Malaria Drugs Can Drive You Nuts
Protozoans include malaria, giardiasis, amoebiasis, trichomoniasis, and toxoplasmosis.
These are all organisms that can cause infection in humans.
Malaria is caused by the parasite Plasmodium, and is spread by mosquitoes.
Plasmodium falciparum infects red blood cells and is fatal in 1% of cases.
Symptoms include recurrent fever and an anemia that is associated with a decrease in energy.
If you are traveling abroad, you have to decide whether or not to use prophylactic medications against malaria.
With the increase in world wide travel and the involvement of US armed forces overseas, there is a need to ensure that travelers are not exposed to infectious diseases like malaria that are not endemic in the US.
It is important to consider the potential detrimental side effects of medications used to prevent diseases like malaria.
The first treatment of malaria was with chloroquine (Aralen).
This drug suppresses malaria but does not prevent relapse.
This drug can affect eye function, blood pressure, liver function, and gastrointestinal function.
Possible side effects include nausea, vomiting, stomach upset, cramps, loss of appetite, diarrhea, tiredness, weakness or headache.
These effects are most severe in the first few days and usually clear as your body adjusts to the medication.
More serious but more rare side effects include blurred vision, ringing in the ears, difficulty hearing, seizures, mood changes, bruising, and allergic reactions.
A commonly used drug for malaria prophylaxis is mefloquine (Lariam).
Mefloquine has a number of neurological side effects including dizziness (96%), nausea (82%), and headache (73%).
This drug has also been associated with an increase in psychiatric symptoms in 11-35% of patients (van Riemsdijk et al 2002).
Possible psychiatric symptoms include paranoia, depression, and psychosis.
Individuals taking mefloquine have increased depression, anxiety, and fatigue, and a loss of vigor as well as impairment in motor control.
Mefloquine is a first line agent to prevent infection by chroroquine resistant falciparum malaria.
Unfortunately mefloquine has been associated with neuropsychiatric side effects that should lead to caution in its use.
An increase in neuropsychiatric side effects, including fatigue, has been seen in users of mefloquine (van Riemsdijk et al 2002) rates of depression, anger, fatigue and vigor were higher with mefloquine than with other prophylactive malaria medications, like atovaquone plus choroguanide.
Mefloquine users have a number of other symptoms, including vertigo in 96%, nausea in 82%, and headache in 73%.
In general symptoms seem to be more common in females.
These studies show that caution should be employed before using mefloquine in future overseas travelers.
The antimalarial drugs atovaquone and chloroguanine were not associated with neuropsychiatric effects and were equally efficacious as mefloquine for malarial prophylaxis.
Dihydroartemisinin-piperaquine (Artekin) was shown to be equally efficacious as artesunate-mefloquine in the treatment of malaria infected children (Smithius, 2006).
Since alternative medications like atovaquone and chloroguanine are equally effective at malarial prophylaxis and treatment as mefloquine, the latter drug should not be used, especially in patients with neuropsychiatric histories.
van Riemsdijk MM, Ditters JM, Sturkenboom MCJM, et al (2002): Neuropsychiatric events during prophylactic use of mefloqine before travelling.
European Journal of Clinical Pharmacology 58:441-445.
These are all organisms that can cause infection in humans.
Malaria is caused by the parasite Plasmodium, and is spread by mosquitoes.
Plasmodium falciparum infects red blood cells and is fatal in 1% of cases.
Symptoms include recurrent fever and an anemia that is associated with a decrease in energy.
If you are traveling abroad, you have to decide whether or not to use prophylactic medications against malaria.
With the increase in world wide travel and the involvement of US armed forces overseas, there is a need to ensure that travelers are not exposed to infectious diseases like malaria that are not endemic in the US.
It is important to consider the potential detrimental side effects of medications used to prevent diseases like malaria.
The first treatment of malaria was with chloroquine (Aralen).
This drug suppresses malaria but does not prevent relapse.
This drug can affect eye function, blood pressure, liver function, and gastrointestinal function.
Possible side effects include nausea, vomiting, stomach upset, cramps, loss of appetite, diarrhea, tiredness, weakness or headache.
These effects are most severe in the first few days and usually clear as your body adjusts to the medication.
More serious but more rare side effects include blurred vision, ringing in the ears, difficulty hearing, seizures, mood changes, bruising, and allergic reactions.
A commonly used drug for malaria prophylaxis is mefloquine (Lariam).
Mefloquine has a number of neurological side effects including dizziness (96%), nausea (82%), and headache (73%).
This drug has also been associated with an increase in psychiatric symptoms in 11-35% of patients (van Riemsdijk et al 2002).
Possible psychiatric symptoms include paranoia, depression, and psychosis.
Individuals taking mefloquine have increased depression, anxiety, and fatigue, and a loss of vigor as well as impairment in motor control.
Mefloquine is a first line agent to prevent infection by chroroquine resistant falciparum malaria.
Unfortunately mefloquine has been associated with neuropsychiatric side effects that should lead to caution in its use.
An increase in neuropsychiatric side effects, including fatigue, has been seen in users of mefloquine (van Riemsdijk et al 2002) rates of depression, anger, fatigue and vigor were higher with mefloquine than with other prophylactive malaria medications, like atovaquone plus choroguanide.
Mefloquine users have a number of other symptoms, including vertigo in 96%, nausea in 82%, and headache in 73%.
In general symptoms seem to be more common in females.
These studies show that caution should be employed before using mefloquine in future overseas travelers.
The antimalarial drugs atovaquone and chloroguanine were not associated with neuropsychiatric effects and were equally efficacious as mefloquine for malarial prophylaxis.
Dihydroartemisinin-piperaquine (Artekin) was shown to be equally efficacious as artesunate-mefloquine in the treatment of malaria infected children (Smithius, 2006).
Since alternative medications like atovaquone and chloroguanine are equally effective at malarial prophylaxis and treatment as mefloquine, the latter drug should not be used, especially in patients with neuropsychiatric histories.
van Riemsdijk MM, Ditters JM, Sturkenboom MCJM, et al (2002): Neuropsychiatric events during prophylactic use of mefloqine before travelling.
European Journal of Clinical Pharmacology 58:441-445.
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