Grabias Bryan, Kumar Sanjai
a Laboratory of Emerging Pathogens, Division of Emerging and Transfusion Transmitted Diseases , Center for Biologics Evaluation and Research, Food and Drug Administration , Silver Spring , MD , USA.
Expert Opin Drug Saf. 2016 Jul;15(7):903-10. doi: 10.1080/14740338.2016.1175428. Epub 2016 Apr 18.
Antimalarial drugs are the primary weapon to treat parasite infection, save lives, and curtail further transmission. Accumulating data have indicated that at least some antimalarial drugs may contribute to severe neurological and/or psychiatric side effects which further complicates their use and limits the pool of available medications.
In this review article, we summarize published scientific studies in search of evidence of the neuropsychiatric effects that may be attributed to the commonly used antimalarial drugs administered alone or in combination. Each individual drug was used as a search term in addition to keywords such as neuropsychiatric, adverse events, and neurotoxicity.
Accumulating data based on published reports over several decades have suggested that among the major commonly used antimalarial drugs, only mefloquine exhibited clear indications of serious neurological and/or psychiatric side effects. A more systematic approach to assess the neuropsychiatric adverse effects of new or repurposed antimalarial drugs on their safety, tolerability and efficacy phases of clinical studies and in post-marketing surveillance, is needed to ensure that these life-saving tools remain available and can be prescribed with appropriate caution and medical judgment.
抗疟药物是治疗寄生虫感染、挽救生命和减少进一步传播的主要武器。越来越多的数据表明,至少某些抗疟药物可能会导致严重的神经和/或精神副作用,这进一步使它们的使用复杂化,并限制了可用药物的范围。
在这篇综述文章中,我们总结已发表的科学研究,以寻找可能归因于单独或联合使用的常用抗疟药物的神经精神效应的证据。除了神经精神、不良事件和神经毒性等关键词外,每种单独的药物都用作搜索词。
基于几十年来已发表报告积累的数据表明,在主要常用的抗疟药物中,只有甲氟喹显示出严重神经和/或精神副作用的明确迹象。需要一种更系统的方法来评估新的或重新利用的抗疟药物在临床研究的安全性、耐受性和有效性阶段以及上市后监测中的神经精神不良反应,以确保这些挽救生命的工具仍然可用,并能在适当的谨慎和医学判断下开具处方。