LSTM Home > LSTM Research > LSTM Online Archive

Deaths and parasuicides associated with mefloquine chemoprophylaxis: A systematic review

Tickell-Painter, Maya, Saunders, Rachel, Mayaan, Nicola, Lutje, Vittoria, Mateo, Alberto and Garner, Paul ORCID: (2017) 'Deaths and parasuicides associated with mefloquine chemoprophylaxis: A systematic review'. Travel Medicine and Infectious Disease.

Tickell-Painter et al 2017.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

Download (1MB) | Preview


Mefloquine is recommended in international health guidelines for preventing malaria in travellers. Reports of psychosis and suicide are often alluded to but are not clearly established.
We carried out a systematic review to identify and critically appraise any death or parasuicide associated with mefloquine prophylaxis. We developed a comprehensive search that included publications up to 11 July 2017. We included case studies but excluded newspaper reports. Two authors independently appraised each death or parasuicide against a standardised causality assessment tool. The protocol was registered on PROSPERO (CRD42016041988).
We identified 527 articles that required full-text retrieval; of these 17 were unique publications that reported deaths or parasuicide. Eight unique publications had sufficient detail to be included in causality assessment. We identified 2 deaths with a probable association that appeared to be idiosyncratic drug reactions; we categorised the remaining 8 deaths as “unlikely” to be related to mefloquine, or “unclassifiable”. There was one parasuicide with a possible causal association. There were 9 additional publications that searched spontaneous drug reporting databases; none provided sufficient detail to perform a causality assessment.
Overall, the number of deaths that we could reliably attribute to the prophylactic use of mefloquine is very low.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 21 Medicine as a profession.
QV Pharmacology > QV 56 Adverse effects (General)
WA Public Health > Preventive Medicine > WA 108 Preventive health services. Preventive medicine. Travel Medicine.
WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WM Psychiatry > WM 100 General works
WM Psychiatry > WM 140 Mental disorders (General)
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):
Depositing User: Stacy Murtagh
Date Deposited: 31 Oct 2017 17:14
Last Modified: 06 Dec 2019 16:27


View details

Actions (login required)

Edit Item Edit Item