Antimalarial side effects

In early October, a study comparing the side effects of commonly prescribed malaria medication was conducted by a team led by Dr. Frederique Jacquerioz at Tulane University. "The review looked at eight clinical trials" of commonly prescribed anti-malarials. Both "atovaquone-proguanil -- sold under the brand-name Malarone -- and doxycycline appear to have fewer side effects" than the other drugs tested. "With these two drugs, there is lower risk of nausea, stomach pain and other gastrointestinal side effects, and also neurological and psychiatric side effects, such as dizziness, sleep disturbances, anxiety and depression."

No drugs produced side effects that were considered life-threatening or required hospitalization; however, the investigators did discover a disturbing link between mefloquine and patient death. They uncovered "published case reports linking mefloquine to 22 deaths, including five suicides." It is important to note that "no other anti-malaria drugs have been linked to deaths when taken at prescribed doses".

Mefloquine is still an effective anti-malarial and may be safely prescribed to patients who have previously taken it without adverse effects. Doctors believe that risk of death is higher for patients who fail to take mefloquine when they should than the risk of serious side effects.

"[S]evere reactions to mefloquine are rare, noted Dr. Andrea Boggild of Toronto General Hospital in Canada, who was not involved in the study. In a written statement, Boggild said that severe neurological and psychiatric symptoms develop in just one out of every 6,000 to 10,000 people who take the drug."

In regard to antimalarial side effects, the Jacquerioz says this: "The main message is that you have to take some malaria chemoprophylaxis (preventive treatment) if you go to an endemic area". Malaria kills approximately one-million people each year, and an estimated ten-thousand to thirty-thousand travelers develop malaria annually.

"Boggild advised people who are planning a trip to a malaria-endemic area to talk with a healthcare provider who specializes in travel medicine about how to best protect themselves."

Source:
Reuters Health. " Two anti-malaria drugs have fewer side effects". Wednesday, October 7, 2009.