Associations between Use of Antimalarial Medications and Health among U.S. Veterans of the Wars in Iraq and Afghanistan
Mefloquine (Lariam ; Roche Holding AG, Basel, Switzerland) has been linked to acute neuropsychiatric side effects. This is a concern for U.S. veterans who may have used mefloquine during recent Southwest Asia deployments. Using data from the , a population-based study of U.S. veterans who served bet...
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Published in | The American journal of tropical medicine and hygiene Vol. 99; no. 3; pp. 638 - 648 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
United States
Institute of Tropical Medicine
01.01.2018
The American Society of Tropical Medicine and Hygiene |
Subjects | |
Online Access | Get full text |
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Summary: | Mefloquine (Lariam
; Roche Holding AG, Basel, Switzerland) has been linked to acute neuropsychiatric side effects. This is a concern for U.S. veterans who may have used mefloquine during recent Southwest Asia deployments. Using data from the
, a population-based study of U.S. veterans who served between 2001 and 2008, we investigated associations between self-reported use of antimalarial medications and overall physical and mental health (MH) using the twelve-item short form, and with other MH outcomes using the post-traumatic stress disorder Checklist-17 and the Patient Health Questionnaire (anxiety, major depression, and self-harm). Multivariable logistic regression was performed to examine associations between health measures and seven antimalarial drug categories: any antimalarial, mefloquine, chloroquine, doxycycline, primaquine, mefloquine plus any other antimalarial, and any other antimalarial or antimalarial combination while adjusting for the effects of deployment and combat exposure. Data from 19,487 veterans showed that although antimalarial use was generally associated with higher odds of negative health outcomes, once deployment and combat exposure were added to the multivariable models, the associations with each of the MH outcomes became attenuated. A positive trend was observed between combat exposure intensity and prevalence of the five MH outcomes. No significant associations were found between mefloquine and MH measures. These data suggest that the poor physical and MH outcomes reported in this study population are largely because of combat deployment exposure. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Authors’ addresses: Aaron I. Schneiderman, Yasmin S. Cypel, and Erin K. Dursa, Department of Veterans Affairs, Epidemiology Program, Post Deployment Health Services (10P4Q), Office of Patient Care Services, Veterans Health Administration, Washington, DC, E-mails: aaron.schneiderman@va.gov, yasmin.cypel@va.gov, and erin.dursa2@va.gov. Robert Bossarte, Department of Behavioral Medicine and Psychiatry, West Virginia University Injury Control Research Center, West Virginia University School of Medicine, Morgantown, WV, E-mail: rbossarte@hsc.wvu.edu. |
ISSN: | 0002-9637 1476-1645 |
DOI: | 10.4269/ajtmh.18-0107 |