Antimalarial chemoprophylaxis and the risk of neuropsychiatric disorders. Schneider, C., Adamcova, M., Jick, S. S., Schlagenhauf, P., Miller, M. K., Rhein, H., & Meier, C. R. Travel Medicine and Infectious Disease, 11(2):71--80, April, 2013. doi abstract bibtex BACKGROUND: Case reports and epidemiological studies have associated the use of mefloquine with neuropsychiatric adverse events. METHODS: We used the General Practice Research Database to conduct a follow-up study with a nested case-control analysis. We assessed the risk of developing first-time anxiety, stress-related disorders/psychosis, depression, epilepsy or peripheral neuropathies in patients using mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil for malaria chemoprophylaxis, as compared to unexposed travelers. RESULTS: Compared to non-users of antimalarials, the adjusted odds ratio in the nested case-control analysis for users of mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil were 0.71 (95% CI 0.56-0.90), 1.04 (95% CI 0.74-1.46), and 0.73 (95% CI 0.61-0.86) for anxiety or stress-related disorders combined, 0.54 (95% CI 0.41-0.71), 1.06 (95% CI 0.71-1.59), and 0.75 (95% CI 0.62-0.91) for depression, 0.69 (95% CI 0.35-1.36), 1.41 (95% CI 0.54-3.67), and 0.75 (95% CI 0.42-1.36) for epilepsy, and 1.22 (95% CI 0.50-2.99), 1.59 (95% CI 0.41-6.15), and 1.05 (95% CI 0.54-2.03) for neuropathies, respectively. The risk of all outcomes was higher in females than in males across all exposure categories. CONCLUSIONS: The risk of neuropsychiatric disorders was similar for users and for non-users of anti-malarial chemoprophylaxis, with evidence for elevated risks in some subgroups.
@article{schneider_antimalarial_2013,
title = {Antimalarial chemoprophylaxis and the risk of neuropsychiatric disorders},
volume = {11},
issn = {1873-0442},
doi = {10.1016/j.tmaid.2013.02.008},
abstract = {BACKGROUND: Case reports and epidemiological studies have associated the use of mefloquine with neuropsychiatric adverse events.
METHODS: We used the General Practice Research Database to conduct a follow-up study with a nested case-control analysis. We assessed the risk of developing first-time anxiety, stress-related disorders/psychosis, depression, epilepsy or peripheral neuropathies in patients using mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil for malaria chemoprophylaxis, as compared to unexposed travelers.
RESULTS: Compared to non-users of antimalarials, the adjusted odds ratio in the nested case-control analysis for users of mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil were 0.71 (95\% CI 0.56-0.90), 1.04 (95\% CI 0.74-1.46), and 0.73 (95\% CI 0.61-0.86) for anxiety or stress-related disorders combined, 0.54 (95\% CI 0.41-0.71), 1.06 (95\% CI 0.71-1.59), and 0.75 (95\% CI 0.62-0.91) for depression, 0.69 (95\% CI 0.35-1.36), 1.41 (95\% CI 0.54-3.67), and 0.75 (95\% CI 0.42-1.36) for epilepsy, and 1.22 (95\% CI 0.50-2.99), 1.59 (95\% CI 0.41-6.15), and 1.05 (95\% CI 0.54-2.03) for neuropathies, respectively. The risk of all outcomes was higher in females than in males across all exposure categories.
CONCLUSIONS: The risk of neuropsychiatric disorders was similar for users and for non-users of anti-malarial chemoprophylaxis, with evidence for elevated risks in some subgroups.},
language = {eng},
number = {2},
journal = {Travel Medicine and Infectious Disease},
author = {Schneider, Cornelia and Adamcova, Miriam and Jick, Susan S. and Schlagenhauf, Patricia and Miller, Mary K. and Rhein, Hans-Georg and Meier, Christoph R.},
month = apr,
year = {2013},
pmid = {23541791},
keywords = {Adolescent, Adult, Aged, Antimalarials, Chemoprevention, Child, Child, Preschool, Female, Great Britain, Humans, Infant, Malaria, Male, Mental Disorders, Middle Aged, Odds Ratio, Risk, Travel, incidence},
pages = {71--80}
}
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We assessed the risk of developing first-time anxiety, stress-related disorders/psychosis, depression, epilepsy or peripheral neuropathies in patients using mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil for malaria chemoprophylaxis, as compared to unexposed travelers. RESULTS: Compared to non-users of antimalarials, the adjusted odds ratio in the nested case-control analysis for users of mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil were 0.71 (95% CI 0.56-0.90), 1.04 (95% CI 0.74-1.46), and 0.73 (95% CI 0.61-0.86) for anxiety or stress-related disorders combined, 0.54 (95% CI 0.41-0.71), 1.06 (95% CI 0.71-1.59), and 0.75 (95% CI 0.62-0.91) for depression, 0.69 (95% CI 0.35-1.36), 1.41 (95% CI 0.54-3.67), and 0.75 (95% CI 0.42-1.36) for epilepsy, and 1.22 (95% CI 0.50-2.99), 1.59 (95% CI 0.41-6.15), and 1.05 (95% CI 0.54-2.03) for neuropathies, respectively. The risk of all outcomes was higher in females than in males across all exposure categories. CONCLUSIONS: The risk of neuropsychiatric disorders was similar for users and for non-users of anti-malarial chemoprophylaxis, with evidence for elevated risks in some subgroups.","language":"eng","number":"2","journal":"Travel Medicine and Infectious Disease","author":[{"propositions":[],"lastnames":["Schneider"],"firstnames":["Cornelia"],"suffixes":[]},{"propositions":[],"lastnames":["Adamcova"],"firstnames":["Miriam"],"suffixes":[]},{"propositions":[],"lastnames":["Jick"],"firstnames":["Susan","S."],"suffixes":[]},{"propositions":[],"lastnames":["Schlagenhauf"],"firstnames":["Patricia"],"suffixes":[]},{"propositions":[],"lastnames":["Miller"],"firstnames":["Mary","K."],"suffixes":[]},{"propositions":[],"lastnames":["Rhein"],"firstnames":["Hans-Georg"],"suffixes":[]},{"propositions":[],"lastnames":["Meier"],"firstnames":["Christoph","R."],"suffixes":[]}],"month":"April","year":"2013","pmid":"23541791","keywords":"Adolescent, Adult, Aged, Antimalarials, Chemoprevention, Child, Child, Preschool, Female, Great Britain, Humans, Infant, Malaria, Male, Mental Disorders, Middle Aged, Odds Ratio, Risk, Travel, incidence","pages":"71--80","bibtex":"@article{schneider_antimalarial_2013,\n\ttitle = {Antimalarial chemoprophylaxis and the risk of neuropsychiatric disorders},\n\tvolume = {11},\n\tissn = {1873-0442},\n\tdoi = {10.1016/j.tmaid.2013.02.008},\n\tabstract = {BACKGROUND: Case reports and epidemiological studies have associated the use of mefloquine with neuropsychiatric adverse events.\nMETHODS: We used the General Practice Research Database to conduct a follow-up study with a nested case-control analysis. We assessed the risk of developing first-time anxiety, stress-related disorders/psychosis, depression, epilepsy or peripheral neuropathies in patients using mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil for malaria chemoprophylaxis, as compared to unexposed travelers.\nRESULTS: Compared to non-users of antimalarials, the adjusted odds ratio in the nested case-control analysis for users of mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil were 0.71 (95\\% CI 0.56-0.90), 1.04 (95\\% CI 0.74-1.46), and 0.73 (95\\% CI 0.61-0.86) for anxiety or stress-related disorders combined, 0.54 (95\\% CI 0.41-0.71), 1.06 (95\\% CI 0.71-1.59), and 0.75 (95\\% CI 0.62-0.91) for depression, 0.69 (95\\% CI 0.35-1.36), 1.41 (95\\% CI 0.54-3.67), and 0.75 (95\\% CI 0.42-1.36) for epilepsy, and 1.22 (95\\% CI 0.50-2.99), 1.59 (95\\% CI 0.41-6.15), and 1.05 (95\\% CI 0.54-2.03) for neuropathies, respectively. The risk of all outcomes was higher in females than in males across all exposure categories.\nCONCLUSIONS: The risk of neuropsychiatric disorders was similar for users and for non-users of anti-malarial chemoprophylaxis, with evidence for elevated risks in some subgroups.},\n\tlanguage = {eng},\n\tnumber = {2},\n\tjournal = {Travel Medicine and Infectious Disease},\n\tauthor = {Schneider, Cornelia and Adamcova, Miriam and Jick, Susan S. and Schlagenhauf, Patricia and Miller, Mary K. and Rhein, Hans-Georg and Meier, Christoph R.},\n\tmonth = apr,\n\tyear = {2013},\n\tpmid = {23541791},\n\tkeywords = {Adolescent, Adult, Aged, Antimalarials, Chemoprevention, Child, Child, Preschool, Female, Great Britain, Humans, Infant, Malaria, Male, Mental Disorders, Middle Aged, Odds Ratio, Risk, Travel, incidence},\n\tpages = {71--80}\n}\n\n","author_short":["Schneider, C.","Adamcova, M.","Jick, S. S.","Schlagenhauf, P.","Miller, M. K.","Rhein, H.","Meier, C. 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