title: Prolonged Neuropsychiatric Symptoms in a Military Service Member Exposed to Mefloquine.
abstract: A 32-year-old male developed neuropsychiatric symptoms 2 weeks after starting mefloquine 250 mg/week for malaria prophylaxis. He continued to take the medication for the next 4 months. Initial symptoms included vivid dreams and anxiety, as well as balance problems. These symptoms persisted and progressed over the next 4 years to include vertigo, emotional lability, and poor short-term memory, which have greatly affected his personal and professional life. An extensive evaluation revealed objective evidence supporting a central vestibulopathy. These symptoms have been unresponsive to pharmacologic therapy and psychotherapy. A Naranjo assessment score of 6 was obtained for his initial symptoms, indicating a probable adverse drug reaction to mefloquine given the relationship between the clinical picture and drug exposure.
authors.affiliation: Department of Clinical Pharmacology, Experimental Therapeutics, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA. Jeffrey.r.livezey.mil@mail.mil.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Livezey
authors.affiliation: Division of Clinical Pharmacology and Medical Toxicology, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Oliver
authors.affiliation: Division of Clinical Pharmacology and Medical Toxicology, Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
authors.forename: Louis
authors.initials: L
authors.lastname: Cantilena