title: Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives.
abstract: The modern medical literature implicates malaria, and particularly the potentially fatal form of cerebral malaria, with a risk of neurocognitive impairment. Yet historically, even milder forms of malaria were associated in the literature with a broad range of psychiatric effects, including disorders of personality, mood, memory, attention, thought, and behaviour. In this article, the history of psychiatric effects attributed to malaria and post-malaria syndromes is reviewed, and insights from the historical practice of malariotherapy in contributing to understanding of these effects are considered. This review concludes with a discussion of the potentially confounding role of the adverse effects of anti-malarial drugs, particularly of the quinoline class, in the unique attribution of certain psychiatric effects to malaria, and of the need for a critical reevaluation of the literature in light of emerging evidence of the chronic nature of these adverse drug effects.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 782, Baltimore, MD, 21205, USA. rnevin@jhu.edu.
authors.forename: Remington L
authors.initials: RL
authors.lastname: Nevin
authors.affiliation: School of Pharmacy and Biomedical Science, University of Portsmouth, James Watson Building (West), Portsmouth, Hants, PO1 2FR, UK.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Croft
mesh_terms: D000962:Antimalarials / Q000009:adverse effects*; D006801:Humans; D008288:Malaria / Q000150:complications* / Q000188:drug therapy*; D001523:Mental Disorders / Q000453:epidemiology*
chemical_list: D000962:Antimalarials
keywords: Anti-malarial drugs; Malaria; Malariotherapy; Psychiatric effects; Toxicity