What the experts say: Though the FDA did not conclude definitively that the events reported were induced by the drugs, the agency in June 2009 requested that the manufacturers of these drugs include a precaution about neuropsychiatric events in their prescribing information and labeling. “[Right now] it is unclear is whether suicidal thoughts and actions are strictly a consequence of the drug, some underlying effect of asthma, or a result of the impact that asthma has on ones sense of self worth and quality of life,” Dr. Calhoun says.
Guidelines for the Diagnosis and Management of Asthma from the National Heart, Lung, and Blood Institute state that “most benefit is achieved with relatively low doses of ICS, whereas the risk of adverse effects increases with dose. … ICS use may be associated with a dose-dependent reduction in bone mineral content, although low or medium doses appear to have no major adverse effect. Elderly patients may be more at risk due to preexisting osteoporosis, changes in estrogen levels that affect calcium utilization, and a sedentary lifestyle.” 6