Case Report: Adverse Drug Reaction to Montelukast as an Etiology for Recurrent Nightmares

Abstract: Since March of 2020, the leukotriene receptor antagonist Montelukast has been recognized by the FDA to cause adverse neuropsychiatric events including rare cases of nightmares and somnambulism. Currently, children and adolescents being treated for asthma and allergic rhinitis represent the most likely population to experience nightmares and somnambulism as adverse drug reactions to Montelukast. Furthermore, primary care providers and allergist/immunologists may be less suspicious of adverse drug reactions to Montelukast in adult patients as compared to adolescents because few adult cases have been reported and adult patients are more likely to present with comorbidities that make an adverse drug reaction to Montelukast less likely than other differential diagnoses. This case report outlines the presentation, diagnosis, and successful treatment of an adult male patient experiencing recurrent nightmares, an uncommon adverse drug reaction to Montelukast for his age group. The diagnosis was complicated by poor medication compliance and chronic comorbidities suggesting both functional and organic alternative etiologies for the patient’s presentation. Successful, holistic treatment entailed stopping Montelukast, improving sleep hygiene, and careful monitoring of comorbidities. Included is a discussion of the differential diagnosis and the importance of psychiatrists in staying up-to-date with organic etiologies of mental health disorders.Short Description: This poster outlines the case report of an adult male experiencing recurrent nightmares secondary to an adverse drug reaction to the asthma and allergy drug Montelukast. The diagnosis was complicated by past medical history, chronic comorbidities, and issues with medication compliance.Name of Sponsoring Organization(s): N/A