title: Acute and long-term psychiatric side effects of mefloquine: a follow-up on Danish adverse event reports.
abstract: BACKGROUND
  The aim of the study was to explore the profile of acute and long-term psychiatric side effects associated with mefloquine.
  
  
  METHODS
  Subjects (n = 73) reported to a Danish national register during five consecutive years for mefloquine associated side effects were included. Acute psychiatric side effects were retrospectively assessed using the SCL-90-R and questions based on Present State Examination (PSE). Subjects reporting suspected psychotic states were contacted for a personal PSE interview. Electronic records of psychiatric hospitalizations and diagnoses were cross-checked. Long-term effects were evaluated with SF-36. SCL-90-R and SF-36 data were compared to age- and gender matched controls.
  
  
  RESULTS
  In the SCL-90-R, clinically significant scores for anxiety, phobic anxiety and depression were found in 55%, 51%, and 44% of the mefloquine group. Substantial acute phase psychotic symptoms were found in 15% and were time-limited. Illusions/hallucinations were more frequently observed among women. Cases of hypomania/mania in the acute phase were 5.5%. Significant long-term mental health effects were demonstrated for the SF-36 subscales mental health (MH), role emotional (RE), and vitality (VT) in the mefloquine group compared to matched controls.
  
  
  CONCLUSIONS
  The most frequent acute psychiatric problems were anxiety, depression, and psychotic symptoms. Data indicated that subjects experiencing acute mefloquine adverse side effects may develop long-term mental health problems with a decreased sense of global quality of life with lack of energy, nervousness, and depression.
authors.affiliation: Department of Health Sciences, Lund University, Lund, Sweden; Department of Pain Rehabilitation, Skane University Hospital, Lund, Sweden. Electronic address: asa.ringqvist@med.lu.se.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Ringqvist
authors.affiliation: Psychiatric Center North Zealand, Psychiatric Research Unit, University of Copenhagen, Hillerød, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
authors.forename: Per
authors.initials: P
authors.lastname: Bech
authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Center for Neuropsychiatric Schizophrenia Research & Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Psychiatric Center Glostrup, Denmark.
authors.forename: Birte
authors.initials: B
authors.lastname: Glenthøj
authors.affiliation: Department of Infectious Diseases, Aarhus University Hospital Skejby, Aarhus, Denmark.
authors.forename: Eskild
authors.initials: E
authors.lastname: Petersen
mesh_terms: D000208:Acute Disease; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000368:Aged; D000962:Antimalarials / Q000009:adverse effects*; D001007:Anxiety / Q000139:chemically induced / Q000453:epidemiology; D001714:Bipolar Disorder / Q000139:chemically induced / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000139:chemically induced / Q000453:epidemiology; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006212:Hallucinations / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D008297:Male; D015767:Mefloquine / Q000009:adverse effects*; D001523:Mental Disorders / Q000139:chemically induced* / Q000453:epidemiology; D008875:Middle Aged; D011605:Psychoses, Substance-Induced / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D000962:Antimalarials; D015767:Mefloquine
keywords: Anxiety; Bipolar; Depression; Mania; Psychotic