Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Sep;99(3):638-648.
doi: 10.4269/ajtmh.18-0107. Epub 2018 Jun 21.

Associations between Use of Antimalarial Medications and Health among U.S. Veterans of the Wars in Iraq and Afghanistan

Aaron I Schneiderman  1 , Yasmin S Cypel  1 , Erin K Dursa  1 , Robert M Bossarte  2
Affiliations

Associations between Use of Antimalarial Medications and Health among U.S. Veterans of the Wars in Iraq and Afghanistan

Aaron I Schneiderman et al. Am J Trop Med Hyg. 2018 Sep.

Abstract

Mefloquine (Lariam®; Roche Holding AG, Basel, Switzerland) has been linked to acute neuropsychiatric side effects. This is a concern for U.S. veterans who may have used mefloquine during recent Southwest Asia deployments. Using data from the National Health Study for a New Generation of U.S. Veterans, a population-based study of U.S. veterans who served between 2001 and 2008, we investigated associations between self-reported use of antimalarial medications and overall physical and mental health (MH) using the twelve-item short form, and with other MH outcomes using the post-traumatic stress disorder Checklist-17 and the Patient Health Questionnaire (anxiety, major depression, and self-harm). Multivariable logistic regression was performed to examine associations between health measures and seven antimalarial drug categories: any antimalarial, mefloquine, chloroquine, doxycycline, primaquine, mefloquine plus any other antimalarial, and any other antimalarial or antimalarial combination while adjusting for the effects of deployment and combat exposure. Data from 19,487 veterans showed that although antimalarial use was generally associated with higher odds of negative health outcomes, once deployment and combat exposure were added to the multivariable models, the associations with each of the MH outcomes became attenuated. A positive trend was observed between combat exposure intensity and prevalence of the five MH outcomes. No significant associations were found between mefloquine and MH measures. These data suggest that the poor physical and MH outcomes reported in this study population are largely because of combat deployment exposure.

PubMed Disclaimer

Comment in

Similar articles

See all similar articles

Cited by

References

    1. Chen LH, Wilson ME, Schlagenhauf P, 2007. Controversies and misconceptions in malaria chemoprophylaxis for travelers. JAMA 297: 2251–2263. - PubMed
    1. Tickell-Painter M, Saunders R, Maayan N, Lutje V, Mateo-Urdiales A, Garner P, 2017. Deaths and parasuicides associated with mefloquine chemoprophylaxis: a systematic review. Travel Med Infect Dis 20: 5–14. - PubMed
    1. Korhonen C, Petersen K, Bruder C, Jung P, 2007. Self-reported adverse events associated with antimalarial chemoprophylaxis in Peace Corps volunteers. Am J Prev Med 33: 194–199. - PubMed
    1. Alkadi HO, 2007. Antimalarial drug toxicity: a review. Chemotherapy 53: 385–391. - PubMed
    1. Taylor WR, White NJ, 2004. Antimalarial drug toxicity: a review. Drug Saf 27: 25–61. - PubMed

MeSH terms