According to new guidelines
released by the FDA, the malaria treatment, Lariam, is to have a black box
warning on it. This is because publicised cases and mounting research has
indicated that the drug causes severe neurological and psychiatric side
effects.
It has repeatedly been argued
that the drugs neuro-toxic effects increase permanent risk for brain injury and
that side effects such as depression, anxiety, nightmares, paranoia, delusions
and hallucinations can at best only affect the person taking the drugs and at
worst have severe consequences for individuals in that person’s surroundings.
As an example, it is worth mentioning that the drug has been implicated in
assault and murder cases where the hallucinations may have led to the offences.
Currently, the drug is still in use by the US military,
but its use is restricted and it is only to be used as a last resort. It is
also still available in some travel clinics and appears to be the third most
prescribed anti-malaria treatment in the US. One of the reasons for its
popularity has been the fact that it only needs to be taken once a week rather
than on a daily basis.
Although these side effects are
alarming, it is worth pointing out that they are not news for most travellers
or clinicians. The Online Clinic has not prescribed this medication for a
number of years as we do not believe that the benefits outweigh the risks when
there are alternatives available.