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CMAJ : Canadian Medical Association Journal logoLink to CMAJ : Canadian Medical Association Journal
. 1995 Feb 15;152(4):515–517.

Adverse reaction to mefloquine associated with ethanol ingestion.

R C Wittes 1, R Saginur 1
PMCID: PMC1337705  PMID: 7859199

Abstract

A 40-year-old man with no history of neuropsychiatric illness was taking one 250-mg tablet of mefloquine (MFQ) weekly for malaria prophylaxis while in Tanzania. He experienced no adverse reaction in association with his first two doses. Concurrently with both his third and his fourth dose he consumed about half a litre of whisky. On both occasions he experienced hallucinations, paranoid delusions and suicidal ideation. Thereafter he continued taking the MFQ, abstained completely from ethanol ingestion and had no recurrence of psychiatric symptoms. It is hypothesized that the combination of MFQ and ethanol caused the two episodes of severe psychiatric disturbance.

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Selected References

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  1. Bem J. L., Kerr L., Stuerchler D. Mefloquine prophylaxis: an overview of spontaneous reports of severe psychiatric reactions and convulsions. J Trop Med Hyg. 1992 Jun;95(3):167–179. [PubMed] [Google Scholar]
  2. Boudreau E., Schuster B., Sanchez J., Novakowski W., Johnson R., Redmond D., Hanson R., Dausel L. Tolerability of prophylactic Lariam regimens. Trop Med Parasitol. 1993 Sep;44(3):257–265. [PubMed] [Google Scholar]
  3. Desjardins R. E., Pamplin C. L., 3rd, von Bredow J., Barry K. G., Canfield C. J. Kinetics of a new antimalarial, mefloquine. Clin Pharmacol Ther. 1979 Sep;26(3):372–379. doi: 10.1002/cpt1979263372. [DOI] [PubMed] [Google Scholar]
  4. Palmer K. J., Holliday S. M., Brogden R. N. Mefloquine. A review of its antimalarial activity, pharmacokinetic properties and therapeutic efficacy. Drugs. 1993 Mar;45(3):430–475. doi: 10.2165/00003495-199345030-00009. [DOI] [PubMed] [Google Scholar]
  5. Patchen L. C., Campbell C. C., Williams S. B. Neurologic reactions after a therapeutic dose of mefloquine. N Engl J Med. 1989 Nov 16;321(20):1415–1416. doi: 10.1056/NEJM198911163212017. [DOI] [PubMed] [Google Scholar]
  6. Steffen R., Heusser R., Mächler R., Bruppacher R., Naef U., Chen D., Hofmann A. M., Somaini B. Malaria chemoprophylaxis among European tourists in tropical Africa: use, adverse reactions, and efficacy. Bull World Health Organ. 1990;68(3):313–322. [PMC free article] [PubMed] [Google Scholar]
  7. Stuiver P. C., Ligthelm R. J., Goud T. J. Acute psychosis after mefloquine. Lancet. 1989 Jul 29;2(8657):282–282. doi: 10.1016/s0140-6736(89)90474-1. [DOI] [PubMed] [Google Scholar]
  8. Stürchler D., Handschin J., Kaiser D., Kerr L., Mittelholzer M. L., Reber R., Fernex M. Neuropsychiatric side effects of mefloquine. N Engl J Med. 1990 Jun 14;322(24):1752–1753. doi: 10.1056/nejm199006143222416. [DOI] [PubMed] [Google Scholar]
  9. Weinke T., Trautmann M., Held T., Weber G., Eichenlaub D., Fleischer K., Kern W., Pohle H. D. Neuropsychiatric side effects after the use of mefloquine. Am J Trop Med Hyg. 1991 Jul;45(1):86–91. doi: 10.4269/ajtmh.1991.45.86. [DOI] [PubMed] [Google Scholar]

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