferon-based therapies were until recently the standard of care in chronic hepatitis C (CHC), despite their side eff ects. We aimed to review the available data on the depression and suicide in CHC patients receiving or not antiviral therapy based on interferon treatment. A PubMed search was performed, identifying relevant papers published between 1991 and January 2015 concerning major depressive disorders and suicidal risk in patients under interferon. A total of 21 relevant papers were retrieved. Prospective studies reported depression as the most common side eff ect of interferon, with an incidence peak between weeks 8 and 12 of therapy. Suicide risk was analyzed in 7 of the reviewed articles, and case reports of attempted suicide were discussed. Moreover, studies have shown that pretreatment with serotonin reuptake inhibitors is a good strategy for the prevention of interferon-induced depression. [ABSTRACT FROM AUTHOR]