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The Mefloquine Intoxication Syndrome: A Significant Potential Confounder in the Diagnosis and Management of PTSD and Other Chronic Deployment-Related Neuropsychiatric Disorders

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Posttraumatic Stress Disorder and Related Diseases in Combat Veterans

Abstract

Intoxication with the antimalarial drug mefloquine (previously marketed as Lariam) is a potentially life-threatening condition marked by changes in affect, behavior, cognition, and thought that may be associated with a risk of central nervous system (CNS) neuronal injury as well as chronic neurological and psychiatric sequelae. The acute symptoms of mefloquine intoxication may mimic and be mistaken for a number of acute psychiatric disorders including posttraumatic stress disorder (PTSD). Particularly in deployed settings, this may delay the correct diagnosis of mefloquine intoxication, risking subsequent morbidity. As the subacute and chronic psychiatric and neurologic sequelae of acute mefloquine intoxication may also confound the later diagnosis and management of PTSD, as well as other chronic neuropsychiatric disorders prevalent among deployed cohorts, health-care providers must screen for prior mefloquine exposure and consider the diagnosis of mefloquine intoxication in patients with appropriate history and findings on clinical evaluation.

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  1. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Rm 782, 21205, Baltimore, MD, USA

    Remington Lee Nevin MD, MPH

  2. Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, 20314, Bethesda, MD, USA

    Prof. Elspeth Cameron Ritchie MD, MPH

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    Elspeth Cameron Ritchie

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Nevin, R., Ritchie, E. (2015). The Mefloquine Intoxication Syndrome: A Significant Potential Confounder in the Diagnosis and Management of PTSD and Other Chronic Deployment-Related Neuropsychiatric Disorders. In: Ritchie, E. (eds) Posttraumatic Stress Disorder and Related Diseases in Combat Veterans. Springer, Cham. https://doi.org/10.1007/978-3-319-22985-0_19

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