Malarone and Mefloquine for Malaria

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QUESTION

Which drug is better for kids for anti-malaria – Malarone or Mefloquine. I have heard about lot of side-effects of Mefloquine. So, which is a safer drug out of these two or is there any other drug with no side-effects? Is it important to take anti-malaria pills keeping in mind the side-effects?

ANSWER

Both drugs are considered safe for children, though Malarone (atovaquone-proguanil) should not be given to pregnant women or those nursing a child under 5kg. Malarone is also available in a pediatric form in some places, where the dose is reduced specifically for prescription to children under 40kg in weight. Personally, I took both Malarone and mefloquine (as Lariam) when I was a child, and experienced no side effects from either, though certainly many more people do report side effects from mefloquine, including disturbed sleep and hallucinations, or increased anxiety, and it is therefore not recommended for people with a history of psychiatric illness or disorders.

If this does not apply to you or your children, then it really is a matter of preference, cost and practicality. Malarone is generally more expensive than Lariam, needs to be taken every day, but only needs to be taken a few days before departing for the malarial area and for only one week after you return. Lariam, on the other hand, is only taken weekly (which can be an advantage with small children), but needs to be started 2 weeks before travel and for 4 weeks afterwards, which can make it less convenient for short trips.

The other thing to consider, finally, is where you are going—some forms of malaria found in south-east Asia are resistant to mefloquine, meaning it is not a suitable anti-malarial for travel in those areas, so Malarone would be a better choice in that circumstance. Both mefloquine and Malarone are suitable for travel in all other malarial areas.

Affected by Lariam… How to Help?

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QUESTION

Five years ago my husband was working in Africa. To get protection against malaria, he took Lariam. Since then, he became strange, poor sleep, constant depression, insecurity and distrust, inability to concentrate, forgetfulness, anger, strange behavior.

I insisted to see a doctor, but he refuses, saying that this is the problem of diabetes (he has type 2 diabetes) and stress at work.We living 12 years together, I can clearly see it’s more than that.
I tried many different things to prove that he was effected by Lariam to get help. But it did not work. All that I got “I m not crazy.” He’s not but not normal either. it’s ruining our family and lives. We have 2 kids.

Is there any method for establishing the presence of problems (blood test, etc.)?  I was hoping that after he stopped taking Lariam he will feel better. It took 4 years, but no significant changes. How to help him, and is it possible?

ANSWER

Thank you for your question—I am sorry to hear that your husband has been so negatively affected by Lariam. His symptoms are certainly consistent with some of the more unpleasant side-effects of mefloquine (the generic name for Lariam), which have been well reported over the years, and which many sufferers claim have continued long after they have stopped taking the drug.

Lariam was the anti-malarial drug of choice for the US military for many years, and a significant number of servicemen returning from Somalia and Iraq have reported back to the Army’s Surgeon General’s office regarding their on-going psychological symptoms. You can read a report about some of these Lariam cases here.

Roche, the pharmaceutical company that makes Lariam, has recently conceded some of the severe side effects that are associated with the drug, and “Lariam-induced psychosis” is a valid medical diagnosis for people who present with symptoms of paranoia, aggression, anger, hallucinations and other psychological side effects. As such, I think it is important for your husband to realise that you don’t think he is crazy, but that he might be suffering from the late-lasting after effects of a medication, similar effects to that felt by hundreds of US servicemen and other people who have taken Lariam.

Showing him the above document, or many other reports of people will long-lasting Lariam side-effects, might help him realise this is not about being crazy, but about side effects over which he had no control. If he is willing to see a psychiatrist, with the understanding that what he is experiencing is not his fault at all, then you might be able to find some solutions to his behavioural changes.

 

Lariam Side Effects

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QUESTION

My son is playing tennis in Rwanda, Africa. He feels terrible and I suspect it may be the Lariam. He has a fever and has been seeing stuff like snakes, etc. I am very worried as there is no doctor nearby. Is there anything to do to help him? The last Lariam he took was on Saturday.

ANSWER

Certainly Lariam is associated with some severe side effects, which include hallucinations such as that which you describe. Unfortunately, the best way to deal with the side effects of Lariam is to stop taking the drug.

If your son decides to do this, I strongly suggest he looks into taking a different malaria prophylactic for the remainder of his trip in Rwanda—doxycycline is readily available from most pharmacies in the region and is very modestly priced. Your son will probably need to take one tablet (100mg) every day (if he is under 8 years old the dosing is slightly different) and should be continued for 4 weeks after he leaves the malarial area. Side effects to look out for include severe sun sensitivity, so he should be diligent with sun block if he starts taking doxycycline.

A more expensive alternative is Malarone, which is also harder to find in Africa, but which has milder side effects and only needs to be taken for a week after returning home.

We are always very interested in our readers’ experiences with malaria preventative drugs and treatment, and we actually have a survey about malaria prophylaxis up on our home page at the moment&mdsh;please have your son take our Malaria Survey when he gets a chance.