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Mefloquine increases the risk of serious psychiatric events during travel abroad: a nationwide case-control study in the Netherlands.
- Source :
-
The Journal of clinical psychiatry [J Clin Psychiatry] 2005 Feb; Vol. 66 (2), pp. 199-204. - Publication Year :
- 2005
-
Abstract
- Background: Psychiatric events during travel abroad account for a large percentage of medical repatriations arranged by insurance companies. Several risk factors have been proposed for such events, one of these being use of mefloquine. We investigated the risk of psychiatric events during use of mefloquine.<br />Method: We performed a nationwide case control study using medical records from 4 large alarm centers in the Netherlands. Cases were patients contacting the alarm centers because of psychiatric events, according to International Code Primary Care code P (all psychiatric symptoms) or International Classification of Diseases, Ninth Edition, codes 290-319 (all psychiatric syndromes). To every case we matched up to 6 controls by alarm center, calendar time, and continent of travel. All controls had contacted the alarm centers because of nonpsychiatric medical reasons. Shortly after the anticipated day of return, cases and controls received a questionnaire regarding travel characteristics, gender, age, marital status, education, weight, height, general health, history of psychiatric diseases, use of medicines, smoking status, alcohol intake, coffee intake, and use of malaria prophylaxis. Dates of travel for the source population were between September 1, 1997, and June 1, 2000.<br />Results: The study population consisted of 111 cases and 453 controls. The risk of psychiatric events during the use of mefloquine was 3.5 (95% CI = 1.4 to 8.7). In females, the risk was strongly increased, with an odds ratio of 47.1 (95% CI = 3.8 to 578.6). Stratification for history of psychiatric diseases showed that the risk of psychiatric events during use of mefloquine in cases without a history of psychiatric diseases was 3.8 (95% CI = 1.4 to 10.1), whereas the risk in cases with a history of psychiatric diseases was 8.0 (95% CI = 1.8 to 35.8).<br />Conclusion: The use of mefloquine is associated with an increased risk of psychiatric events in females and in patients with a history of psychiatric diseases.
- Subjects :
- Adult
Affective Disorders, Psychotic chemically induced
Affective Disorders, Psychotic epidemiology
Antimalarials administration & dosage
Case-Control Studies
Cohort Studies
Female
Humans
Insurance economics
Insurance, Health, Reimbursement
International Agencies economics
International Cooperation
Male
Mefloquine administration & dosage
Mental Disorders epidemiology
Middle Aged
Netherlands epidemiology
Odds Ratio
Risk Factors
Sex Factors
Surveys and Questionnaires
Travel economics
Antimalarials adverse effects
Insurance statistics & numerical data
International Agencies statistics & numerical data
Malaria prevention & control
Mefloquine adverse effects
Mental Disorders chemically induced
Travel statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 0160-6689
- Volume :
- 66
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of clinical psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 15705005
- Full Text :
- https://doi.org/10.4088/jcp.v66n0207