The most common neuropsychiatric reactions to mefloquine include abnormal dreams, insomnia, anxiety and depression. Hallucinations, psychosis and suicide/suicidal ideation have also been reported. As mefloquine has a long half life, these reactions may be delayed or persist for up to several months after discontinuing treatment.
Start 10 days before entering malarial area
Lariam should now be started 10 days (rather than seven days) before entering the endemic area, to ensure it is well tolerated. If neuropsychiatric reactions occur, Lariam should be discontinued immediately and an alternative antimalarial initiated.
Prescribers should remember that Lariam must not be used for chemoprophylaxis in patients with a psychiatric disorder or a history of such disorders.
Further information: Roche