I just read David Stuart MacLean’s recent Op-Ed piece in The New York Times, “Crazy Pills.” My heart is racing, my breath is short – he tells of being in India and having a 4-day amnesiac event. I wrote recently about my 90-minute episode of amnesia. His had a clear cause: the drug Lariam (melfoquine hydrochloride), prescribed for prevention of malaria. It was recommended by the CDC for Americans traveling in areas that have a high risk of malaria. It has been given to tens of thousands of US troops, though now that has stopped.
While effective against malaria, the side effects range from none to hallucinations, aggression, paranoia, amnesia, neurological problems and more. One study in the Netherlands found 67% of those taking the drug (in a double-blind, randomized study) had side effects, 6% so severe they had to be hospitalized. The effects can be long-lasting and might be permanent. The FDA has recently added a “black box” warning on Lariam.
Three years ago my husband and I went to a doctor we didn’t know who specialized in the array of vaccinations one needs for going to Third World countries. We were going to South Africa, Kenya and Rwanda and would be in the jungle some of the time.
I remember the doctor checking the CDC web site for required vs recommended shots. We each got a half-dozen shots. Beyond tetanus, I don’t remember the others and I don’t think I wrote them down. I remember the doctor discussing the shot for preventing malaria. We knew nothing and accepted her suggestion blindly, which was: “The drug to prevent malaria has a lot of bad side effects. We can treat malaria. Better to risk malaria than use the preventatives.”
We went on the trip and had a wonderful time. No malaria. No side effects. When I consider that I was willing to take blindly whatever the doctor suggested, I shudder at the risk I might have taken if she had prescribed Lariam.
But this was a doctor who considered the significant side effects. In an ideal world, my husband and I would have received information about the short- and long-term consequences of having malaria and the side effects of the medications used to prevent it and then participated in the decision.
It was good advice. Thank you doctor, whoever you are.
