Montelukast Linked to Higher ADHD and Conduct Risk Versus Inhaled Steroids

This pooled birth cohort analysis quantifies neuropsychiatric risks of first-line montelukast versus inhaled corticosteroids in young children with newly diagnosed asthma, informing counseling and monitoring after the FDA boxed warning.

📅 Journal publication: Oct 1, 2026 · Last updated: Oct 7, 2026

montelukastleukotriene receptor antagonistinhaled corticosteroidspediatric asthmaADHDsleep disordersoppositional defiant disorderconduct disorderneuropsychiatric adverse eventspharmacoepidemiologycohort studyFDA boxed warning Pediatric Pharmacy

Also in Psychiatry / Psychopharmacology

Background Information

Montelukast may increase neuropsychiatric risks in children with asthma.

Montelukast is frequently prescribed for asthma in children, and understanding its neuropsychiatric impact is essential for informed therapy choices. Montelukast use is linked to higher risks of attention-deficit/hyperactivity disorder (ADHD) (HR 1.40) and oppositional defiant and conduct disorders (HR 1.43) compared to inhaled corticosteroids (ICS). The study suggests caution when prescribing montelukast due to possible neuropsychiatric risks, particularly in children with newly diagnosed, controlled asthma. Consider neuropsychiatric risks when choosing montelukast over inhaled corticosteroids in children.

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Authors: Jiao XF, Ducharme FM, Leal LF, Longo C, Sheehy O, Kaguelidou F, Bérard A

Citation: Jiao XF, Ducharme FM, Leal LF, et al. Neuropsychiatric outcomes after montelukast versus inhaled corticosteroids in pediatric asthma: a pooled birth cohort study. BMC medicine. 2026;24(1). doi:10.1186/s12916-026-05235-7

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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