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Montelukast's (Singulair) unexpected benefits
I am 70 years old now, and I have been taking the anti-inflammatory drug montelukast for over 2 years , and I have been posting the results on this board. Within a week after I started taking this drug, my extreme mental fatigue and occasional confusion disappeared, and I was completely back to normal.
I have discovered some added and unexpected benefits that I would like to mention:
Benign prostate enlargement. Before taking this drug, I had been experiencing symptoms of this condition which is often seen in older men. I had difficulty urinating, and I was taking several medications which did not work and which I discontinued. After taking montelukast for about 3 months, the symptoms started to go away. For the last year and a half, I have been symptom free. It makes sense because inflammation is a probable cause of this condition, and the prostate contains luekotriene producing mast cells and luekotriene receptors. Montelukast blocks inflammation causing luekotrienes from entering cells with luekotriene receptors.
Muscle aches due to exercise. I started running daily more than 55 years ago when I joined my high school track team, and I continued to run on the track team in college. I have continued to run daily up till now. About 3 years ago, I thought I was going to have to give up jogging and start walking because my legs were giving me so much pain. After I started taking montelukast, the muscle pains went away. Again muscle also contain mast cells producing leukotrienes and also leukotriene receptors. I am still running about 2 miles every morning morning. The muscle pains in my legs are gone and I feel like 20 years younger when I run.
Better sleep. I have mentioned this before in my posts. Before taking montelukast, I couldn't sleep very soundly and I was feeling sleep deprived. I also rarely had dreams. After taking the drug, I sleep much more soundly and often have dreams, and I feel much more rested. Evidently reducing brain inflammation can improve sleep.
You might ask, if montelukast is a widely prescribed drug for the prevention of asthma attacks, why haven't people noticed its beneficial effects on other conditions. One reason is that the recommended adult dosage for asthma is very low - only 10 mg once a day. I myself am taking 40 mg (20 mg twice a day). Since the drug has to cross the blood brain barrier to treat Alzheimer's and dementia, 10 mg a day is probably not enough to make much difference. Other conditions may also require higher than 10 mg a day. So people taking the low dosage may not see much change in other conditions.
A reason that montelukast is not being considered for repurposing is that big pharma is not interested in paying for clinical trials for inexpensive off patent drugs. There is a lot of repurposing trials going on right now, but they are for high priced on-patent drugs and high priced biologics and cancer drugs.
Still there a small drug company in Canada, Intelgenx, run by research scientists (not finance people) that is sponsoring a clinical trial on montelukast for Alzheimer's and dementia under the supervision of the Canadian government. Hopefully we should get a progress report before the end of the year. When this drug becomes more widely prescribed in higher doses, then we will find out more about its anti-inflammatory uses and how it can treat other medical conditions and even slow down the aging process.
I predict that montelukast and other leukotriene blocking drugs will eventually become as common as statins in preventing diseases. Big pharma may not be interested in these drugs because the big money is not there, but once montelukast becomes the standard for Alzheimer's and dementia treatment, governments around the world will begin looking into doing clinical trials for leukotriene blocking drugs for other diseases.
Thank you for the thorough update, Larry. When I broached the subject with my neurologist, he was not interested, saying that results were inconclusive. I am interested in the Canadian results.
Iris, I am not surprised that your neurologist won't prescribe it. I have received a number of replies to some of my posts and it is the same story. I feel lucky that I am now living in a country where I don't have to have a prescription.
About the time that the patent for Singulair was about to expire, Merck applied to the FDA for over-the-counter status. Even though it had a very good safety record, it was turned down mainly because the FDA board was concerned that consumers would mistakenly think it is a rescue medication for asthma attacks, where as it is supposed to be used to prevent or reduce the number of attacks. I think that if it had become over-the-counter, it would have become widely used today for Alzheimer's and other conditions as word got around.
I think it is necessary to look at the neurologist's situation. Many of his/her patients take a lot of drugs with possible serious side effects, and many patients are not in good health. What happens if a patient has a serious medical emergency and the patient or relatives are seeking to blame the doctor? When a patient is taking a lot of drugs, in most cases, it is difficult to pin the cause on a particular drug with certainty. So what the lawyers often do is look into the patient's prescription history and look for some action that is not generally accepted. A neurologist has only a very limited number of drugs that he/she can prescribe off label that are generally accepted as a treatment for the symptoms related to Alzheimer's and dementia. If the neurologist strays from that list, he/she is taking a big legal risk. It is possible that the medical group that the neurologist belongs to has a policy not to write prescriptions for off label drug treatments that are not generally accepted. Malpractice insurance companies may also have counselled them against this practice.
I think that you might be better off seeing a GP or internist. They would be more familiar with this drug, and they would likely know how it works and its safety record. Still, a lot has to do with the personality of the physician, and also the group he/she belongs to. In the case of Dr Rozin, he was running a study on the drug, and no doubt, the patients or legal guardians had to sign papers informing them of the risks, so he was legally covered.
If the early results of the clinical trial in Canada turn out to be positive, it might be better to go to a physician who is not a neurologist. It may take years to complete the trial and still more years for neurologists to start prescribing it because is not being marketed by a big pharma company with lots of money for advertising and for lobbying doctors.
Iris, thanks a lot for your interest. I will keep you informed about the trials.
Markus, I agree with you one hundred percent. Why shouldn't your wife be able to try a drug as safe and commonly used as montelukast (Singulair).
Going to Mexico might not be the best way, unless you live near the border and can drive across. Even if you can buy the drug there, you might get stopped at the border coming back and have your drugs confiscated. I don't know if they would recognize a prescription from a Mexican doctor.
Why not do your own clinical trial? Get a prescription for 3 months (12 weeks) and let her take 2 X 10mg twice a day for 3 weeks. From my experience with this anti-inflammatory drug, I got full benefit after only one week. It works amazingly fast.
If it works for her, you will need to get prescriptions from 3 more doctors (for reduction of asthma attacks) to maintain the 40mg a day level. This drug is so common that I doubt any doctor is going to question your intent. You can say that you have previously taken it and want to start back again. Since there is really no common test for asthma, they will take your word for it. And don't go to a neurologist. Go to a GP, family physician, internist, etc.
I know that you don't like doing it this way, but it is the only practical way I can think of, unless you want to move overseas. I hear Costa Rica is really nice.
Good luck, Markus
Markus, I am a patient myself, with a diagnosis of cognitive impairment nos. I am on Exelon patch and Namenda XR since 2009. Markus and Larry, I was a physician in my career life. I know all about the legalities of prescribing medications. No doctor would prescribe a medication for asthma without seeing signs of asthma. At least, not in California, the most litigious state. But I'm glad you reminded me. Tijuana is just down the road, two hours away. I'll keep that in mind.