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Aust Fam Physician. 1998 Dec;27(12):1119-20.

A severe adverse reaction to mefloquine and chloroquine prophylaxis.

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School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.


A 23 year old man with no history of neurological or psychiatric illness ingested three weekly 228 mg doses of mefloquine base (250 mg salt) as malaria prophylaxis while in India. He experienced an increasingly severe adverse reaction after each dose, including symptoms of paranoia, hallucinations, and suicidal ideation. The man discontinued mefloquine and continued malaria prophylaxis with chloroquine. Shortly after the first 300 mg dose of chloroquine base (500 mg chloroquine phosphate salt), symptoms acutely intensified and became debilitating. Severe symptoms persisted for 12 months following the discontinuation of both antimalarial drugs.

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