AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 45(1), 1991, pp. 86-91
Copyright © 1991 by The American Society of Tropical Medicine and Hygiene

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Neuropsychiatric Side Effects after the use of Mefloquine

Thomas Weinke, Matthias Trautmann, Thomas Held, Gertrud Weber, Dieter Eichenlaub, Klaus Fleischer, Winfried Kern AND Hans D. Pohle
Klinikum Rudolf Virchow/Wedding, II Medizinische Klinik, und Klinikum Rudolf Virchow/Charlottenburg, Freie Universitat Berlin, Germany; Tropenmedizinischer Dienst der Lufthansa, Frankfurt, Germany; Krankenhaus Schwabing, Munchen, Germany; Missionsarzliche Klinik, Wurzburg, Germany; Medizinische Klinik und Poliklinik, Universitat Ulm, Ulm, Germany

This study describes neuropsychiatric side effects in patients after treatment with mefloquine. Reactions consisted mainly of seizures, acute psychoses, anxiety neurosis, and major disturbances of sleep-wake rhythm. Side effects occurred after both therapeutic and prophylactic intake and were graded from moderate to severe. In a risk analysis of neuropsychiatric side effects in Germany, it is estimated that one of 8,000 mefloquine users suffers from such reactions. The incidence calculation revealed that one of 215 therapeutic users had reactions, compared with one of 13,000 in the prophylaxis group, making the risk of neuropsychiatric reactions after mefloquine treatment 60 times higher than after prophylaxis. Therefore, certain limitations for malaria prophylaxis and treatment with mefloquine are recommended.




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