Meta-analysis of the relationship between montelukast use and neuropsychiatric events in patients with allergic airway disease
Yakui Mou,
Qing Song,
Chunying Zhao,
Han Fang,
Chao Ren,
Xicheng Song
Affiliations
Yakui Mou
Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong Province, 264000, China; Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, Shandong Province, 264000, China; Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai, Shandong Province, 264000, China
Qing Song
Department of Otolaryngology, Yantai YEDA Hospital, Yantai, Shandong Province, 264000, China
Chunying Zhao
Epilepsy Sleep Center, Linyi People Hospital, Linyi, Shandong Province, 276000, China
Han Fang
Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong Province, 264000, China
Chao Ren
Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, Shandong Province, 264000, China; Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai, Shandong Province, 264000, China; Department of Neurology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong Province, 264000, China; Corresponding author. Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, Shandong Province, 264000, China.
Xicheng Song
Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong Province, 264000, China; Shandong Provincial Clinical Research Center for Otorhinolaryngologic Diseases, Yantai, Shandong Province, 264000, China; Yantai Key Laboratory of Otorhinolaryngologic Diseases, Yantai, Shandong Province, 264000, China; Corresponding author. Department of Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong Province, 264000, China.
Use of montelukast, as a cause of neuropsychiatric events, in patients with asthma or allergic rhinitis is controversial, and comprehensive statistical analyses verifying this relationship remain lacking. To better understand the relationship between montelukast and neuropsychiatric events, it is vital to guide patients in the effective use of the drug, especially in children whose mothers are concerned about its side effects. In this study, randomized controlled trials (RCTs) investigating montelukast and neuropsychiatric events were retrieved from a literature search of the Medline (1966 to February 2023), Embase (1974 to February 2023), Web of Science, and other related databases. After screening, 18 RCTs were ultimately included in a meta-analysis to merge statistics, which demonstrated no significant increase in neuropsychiatric events compared with placebo. A similar pattern of adverse neuropsychiatric events was observed in patients grouped according to age, with headache being the most common adverse neuropsychiatric event. Overall, montelukast did not significantly increase neuropsychiatric events in patients with allergic rhinitis and/or asthma compared with placebo. Large-sample RCTs are needed to verify the association between neuropsychiatric events and montelukast use in children, and attention is also devoted to FDA warnings.
