ICMR-National Institute of Malaria Research, New Delhi, India.
Indian Council of Medical Research, New Delhi, India.
Int J Parasitol Drugs Drug Resist. 2021 Dec;17:23-26. doi: 10.1016/j.ijpddr.2021.06.003. Epub 2021 Jun 24.
According to WHO, 2019 witnessed 229 million cases of malaria globally, of which Africa accounted for 94% of cases. Early diagnosis and treatment are the basis of malaria management, and the need for good chemoprophylaxis especially for people travelling to endemic areas is vital. There are a number of drug options available for the prophylaxis of malaria, mefloquine being one of the drugs used. Mefloquine has been around from the 1970s, and was developed in the United States keeping in mind the soldiers that were being deployed to areas where chloroquine resistant strains of Plasmodium were discovered. Mefloquine was preferred for its once a week dosage. Within a decade of its introduction, reports of the side effects associated with its long-term use surfaced. Mefloquine is now reported to cause a myriad of neuropsychiatric side effects including anxiety, sleep disturbance, depression, dizziness and frank psychosis, especially in patients with pre-existing psychiatric disorders. Many countries like the United States and the United Kingdom have updated their drug boxes to include the warning of these potential neuropsychiatric effects. This paper reviews the side effects of mefloquine and why there is a need to revisit its use in Indian drug policy.
根据世界卫生组织的数据，2019 年全球有 2.29 亿例疟疾病例，其中非洲占 94%。早期诊断和治疗是疟疾管理的基础，对于前往流行地区的人来说，良好的化学预防措施尤其重要。有多种药物可用于预防疟疾，其中包括氯喹。氯喹自 20 世纪 70 年代就已经存在，当时是为了满足那些被部署到发现耐氯喹疟原虫地区的士兵的需求而开发的。氯喹因其每周一次的剂量而受到青睐。在其推出后的十年内，就出现了与长期使用相关的副作用报告。现在氯喹被报道会引起一系列神经精神副作用，包括焦虑、睡眠障碍、抑郁、头晕和明显的精神病，尤其是在有潜在精神疾病的患者中。许多国家，如美国和英国，已经更新了他们的药物清单，包括对这些潜在神经精神副作用的警告。本文综述了氯喹的副作用，以及为什么有必要重新考虑其在印度药物政策中的使用。
