طفل عمره ٨ سنوات عنده ربو، بدأ مونتيلوكاست قبل ٣ أسابيع، وتحسنت كحته الليلية. أمه تقول إنه صار يرى كوابيس ويصحو خائفاً، وصار عصبياً في المدرسة على غير عادته. ما التصرف الأنسب؟

An 8-year-old with asthma started montelukast 3 weeks ago and his night cough improved. His mother says he now has nightmares, wakes frightened and has become unusually irritable at school. What is the most appropriate action?

1. Give it only in the morning without telling anyone
2. Tell the prescriber; it can cause neuropsychiatric effects
3. Double the dose because the asthma is uncontrolled
4. Reassure her that these symptoms are unrelated to the drug

Answer: B) Tell the prescriber; it can cause neuropsychiatric effects. Montelukast can cause neuropsychiatric effects such as nightmares, aggression and depression, rarely suicidal thoughts. The prescriber is told so continuation can be reviewed.