Mefloquinum - is it dangerous?

SarahM

Hi Guys

I have just been prescribed mefloquinum (Lariam) as a prevention for malaria, i was aware that it had some side effects but was assured by the Dr that it is OK. Since checking on the internet it looks like the risk of psychological/ psychotic problems could be really quite a risk. But like all drug "risk lists" all the risks have to be noted, so its hard to determine, although i feel a little nervous.

Would love to know if any one has taken this drug and what their opnions are and whether or not any side effects were experienced?

Cheers Sarah

sirensongs

Really, Lariam has been linked to psychosis and violence (or at the very best, some pretty wild trips). I am surprised (considering the North Carolina murders linked to Lariam) that they are still prescribing it.

Instead, try Malorone. A completely different formula. I took this with no noticeable side FX for 3 months. Never heard any bad news about it.

I would ditch the Lariam. But for an entertaining read, go to
Paul Harper's account of his Lariam "trips":
Have Lariam, Will Astral Travel

__________________
"Why do people go to India to find themselves? India is where you go to lose yourself."
Feringhee: The India Diaries

SarahM

Unfortunately i can not get Malarone as they do not stock it in Budapest, can i get it in Calcutta and do you know how much it is?

sirensongs

Ooh sorry, for once know-it-all Me does not know.

Anyone???

Anders

Sarah,
I would not call Lariam dangerous but it does have a higher rate of psychological side effects than any other malaria prophylax and personally I try to stay away from it. I have heard that Malarone is not available in India. I think the best thing to do is to go back to the doctor (or another doctor) and tell him you want something else.

Sama

lots lots lots of threads on IM about pros and cons of all malaria meds -- just do a search.....

as for me, malarone was no problem, no side effects whatsoever. you can also try the antibiotic doxycycline, Sarah, that is easy to get in India, and not associated with heavy side-effects, other than making your skin more sun-sensitive, and some others I can not think of right now.....

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BE THE REVOLUTION

Dr.Barai

Doxycycline can cause liver and vestibular damage. wwhich in turn can produce ataxia, vertigo and nystagmus. Incidences of angiooedema and anaphylaxis has also been reported.And be cautioned Doxacycline is the most common antibiotic responsible for superinfection as it causes marked supression of resident flora. Though u may got get malaria u will certainly get some other infection as a compensation!!
Choice is urs!

Sama

yah, like yeast infections! (scratch scratch scratch)

as I said, Sarah can search the site for everyone's OPINIONS about malaria meds, but for better info, she should go to the WHO and CDC websites....

the truth of the matter is that people can have side-effects from every type of pill or drug one injests whether it's baby aspirin or Larium. don't forget that drug companies have to put EVERY side effect that they've ever seen in their drug reseach into their pharmaceutical literature, from the smallest side effect to the most life-threatening.

edwardseco

Malarone isn't available in India. I use Doxy for my family as my sis in law in India dictates. Had great success in a malaria ridden area. Only side effect for me only was sun sensitivity at first..

Sama

CDC website

of course, sometimes this scares you more than helps you!

70s-80s overlander

First let me note that I was amazed at the paucity of recent literature when I consulted www.pubmed.gov [abstracts of the world med lit courtesy of the US government]. The following are the best of the very few:

J Travel Med. 2000 Mar-Apr;7(2):79-84. Reported side effects to chloroquine, chloroquine plus proguanil, and mefloquine as chemoprophylaxis against malaria in Danish travelers. Petersen E, Ronne T, Ronn A, Bygbjerg I, Larsen SO. Laboratory of Parasitology, Statens Serum Institut, DK-2300 Copenhagen S., Denmark. ep@ssi.dk
BACKGROUND: The aim of the study was to provide data on the relative frequency of reported symptoms in travelers using chloroquine, chloroquine plus proguanil, and mefloquine. METHOD: The study was an open, nonrandomized study recording self- reported events in travelers recruited consecutively from two travel clinics in Copenhagen, Denmark. The main outcome measures were the relative proportion of travelers reporting particular symptoms in the three prophylaxis groups, compliance, hospitalization and premature termination of the travel. RESULTS: From May 1996 to April 1998 5, 446 travelers were included and 4,158 questionnaires (76.3%) returned. Compliance was significantly better in mefloquine users with 83.3% of short term travelers compared to 76.3% in chloroquine plus proguanil users. Also, 84.8%, 59.3% and 69.5% using chloroquine, chloroquine plus proguanil, and mefloquine respectively reported no symptoms and 0.6%, 1.1% and 2.8% reported "unacceptable" symptoms. Compared to chloroquine, mefloquine users had a significantly higher risk of reporting depression, RR 5.06 (95% CI 2.71 - 9.45), "strange thoughts," RR 6.36 (95% CI 2.52 - 16.05) and altered spatial perception, RR 3.00 (95% CI 1.41 - 6.41). CONCLUSION: Overall mefloquine is tolerated at least as well as chloroquine plus proguanil and shows better compliance, however, symptoms related to the central nervous system are more prevalent in mefloquine users and when symptoms develop, they are perceived as more severe.

Ned Tijdschr Geneeskd. 1997 Feb 15;141(7):331-4. [Not more symptoms with mefloquine use than with other drugs in malaria prophylaxis] [Article in Dutch] Wolters BA, Bosje T, Luinstra-Passchier MJ. Gemeenschappelijke Gezondheidsdienst Groningen Stad en Ommelanden.
OBJECTIVE: To investigate the prevalence of health problems and compliance with respect to malaria prophylaxis of travellers to the (sub)tropics. SETTING: Travel department of the Public Health Care Centre Groningen, the Netherlands. DESIGN: Retrospective follow-up study. METHODS: A questionnaire was sent out to 450 visitors to the Public Health Care Centre. They had stayed in the (sub)tropics for at most three months. Two subgroups used malaria prophylaxis (mefloquine or proguanil/proguanil-chloroquine): the control group used no prophylaxis. RESULTS: 40% of the 321 responders reported health problems during their stay in the (sub)tropics. Users of proguanil (with or without concurrent chloroquine prophylaxis) reported significantly more health problems (55%). Symptoms reported most frequently were vomiting and diarrhoea. Insomnia and neuropsychiatric disorders were reported only rarely (1%) and these complaints were equally distributed over the prophylaxis subgroups. The reported compliance with chemoprophylaxis was 77%. CONCLUSIONS: The frequently reported psychiatric complaints during use of mefloquine were not confirmed by this study. The compliance with malaria prophylaxis in this study was similar to that in other studies.

hfot2

Ditto!

Antibiotics should not be taken lightly. And yeast infections are really the pits and hyper sensitivity to the sun can be a big issue too, besides all the really bad side effects above.

Malarone worked fine for us; but, if it's not available, I would still stay clear of Lariam [as well as doxy]. We took Lariam years ago with no side effects, but, as everyone has said, we've all heard the horror stories.