title: Psychiatric side effects of mefloquine: applications to forensic psychiatry.
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.
authors.affiliation: Department of Mental Health,District of Columbia Department of Health, 609 H Street NE, Washington, DC 20002, USA. elspeth.ritchie@dc.gov
authors.forename: Elspeth Cameron
authors.initials: EC
authors.lastname: Ritchie
authors.forename: Jerald
authors.initials: J
authors.lastname: Block
authors.forename: Remington Lee
authors.initials: RL
authors.lastname: Nevin
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000374:Aggression / Q000187:drug effects / Q000523:psychology; D000962:Antimalarials / Q000627:therapeutic use / Q000633:toxicity*; D015897:Comorbidity; D000075202:Contraindications; D003937:Diagnosis, Differential; D004348:Drug Labeling / Q000331:legislation & jurisprudence; D005104:Expert Testimony / Q000331:legislation & jurisprudence*; D006801:Humans; D007298:Insanity Defense; D016365:Liability, Legal; D015767:Mefloquine / Q000627:therapeutic use / Q000633:toxicity*; D001523:Mental Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology*; D009483:Neuropsychological Tests; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000523:psychology*; D013405:Suicide / Q000331:legislation & jurisprudence / Q000523:psychology; D014754:Violence / Q000331:legislation & jurisprudence / Q000523:psychology
chemical_list: D000962:Antimalarials; D015767:Mefloquine