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Montelukast neuropsychiatric effects — GPhC CRA MCQ

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HardRespiratory TherapeuticsMontelukast neuropsychiatric effectsGPhC CRA

A 9-year-old develops new nightmares and behavioural change one month after starting montelukast. Consider these actions: 1) discontinue montelukast; 2) seek immediate medical advice and review alternative asthma management; 3) report the suspected reaction through the Yellow Card scheme. Which combination reflects current MHRA advice?

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Correct answer: B — 1, 2 and 3

All three actions apply. MHRA tells healthcare professionals to discontinue montelukast for new or worsening neuropsychiatric symptoms, advise immediate medical attention and report suspected reactions through Yellow Card. Nightmares and behavioural changes are recognised reactions in younger children. Because montelukast may have been contributing to control, alternative asthma management must be reviewed rather than leaving treatment unplanned.

Reference: MHRA: Montelukast neuropsychiatric reactions: https://www.gov.uk/drug-safety-update/montelukast-reminder-of-the-risk-of-neuropsychiatric-reactions