Acute and long-term psychiatric side effects of mefloquine: A follow-up on Danish adverse event reports

• Published in: Travel medicine and infectious disease Vol. 13; no. 1; pp. 80 - 88
• Main Authors: Ringqvist, Åsa, Bech, Per, Glenthøj, Birte, Petersen, Eskild
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.01.2015; Elsevier Limited
• Subjects: Acute Disease; Adult; Adverse Drug Reaction Reporting Systems; Age; Aged; Antimalarials - adverse effects; Anxiety; Anxiety - chemically induced; Anxiety - epidemiology; Bipolar; Bipolar Disorder - chemically induced; Bipolar Disorder - epidemiology; Clinical Medicine; Denmark - epidemiology; Depression; Depression - chemically induced; Depression - epidemiology; Electronic Health Records; Ethics; Female; Follow-Up Studies; Gender; Hallucinations - chemically induced; Hallucinations - epidemiology; Health problems; Humans; Illnesses; Infectious Disease; Infectious Medicine; Infektionsmedicin; Interviews; Klinisk medicin; Male; Mania; Medical and Health Sciences; Medicin och hälsovetenskap; Mefloquine - adverse effects; Mental depression; Mental disorders; Mental Disorders - chemically induced; Mental Disorders - epidemiology; Mental health care; Middle Aged; Population; Psychoses, Substance-Induced - epidemiology; Psychoses, Substance-Induced - etiology; Psychotic; Quality of life; Questionnaires; Side effects; Studies; Surveys and Questionnaires; Time Factors; Travel medicine; Young Adult; Denmark; Mania; Bipolar; Depression; Anxiety; Psychotic
• ISSN: 1477-8939; 1873-0442; 1873-0442
• DOI: 10.1016/j.tmaid.2014.10.021

Summary Background The aim of the study was to explore the profile of acute and long-term psychiatric side effects associated with mefloquine. Methods Subjects ( n  = 73) reported to a Danish national register during five consecutive years for mefloquine associated side effects were included. Acute psychiatric side effects were retrospectively assessed using the SCL-90-R and questions based on Present State Examination (PSE). Subjects reporting suspected psychotic states were contacted for a personal PSE interview. Electronic records of psychiatric hospitalizations and diagnoses were cross-checked. Long-term effects were evaluated with SF-36. SCL-90-R and SF-36 data were compared to age- and gender matched controls. Results In the SCL-90-R, clinically significant scores for anxiety, phobic anxiety and depression were found in 55%, 51%, and 44% of the mefloquine group. Substantial acute phase psychotic symptoms were found in 15% and were time-limited. Illusions/hallucinations were more frequently observed among women. Cases of hypomania/mania in the acute phase were 5.5%. Significant long-term mental health effects were demonstrated for the SF-36 subscales mental health (MH), role emotional (RE), and vitality (VT) in the mefloquine group compared to matched controls. Conclusion The most frequent acute psychiatric problems were anxiety, depression, and psychotic symptoms. Data indicated that subjects experiencing acute mefloquine adverse side effects may develop long-term mental health problems with a decreased sense of global quality of life with lack of energy, nervousness, and depression.