A Cross-sectional Cohort Study to Assess Long-term Neurocognitive and Psychiatric Symptoms of Mefloquine Use in Veterans

Author:

Reinhard Matthew J12ORCID,Chester Jeremy E1ORCID,Breneman Charity B13ORCID,Samuel Immanuel B H13ORCID,Prisco Michelle K1,Vincent Terra D4,Rumm Peter D4,Smith Shanna R4ORCID,Barrett John P15ORCID

Affiliation:

1. Department of Veterans Affairs, War Related Illness and Injury Study Center (WRIISC) , Washington, DC 20422 , USA

2. Department of Psychiatry, Georgetown University Medical School , Washington, DC 20007, USA

3. Henry M. Jackson Foundation for the Advancement of Military Medicine Inc. , Bethesda, MD, USA

4. Department of Veterans Affairs, Health Outcomes Military Exposures (HOME) , Washington, DC 20420, USA

5. Department of Preventive Medicine and Biostatistics, Uniformed Services University , Bethesda, MD 20814, USA

Abstract

ABSTRACT Introduction To evaluate the associations between neurocognitive and psychiatric health outcomes with mefloquine or any antimalarial exposure. Materials and Methods Medical records were systematically reviewed to identify veterans that indicated antimalarial medication use. Linear regression was performed to examine associations between mefloquine/antimalarial exposure and health outcomes. The mefloquine-exposed group was further compared with normative populations for the same health outcomes. Results In the adjusted models, no significant differences were noted between the two exposure groups and the unexposed group for any of the health measures (P-value > 0.05). When compared to normative population samples, the mefloquine-exposed group had poorer health and greater neurobehavioral symptom severity or cognitive complaints. Conclusion This study suggests that mefloquine use by veterans referred for intensive evaluation of their military deployment exposures and health was not associated with increased, long-term, neurocognitive/psychiatric symptoms compared to unexposed veterans.

Publisher

Oxford University Press (OUP)

Subject

Public Health, Environmental and Occupational Health,General Medicine

Reference26 articles.

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2. FDA approves label changes for antimalarial drug mefloquine hydrochloride due to risk of serious psychiatric and nerve side effects;U.S. Food and Drug Administration

3. Psychiatric side effects of mefloquine: applications to forensic psychiatry;Ritchie;J Am Acad Psychiatry Law,2013

4. Associations between use of antimalarial medications and health among U.S. Veterans of the Wars in Iraq and Afghanistan;Schneiderman;Am J Trop Med Hyg,2018

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