"I took my first pill 24 hours ago. I started feeling dizzy and weakened. Because the doctor had not mentioned a single side effect, I decided to check the Web ... I was shocked to find ... what this drug is capable of."

Recent Research on Mefloquine (Lariam)

Effectiveness of malaria chemoprophylaxis against P.falciparum infection in UK travellers: Retrospective observational data. Zuckerman, Batty, Jones. Travel Med and Infectious Disease, Sept 2009.

Mefloquine neurotoxicity: A literature reveiw, Stephen Toovey, Travel Medicine and Infectious Disease, January 2009.
“Given that such individuals will not be ill on departure, and that anti-malria use is prophylactic, the prescribed agent should enjoy a very low risk-benefit ratio, i.e. prophylactic antimalarials should be very well tolerated.”

Prevalence of contraindications to mefloquine use among USA military personnel deployed to Afghanistan, Remington L Nevin et al., Army Medical Surveillance Activity, US Army Center for Health Promotion and Preventive Medicine, published in Malaria Journal, Feb 2008.

Mefloquine-Induced Disruption of Calcium Homeostasis in Mammalian Cells Is Similar to That Induced by Ionomycin; D. Caridha, G.S. Dow, et al., Walter Reed Army Institute of Research, in Antimicrobial Agents and Chemotherapy, Feb 2008.

Mefloquine Preventive Measures in Coalition Troops in Afghanistan, Research Letter to Editor, JAMA, May 23/30, 2007, Dr Ashley Croft et al. (see letter two)

Mefloquine Induces Dose-Related Neurological Effects in a Rat Model. GS Dow et al., Walter Reed Army Institute of Medical Research (WRAIR), March 2006. This study documents that at treatment levels, the concentration of mefloquine in the bloodstream (reached in women after the 4th or 5th preventive dose) “caused degeneration of specific brain stem nuclei.” Also see Dow’s earlier research (below) which further documents mefloquine’s neurotoxicity.

MDR1 gene polymorphisms are associated with neuropsychiatric adverse effects of mefloquine. Aarnoudse AL, van Schaik RH, Dieleman J, Molokhia M, van Riemsdijk MM, Ligthelm RJ, Overbosch D, van der Heiden IP, Stricker BH. Clinical Pharmaclogy Therapy, Oct 2006.

Mefloquine Increases the Risk of Serious Psychiatric Events During Travel Abroad: A Nationwide Case-Control Study in the Netherlands, van Riemsdijk et al., Journal of Clinical Psychiatry 2005;66:199-204 February 2005.

“Effectiveness of antimalarial drugs” (scroll to letter #3), Croft, Beer, Herxheimer, New England Journal of Medicine, Nov 28, 2005.

The antimalarial potential of 4-Quinolinecarbinolamines may be limited due to neruotoxity and cross-resistance in mefloquine-resistant plasmodim flaciparum strains. Dow, GS et al., Walter Reed Army Institute of Research (WRAIR), Antimicrobial Agents Chemotherapy, 48(7):2624-2632 (2004).

Malaria drug blocks brain conduits. Brown University Press Release. Brown researchers have discovered that mefloquine, an anti-malarial drug, blocks two gap junction proteins, or connexins, in low doses and with very few side effects in the brains of laboratory mice. The work opens an important door: Connexins found in high concentrations in the brain are believed to play a critical role in movement, vision and memory. August 7, 2004. Study follows.

Potent block of Cx36 and Cx50 gap junction channels by mefloquine. Cruickshank, Connors, et al., Proceedings of the National Academy of Science, 101(33): 12364-12369). PDF REPRINT.

Schlagenhauf Patricia et al., Tolerability of malaria chemoprophylaxis in non-immune travellers to sub-Saharan Africa: A multicentre,
randomised double blind, four arm study. BMJ Nov 2003.

The acute neurotoxicity of mefloquine may be mediated through a disruption of calcium homeostasis and ER function in vitro. Dow, GS et al., WRAIR, Malar J. 2003; 2: 14. Published online 2003 June 12.

Overbosch, David, et al. 2001. Atovaquone-proguanil versus mefloquine for malaria prophylaxis in nonimmune travelers: Results from a randomized, double-blind study. Clinical Infectious Diseases 33 (1
Oct):1015-1021.

Response to Overbosch from UK medical experts Croft and Herxheimer, Tolerability of Antimalarial Drugs, with authors’ reply, Clinical Infectious Diseases, 2002;34:1278.

van Riemsdijk MM, et al., Atovaquone plus chloroguanide [Malarone] versus mefloquine [Lariam] for malaria prophylaxis: a focus on neuropsychiatric adverse events. Clin Pharmacol Ther, 2002 Sep;72(3):294-301. “Prophylactic use of mefloquine was associated with significantly higher scores on scales for depression, anger, and fatigue and lower scores for vigor than prophylactic use of atovaquone plus chloroguanide.” [randomized, double blind study]

van Riemsdijk MM, et al. “Neuropsychiatric events during prophylactic use of mefloquine before travelling”, Published online: 27 July 2002, Springer-Verlag

“Neurological Effects of Mefloquine a Trans-Atlantic Debate”, by RPCV Rebecca Brodsky, Returned Peace Corps Volunteer, October 2, 2001, A review of research to date.

MASTA (Malaria Advisory Services for Travelles Abroad) study: Comparison of adverse events associated with use of mefloquine and combination of chloroquine and proguanil as antimalarial prophylaxis: postal and telephone survey of travellers P J Barrett, P D Emmins, P D Clarke, D J Bradley, BMJ, 7056, Vol 313, August 31, 1996.

Mefloquine prophylaxis: An overview of spontaneous reports of severe psychiatric reactions and convulsions, Bem et al., Roche Switzerland, J Trop Med Hyg,1992.

World Health Organization (WHO) review:
Review of Central Nervous System Adverse Events Related to the Antimalarial Drug, Mefloquine, 1985 – 1990 Report by the Malaria Control Unit, Division or Control of Tropical Diseases, WHO, in cooperation with the Drug Safety Unit, F. Hoffmann-La Roche. Issued in 1991.

World Health Organization (WHO) report: Central Nervous System Reactions Related to the Antimalarial Drug, Mefloquine, Report from Geneva, 17 July 1989; includes list of participants.

For more scientific studies about Lariam, see Medical Research References.