Travellers, doctors blame malaria drug for lasting psychiatric problems

When Chatham, Ont., resident Jessica Konecny travelled to Ghana for a university work term 12 years ago, she was prescribed mefloquine sold then under the brand name Lariam to help prevent her from contracting malaria, endemic in that region of Africa.

• 'Treated like lab rats': malaria drug's dark side-effects haunt Canadian vets

Almost immediately, she began experiencing vivid nightmares.

"I had a dream about a spider. I was sleeping in a bug net so when I woke up, the spider was huge and it was on my net and my roommate had to turn on the lights and physically take me out of the net for me to believe that it wasn't happening."

Konecny was 22 at the time.

She says she had never experienced psychological problems before going to Africa, but soon became depressed, anxious and suspicious.

"I became so paranoid that I thought everyone was talking about me, and I had to go to the doctor right away he said, 'What are you on?' And I said, 'Lariam,' and he said, 'Get off of it.'"

Soldiers blame drug for psychological problems

Mefloquine had already come under scrutiny, withCanadian soldiers blamingthe drug for psychological problems they experienced in Somalia in 1992-93. Others alsoreported having hallucinatory nightmares that felt like out-of-body experiences.

Konecny said the doctor who prescribed the drug for her did not tell her about any possible side effects. She chose mefloquine over other possible anti-malarial drugs because it was inexpensive and only needed to be taken once a week.

Shestopped taking the pill after a two and a half months because of thepsychological problems she experienced, but she says her mental health issuescontinued for the rest of her time in Ghana and after she returned to Canada.

"So right away when Icame back the biggest ones were anxiety and depression...and then with the depression Istayed in bed a lot...Istarted seeing a psychiatrist here in Windsor and Iwas treated for anxiety and depression and also added on a mood disorder.

Travel doctor has heard complaints

Travel medicine clinic doctorPeterTeitelbaumsaid over the years he's prescribedmefloquinefor his clients in Ottawa. But more and more he now prescribes other anti-malaria medications.

It didn't take very long to become apparent to me that mefloquine sometimes caused problems for people.- Dr. Peter Teitelbaum, Riverside Travel Medicine Clinic

"It didn't take very long to become apparent to me that mefloquine sometimes caused problems for people I certainly had people coming back for a second or third trip who said I don't want to take that pill again.

"A very common thing was vivid dreams or nightmares, that was the most common complaint I heard," he said. He also had reports of insomnia and, in rarer cases,depression and paranoia.

Earlier this year Health Canada updated its information on the drug, warning patients to avoid it if they have ever experienced seizures or any psychiatric issues.

According to Dr. BarbaraRaymond, with the Public Health Agency of Canada, bad dreams, insomnia and sleep disturbancesare not uncommon. But she said"anything more serious, psychological psychiatric effects are considered to be rare.Less than one in ten thousand people would experience such an occurrence."

Official rate of adverse reaction to drug called into question

Doctors and patients questionthat rate, saying serious issues are likely more common.

Teitelbaumsays Health Canadaused a "passive reporting system," meaning the onus is on the doctor and patient to report any adverse effects.

He says without any system of registering or tracking patients, most people experiencing mental health issues will not take the time to file a report.

"It's not compulsory reporting and they're not going out and asking us," says Teitelbaum.

..more stories are starting to come in, of people saying..that could very much explainwhat is happening to me.- Cathay Wagantall, Conservative MP

No plans to take drug off shelves

It's estimated about 30,000 people are prescribed mefloquine each year in Canada, down from twice that many a year in the early 2000s.

Health Minister Jane Philpott says there are no plans to take the drug off the shelves in Canada, but that her ministry will continue to monitor its use.

"The department makes decisions addressing the efficacy of this medication and all other medications on the basis of scientific knowledge and as new information comes to light, they bring that information forward," she said.

Ironically, Jessica Konecny contracted malaria, after going off mefloquine while she was still in Ghana.

She says she became terribly sick at the time, but quickly recovered.

Given a choice, she said she'd rather get malariathan deal with the after-effects of the drug.