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Psychiatric side effects of mefloquine: applications to forensic psychiatry
Elspeth Cameron Ritchie1, Jerald Block, Remington Lee Nevin
1Department of Mental Health,District of Columbia Department of Health, 609 H Street NE, Washington, DC 20002, USA. elspeth.ritchie@dc.gov
Abstract:
Mefloquine (previously marketed in the United States as Lariam®) is an antimalarial medication with potent psychotropic potential. Severe psychiatric side effects due to mefloquine intoxication are well documented, including anxiety, panic attacks, paranoia, persecutory delusions, dissociative psychosis, and anterograde amnesia. Exposure to the drug has been associated with acts of violence and suicide. In this article, we discuss the history of mefloquine use and describe plausible mechanisms of its psychotropic action. Mefloquine intoxication has not yet been successfully advanced in legal proceedings as a defense or as a mitigating factor, but it appears likely that it eventually will be. Considerations for the application of claims of mefloquine intoxication in forensic settings are discussed.
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