I ran across this article in my scan of journals. There's been a lot of discussion about adverse drug reactions on AR, so I'll add this one to the discussion. I'd sure look for alternatives. Nothing like a psychosis in the bush to disrupt the safari! And carrying loaded guns around! I was glad I went to a low risk area of Namibia in the winter, so I avoided the meds. Bob



Mefloquine May Raise Risk of Psychiatric Events During Travel Abroad



NEW YORK (Reuters Health) Feb 24 - Treatment with the antimalarial agent mefloquine appears to increase the risk of psychiatric events during travel abroad, especially among females and patients with a psychiatric history, new research shows.

Although mefloquine's antimalarial efficacy is widely accepted, its tolerability is unclear, senior author Dr. Bruno H.Ch. Stricker and colleagues, from Erasmus University Medical Centre in Rotterdam, the Netherlands, note. In particular, there have been concerns that treatment with the drug may increase the risk of psychiatric events.

To investigate, the researchers conducted a case control study using data reported to travel insurance companies. The study involved 111 subjects who had experienced a psychiatric event while traveling and 453 matched controls who had not.

The authors' findings appear in the Journal of Clinical Psychiatry for February.

Overall, mefloquine use raised the risk of psychiatric events by 3.5-fold, the authors point out. However, among females and patients with a psychiatric history, the elevated risks were even higher -- 47.1- and 8.0-fold, respectively.

"Despite the fact that mefloquine is contraindicated in persons with a history of psychiatric diseases, a substantial number of users of mefloquine had such a history," the authors point out. "Since persons with a positive history of psychiatric diseases have a strong risk of relapse with mefloquine use, other antimalarial drugs should be prescribed to such individuals."

J Clin Psychiatry 2005;66:199-204.

bobc

Since your author doesn't differentiate between females and those with psychiatric disorders, I wouldn't be so brave to respond.

Come on guys, step forward!

Dak

Ok, I will take the bait..... I am sure that we can come up with hundreds of medicines/words/actions/events and even unexplainable things (to we mere males)that incite psychiatric behavior in females!!

I have been sending folks overseas for years and never had but one incident in thousands of clients, and that was a lady on Malarone and she was nuts to begin with....Our service men take Lariam and with few effects considering the high numbers that take it.

ANY prescription medicine you take,according to my sawbone clients, may have minor to serious consequences and I know of a guy that died on Penicillin..

All this stuff is and has been a over reaction from the beginning of time...Take the medicine, it beats the hell out of Malaria any day....

I have seen some minor disorders such as some bad dreams, but thats about it...

Bottom line with me is take it or stay home, its as simple as that...

Same with the big 5, if your scared of them, stay home.....

I took Larium 3 weeks before I left [started early in case I had problems, I could switch to something else] the 21 days I was there, and for a month after I got back. NO problems.
I did not use any bug repellent.
Zimbabwe in June.

450,

Forgive me, what is the correlation with Larium and bug repellant? Am I missing something? Thanks.

Larium makes me very grumpy ... I won't take it again. Luckily winter in Namibia in July and August..

Sorry should have been more clear, I used no bug repellent because bugs were not a problem.

I think the best choice is based on knowing the risks and benefits of larium and choosing alternatives. Even if the risk is low, a psychosis is no fun for the unlucky few. I read a report the other day about somebody dying of liver failure after taking the meds for toenail fungus. Better to be informed. bob

I think Larium is what I took, made me edgy, or you might just say, down right mean. I had wild ass dreams, wake up in the middle of the night the whole bit. Thought I was loosing my mind................not sure I had much to loose, but I had to quite taking it. PH I hunted with said he had more than one person go goofy on it, he couldnt take it either.

I can't take Larium because the stuff is poison to me, even if Ray does use it to flavor his coffee.

Doxycycline kills all the malaria that Larium does, it has no side effects (other than a little sun sensitivity), and it also kills the plague. So why take Larium anyway?

My wife and I have used Lariam on 4 previous trips without any adverse side effects.

Regards,

Terry

I took Larium on one trip and kept getting the willys in the field, thought every one was out to get me. It wasn't really bad but just there under the surface. Was like being back in a war zone. Didn't really make the connection until I got back home and the wife asked "What the hell is wrong with you?" Took Deltaprim (a local zim drug) last year. Came down with malaria a month and a half after I got home. That was not fun! Doxycycline for me this trip.

465H&H
"Landa enne!"

465 H&H,

Thats how the stuff made me feel. I'm of the opinon not everybody can take it.

My son who flies all the time and is a pilot to boot,was afraid to the point of hysteria when we got on the plane to fly home.It was like a panic attack of some sort.

As for me ,I get some pretty vivid dreams while on the stuff but no other symptoms.

I took larium on my last trip to Africa. One wierd dream, but no other side effects. Of course I blamed the wierd dream on the larium, but I am not sure what caused it. I have wierd dreams sometimes when I'm not takin larium. In fact, some think I'm wierd anyway.

Malarone.

No side effects, works effectively. Don't have to worry about sensitivity to the sun (very sunny & hot during safari season in Zim).

Downside is that it is a bit more expensive (who cares about an extra $100 on a $15,000 safari) and you have to take it once a day (just take one with dinner).

Tim

For those who don't like Lariam, take Malarone, Doxycycline is the last choice in effectiveness I have been told by the doctors that I hunt...Its not an issue with me as I take Lariam...
I think perhaps some of these symptons can be the effect of jet lag, traveling and a change in diet, and you normal way of life and Lariam gets the rap for you being cranky...Maybe, maybe not, but its a consideration...

I had to take Doxy one time as my Lariam disapeared...I got a terrible sunburn on my hands and face and I do not sunburn, so I save it for tick fever on the trip home should I contact it...It is a good buckshot drug or again so I am told...

500 grs.
No need to put Lariam in my coffee, the coffee in Africa alone probably kills the Malaria bug and poisons millions of tetsi flys every year...

Malarone works very well with no side effects for me. Larium did make me feel wierd also. Under no circustances should you go into a malaria area without having started medication.

CFA

Dr. Saio of Nairobi Hospital in Kenya is recognised here in E.A. as one of THE malaria experts.

He currently recommends COARTEM (which i understand is similar to Malarone ??). He says Doxy is a total waste of time against malaria! He only uses it in combination with COARTEM (Malaria drug) when there are secondary infections such as pneumonia, etc.

Similarly, he is totally against Lariam and when he has to treat someone who has been taking Lariam, he goes all grumpy and rolls his eyes...

I have been living in Malaria areas all my life, got it twice when i was a teen - back then we used different drugs to treat it - but have never taking a profilactic since I was 1 year old. In Kenya, if you lived at the coast as I was, all mothers with new borns were prescribed a profylactic for the first year. Babies got their share through breast milk. after that it was never recommended. Immagine your liver if you had to take an anti-malarial for 36 years

as a non resident or visitor to a malaria zone not taking a profylactic can have "grave" consequences - pun intended

After watching a few PHs drive across Tanzania with a friggen drip hanging from the roof of their truck and seeing them shit and sweat in a bunk, I will take Lariam, cynide or whatever it takes....

I've taken Larium for an extended period of time when working in Indonesia. No ill effects.
"That I can Remember"

quote:

Originally posted by Bwanamich:
Dr. Saio of Nairobi Hospital in Kenya is recognised here in E.A. as one of THE malaria experts.

...He says Doxy is a total waste of time against malaria!

Mich,

Although I don't know if it is a total waste, I do know that I got malaria while on Doxy. Whilst my wife on Lariam didn't get malari. I on the otherhand can't use Lariam because I get occational dizzy spells from it. So there might be something to what the doc says re Doxy, but the good thing with it is that it also cures tickbite fever which I used it for in Botswana. So doxy is a good thing to bring along anyway.

For shorter trips, if a profylactic is needed, I'm all for Malarone. It is however too expensive for longer periods of time in malaria zones IMO.

I will comment though that in most of southern africa during the winter, I personally don't feel the need to use a malaria profylactic since hospitals are never too far away. Relativly speaking. My wife and I stopped using malaria profylactics when we left Mozambique and continued thru Swaziland, RSA, Botswana and Namibia for 4 months. But we did have more than enough cures with us, so it was not a big problem for us. And I am in no way saying that others should drop using a profylactic!!!

I definatly think people should try whatever profylactic they plan to use well beforehand so they know if they get any reactions to it. If one does decide to take Doxy, I would recommend that the pill is taken at dinner. For some reason, the sun sensitivity problem is then lessened when compaired to taking the pill in the morning. I would guess some effect from the drug passing thru the body all night and thus leaving a less consentrated mix in ones body during the daytime.