THESE PILLS MUST BE USED WITH CAUTION
TRAVEL HEALTH SPOKESMAN FOR THE ROYAL COLLEGE OF GENERAL PRACTITIONERS
LARIAM was developed in the Seventies by the U.S. Army after more than 40,000 soldiers fell ill and nearly 80 died from malaria during the Vietnam War.
Drugs available at the time could not keep the mosquitoborne disease at bay.
Since then, it has been taken by millions around the world and is extremely effective — studies suggest it stops the infection in its tracks in 98 per cent of cases.
Use of Lariam (also called mefloquine) and similar antimalarials has risen in recent years because mosquitoes have become increasingly resistant to the older treatments, such as chloroquine, the drug of choice for travellers for decades.
In fact, for any British tourists visiting countries in Africa today, chloroquine is now effectively useless.
Studies suggest around one in 10,000 people who take Lariam is at risk of serious psychiatric effects.
But how can doctors spot those patients? The best way is to start them on the drug two to three weeks before their departure date. The adult dose is 250mg once a week — and on the same day each week.
So three weeks is ample time to identify any major side-effects so patients can be switched to another drug.
Another option, for example, would be a drug called Malarone, which is slightly dearer and also has side-effects (including
nausea, abdominal pain, diarrhoea and loss of appetite) but not psychiatric ones.
If you have had Lariam before and suffered no adverse effects, you only need to start it a week or so before the trip begins.
Of course, there is no guarantee that if you are going to develop mental health problems they will manifest themselves before you leave.
Symptoms could still develop while you are away but the drug label states it should be stopped at the first sign of any problems.
As a general rule, anyone who has a history of anxiety or depression should not be prescribed Lariam but given Malarone instead.
If someone is already on antidepressants, for example, then Lariam isn’t appropriate.
And it’s not just someone’s mental health that’s potentially in danger.
Patients who have heart or kidney conditions may also be unsuitable and may need to take alternative medicines.
Lariam is one of the best weapons we have against one of the world’s biggest killers. But it must be used with care.