Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force

Journal of Parasitology Research
Stuart McCarthy

Abstract

The Australian Defence Force (ADF) has used mefloquine for malaria chemoprophylaxis since 1990. Mefloquine has been found to be a plausible cause of a chronic central nervous system toxicity syndrome and a confounding factor in the diagnosis of existing neuropsychiatric illnesses prevalent in the ADF such as posttraumatic stress disorder and traumatic brain injury. Overall health risks appear to have been mitigated by restricting the drug's use; however serious risks were realised when significant numbers of ADF personnel were subjected to clinical trials involving the drug. The full extent of the exposure, health impacts for affected individuals, and consequences for ADF health management including mental health are not yet known, but mefloquine may have caused or aggravated neuropsychiatric illness in large numbers of patients who were subsequently misdiagnosed and mistreated or otherwise failed to receive proper care. Findings in relation to chronic mefloquine neurotoxicity were foreseeable, but this eventuality appears not to have been considered during risk-benefit analyses. Thorough analysis by the ADF would have identified this long-term risk as well as other qualitative risk factors. Historical exposure of ADF personnel...Continue Reading

References

Jun 1, 1978·Antimicrobial Agents and Chemotherapy·L H SchmidtD Vaughan
Nov 1, 1978·Antimicrobial Agents and Chemotherapy·L H SchmidtD Vaughan
Dec 1, 1992·The Journal of Infectious Diseases·F O ter KuileN J White
Jul 1, 1991·The American Journal of Tropical Medicine and Hygiene·T WeinkeH D Pohle
Oct 1, 1990·Clinical Pharmacokinetics·J Karbwang, N J White
Apr 1, 1989·Annals of Internal Medicine·B RouveixJ L Vienne
Oct 1, 1971·Journal of Medicinal Chemistry·C J OhnmachtR E Lutz
Apr 1, 1982·Antimicrobial Agents and Chemotherapy·R Chevli, C D Fitch
Sep 6, 1994·Forensic Science International : Synergy·R JonesC Stahl
Jan 1, 1993·La Revue de médecine interne·T MarsepoilF Benaiche
Jul 7, 1994·The New England Journal of Medicine·R Speich, A Haller
Jul 1, 1993·Transactions of the Royal Society of Tropical Medicine and Hygiene·R A PennieC Crevoisier
Apr 5, 1993·The Medical Journal of Australia·K H RieckmannR Simpson
Apr 1, 1993·Environmental Research·W K Anger, M G Cassitto
Jun 1, 1996·The Journal of Infectious Diseases·A P Hopperus BumaP A Kager
Aug 1, 1996·Tropical Medicine & International Health : TM & IH·P SchlagenhaufD Stürchler
Jul 1, 1996·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·R EdwardsC Martinez
Mar 1, 1997·Transactions of the Royal Society of Tropical Medicine and Hygiene·A M CroftM J World
Dec 24, 1997·The Journal of Pharmacy and Pharmacology·S BaudryR Farinotti
Mar 1, 1996·Journal of Travel Medicine·M A Phillips, R B Kass
Apr 15, 1999·The British Journal of Oral & Maxillofacial Surgery·A E ObiechinaJ O Ogunbiyi
Jun 26, 1999·Journal of Travel Medicine·P Schlagenhauf
Sep 24, 1999·Transactions of the Royal Society of Tropical Medicine and Hygiene·M S PeragalloG Sarnicola
Jun 2, 2001·The Journal of Hand Surgery : Journal of the British Society for Surgery of the Hand·M M TomainoJ D Towers
Aug 16, 2001·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·S Watt-SmithC Scully
Aug 31, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·D OverboschUNKNOWN Malarone International Study Team
Sep 18, 2002·Clinical Pharmacology and Therapeutics·M M van RiemsdijkB H Ch Stricker
Dec 12, 2002·Transactions of the Royal Society of Tropical Medicine and Hygiene·Mario S PeragalloScott J Kitchener
Jan 18, 2003·Sleep Medicine Reviews
Mar 14, 2003·The Medical Journal of Australia·Fary KhanIan D Cameron
Jun 24, 2003·Occupational and Environmental Medicine·W Kent Anger
Jun 1, 1963·Electroencephalography and Clinical Neurophysiology·M G SASLOW, D SUTTON
Jan 1, 1987·Archives of Clinical Neuropsychology : the Official Journal of the National Academy of Neuropsychologists·D E Hartman
Oct 1, 1951·Transactions of the Royal Society of Tropical Medicine and Hygiene·G C DOCKERAY
Mar 17, 2004·British Journal of Pharmacology·Sylvie Barraud de LagerieFrançois Gimenez
Jul 2, 2004·The New England Journal of Medicine·Charles W HogeRobert L Koffman
Aug 7, 2004·Proceedings of the National Academy of Sciences of the United States of America·Scott J CruikshankMiduturu Srinivas
Feb 22, 2005·The Medical Journal of Australia·Scott J KitchenerMichael D Edstein
Apr 27, 2005·International Journal of Epidemiology·Helen KelsallPeter Ittak
May 17, 2005·International Archives of Occupational and Environmental Health·Roberto LucchiniLorenzo Alessio
Jul 14, 2005·Journal of Clinical Psychopharmacology·Alexandra B Whitworth, Wolfgang Aichhorn
Oct 26, 2005·Transactions of the Royal Society of Tropical Medicine and Hygiene·Sanjeev JhaRaj Kumar
Feb 8, 2006·Acta Neuropathologica·Arie Perry, Robert E Schmidt

❮ Previous
Next ❯

Citations

Apr 14, 2017·BMJ Case Reports·Peter B Chansky, Victoria P Werth
Oct 31, 2017·The Cochrane Database of Systematic Reviews·Maya Tickell-PainterDavid Sinclair
Aug 3, 2021·International Journal for Parasitology. Drugs and Drug Resistance·Sundus Shafat AhmadAmit Sharma

❮ Previous
Next ❯

Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

PubMed
Google Scholar
Scopus

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

Antimalarial Agents (ASM)

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.

Anxiety Disorders

Discover the latest research on anxiety disorders including agoraphobia, panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder here.

Antimalarial Agents

Antimalarial agents, also known as antimalarials, are designed to prevent or cure malaria. Discover the latest research on antimalarial agents here.