Tolerance of mefloquine by SwissAir trainee pilots.
Due to presumed adverse performance impact, a World Health Organization clause currently restricts the use of mefloquine malaria chemoprophylaxis in individuals requiring fine coordination and spatial discrimination. We conducted a double-blind, placebo-controlled, cross-over study to quantitatively assess the effects of mefloquine at steady state on performance in 23 trainee airline pilots. Flying performance was assessed using a flight simulator, psychomotor function was evaluated, sleep and wake cycles were monitored, and symptoms and moods were assessed using standardized questionnaires. A simplified postural sway meter recorded sway in three test positions. In the mefloquine loading dose phase, there was one withdrawal due to dizziness, diarrhea, and flu-like symptoms, and three volunteers reported nonserious, sleep-related adverse events. There was no significant difference in flying performance, psychomotor functions, or mean sway for any test position. Nonsignificant reductions in mean total nocturnal sleep (mefloquine = 450 min versus placebo = 484 min) and poorer sleep quality were detected in the mefloquine phases. The mood findings indicated a predominance of positive states, with vigor the predominant mood in all phases. No significant performance deficit was documented under laboratory conditions during use of mefloquine at steady state.
Schlagenhauf
P
P
Division of Communicable Diseases, Institute for Social and Preventive Medicine, University of Zurich, Switzerland.
Lobel
H
H
Steffen
R
R
Johnson
R
R
Popp
K
K
Tschopp
A
A
Letz
R
R
Crevoisier
C
C
D000328:Adult; D000337:Aerospace Medicine; D000339:Affect / Q000187:drug effects; D000962:Antimalarials / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D018592:Cross-Over Studies; D003967:Diarrhea / Q000139:chemically induced; D004244:Dizziness / Q000139:chemically induced; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011187:Posture; D011597:Psychomotor Performance / Q000187:drug effects*; D012140:Respiratory Tract Diseases / Q000139:chemically induced; D012890:Sleep / Q000187:drug effects*; D014195:Travel
D000962:Antimalarials; D015767:Mefloquine