Bem J L, Kerr L, Stuerchler D
F. Hoffmann-La Roche Ltd, Basel, Switzerland.
J Trop Med Hyg. 1992 Jun;95(3):167-79.
Since the time of its introduction in 1985, mefloquine (Lariam) has been used extensively for malaria prophylaxis. The international Drug Safety Department of the manufacturer gathered all spontaneous adverse drug reactions reported in association with this drug from all available sources and monitored the literature on a world-wide basis. The serious neurologic and psychiatric adverse events reported in association with Lariam prophylaxis from the time of introduction until May 1991 were reviewed. During this time, 59 serious neurologic and psychiatric adverse reactions were reported as follows: 26 convulsions, 12 depressions, 20 psychotic episodes, and one toxic encephalopathy; none were fatal. While spontaneous reporting systems are biased by under-reporting, they provide useful instruments for analysis of clinical risks factors. The neurologic and psychiatric adverse events reported in association with mefloquine prophylaxis were of the same types as those reported with other quinine derivative antimalarials. The precise mechanism of serious neurologic and psychiatric reactions is unknown. The only patient population identified at this time as having an increased risk of developing these serious reactions to mefloquine are persons with a history of seizures or manic-depressive illness. Mefloquine prophylaxis should not be prescribed to such patients.
自1985年甲氟喹（商品名：Lariam）问世以来，它已被广泛用于疟疾预防。该药品制造商的国际药品安全部门收集了所有来源报告的与该药相关的自发药物不良反应，并在全球范围内监测相关文献。对自甲氟喹问世至1991年5月期间报告的与甲氟喹预防用药相关的严重神经和精神不良反应进行了回顾。在此期间，共报告了59例严重神经和精神不良反应，具体如下：26例惊厥、12例抑郁、20例精神病发作和1例中毒性脑病；无一例死亡。虽然自发报告系统存在漏报偏倚，但它们为分析临床风险因素提供了有用的工具。与甲氟喹预防用药相关的神经和精神不良反应类型与其他奎宁衍生物抗疟药报告的类型相同。严重神经和精神反应的确切机制尚不清楚。目前确定的唯一一类使用甲氟喹发生这些严重反应风险增加的患者群体是有癫痫发作或躁狂抑郁症病史的人。不应给这类患者开具甲氟喹预防用药。
