Adverse reactions to mefloquine associated with alcohol ingestion : a case report

Abstract EN

A 34-year-old male patient with no history of mental health problems was taking one 250-mg tablet of mefloquine weekly for malaria prophylaxis during his stay for six months as a participate in Jordanian Peace Keeping Forces Liberia Western Africa.

He reported abnormal dreams and a low mood associated with the first three doses.

After taking his fourth dose of mefloquine, the patient consumed seven bottles of beer (330ml bottle, 5% alcohol) while socializing with friends in a club.

Soon after consuming the beer, he started to behave dramatically and out of character; he became physically and verbally aggressive, shouted at nearby people, accused friends and nearby patrons of being against him, seemed unable to recognize and acknowledge the familiar people around him, and his gait and gestures were noticeably unsteady.

The next morning, accompanied by his friends, he was admitted to the Jordan Level III Hospital in Monrovia-Liberia.

The symptoms diminished spontaneously few hours after admission.

The patient was noticeably distressed, even terrified, by the episode, but returned to baseline behavior quickly.

Mefloquine was discontinued and the patient was started on Doxycycline capsules 100mg/day, as an alternative malaria prophylaxis.

The patient’s status was followed for 6 weeks with no recurrence of neuropsychiatric symptoms.

It is hypothesized that in this case, the consumption of alcohol aggravated and amplified the neuropsychiatric side effects of mefloquine