[Neuropsychiatric symptoms caused by mefloquine (report of several cases)]

The number of Hungarian citizens travelling to countries infected with malaria is increasing year by year. Mefloquine is the most effective medicine in the prophylaxis and treatment of malaria. However, neuropsychiatric side-effects can more often be seen with the use of mefloquine compared to other anti-malaria drugs.

To assess the neuropsychiatric side-effects with mefloquine prophylaxis; to screen those patients who are possibly affected by the side-effects and to explore factors that forecast the possible side-effects.

The retrospective analysis of patients, who in the past 2 years, have had mefloquine prophylaxis and then turned up at Semmelweis University, Department of Psychiatry and Psychotherapy and at Szent László Hospital, Outpatient Department of Psychiatry and Addictology because of neuropsychiatric symptoms.

Out of the 6 cases presented, whose neuropsychiatric symptoms ranged from slight dizziness, malaise through panic attacks and depression to psychosis, the preceeding psychiatric condition was positive in 4 cases. Even the most serious psychiatric symptoms disappeared within a few days using temporary drug-treatment. In those cases in whom the side-effects were more serious, a positive psychiatric history or a more sensitive personality differing from the average was established.

Because of the low number of cases it is not possible to draw a general conclusion. After analysis of the data the authors assume, that besides the psychiatric history, the premorbid personality can also be a factor that forecasts the possible neuropsychiatric side-effects caused by mefloquine prophylaxis.