I Take Medicine That Might Make Me Go Insane

I’m still sadly too busy to really blog, so here’s another old entry I’ve been saving…More trip photos eventually.

Being right next to a nature reserve attached to Kruger National Park, I’m on the edge of a Malaria zone. What do white people living in a Malaria zone get to take?

PILLS!

Because Malaria is very not cool, Peace Corps insists that we take anti-malarial medication to keep us from dying and stuff. Everyone at my site thinks it is hilarious that I take preventative medication for Malaria. None of them do, and they’re doing fine. White people are weird.

Peace Corps South Africa gives us a choice between two medications. One is Doxycycline, an antibiotic. You take it everyday, hopefully with a hearty morning meal. But it’s not exactly a trip to the zoo. Wikipedia on the fun side effects:

Cautions and side effects are similar to those of other members of the tetracycline antibiotic group. However, the risk of photosensitivity skin reactions is of particular importance for those intending long-term use for malaria prophylaxis, because it can cause permanent sensitive and thin skin.

So we have sensitivity to sun…that’s handy to have in Africa!

It should be taken with a full glass of water, and patients should be upright for at least 30 minutes after administration to prevent irritation of the esophagus and stomach. It is also recommended to be taken with a small meal of a nondairy nature if gastrointestinal side effects occur.

And it makes your stomach angry.

Expired tetracyclines or tetracyclines allowed to stand at a pH less than 2 are reported to be nephrotoxic due to the formation of a degradation product, anhydro-4-epitetracycline

I don’t even understand this, but something about messing up your kidneys!

I don’t take Doxycycline (Doxy, to us hip aid-worker types). I had to take it for an illness, and it made me miserable. The sun felt like fire, my stomach got VERY ANRGY, and I have some fairly graphic digestive waste stories I’m keeping to myself. So what do I get to take? Wikipedia again…

Mefloquine hydrochloride (also known as Lariam or Mefaquin) is an orally administered medication used in the prevention and treatment of malaria. Mefloquine was developed in the 1970s at the United States Department of Defense’s Walter Reed Army Institute of Research as a synthetic analogue of quinine. The brand name drug, Lariam, is manufactured by the Swiss company Hoffmann–La Roche. In August 2009, Roche stopped marketing Lariam in the United States. Generic mefloquine from other manufacturers, is still widely available. Rare but serious neuropsychiatric problems have been associated with its use.

Blah blah malaria blah blah Walter Reed blah blah NEUROPSYCHIATRIC PROBLEMS? Are you ready to pound this “eat me” I found in yonder rabbit hole? Let’s start with the boring ones:

The FDA has reported an association with pneumonitis and eosinophilic pneumonia[9]

Mefloquine may cause abnormalities with heart rhythms that are visible on electrocardiogram. Combining mefloquine with other drugs that cause similar effects, such as quinine or quinidine, can increase these effects.

Ok, well, I don’t really need my lungs or my heart.

Neuropsychiatric effects are reported with mefloquine use…The FDA product guide states it can cause mental health problems including: anxiety, hallucinations, depression, unusual behavior, and suicidal ideations among others. Some have reported severe central nervous system events requiring hospitalization in about 1:10,000 people taking mefloquine for malaria prevention with milder events (e.g., dizziness, headache, insomnia, and vivid dreams) in up to 25%. When some measure of subjective severity is applied to the rating of adverse events, about 11-17% of travelers are incapacitated to some degree.

OH YEAH. It’s party time!

I was honestly pretty pumped for Mefloquine. When I hear “hallucinations”, I think “60s theme party”. But I’ve had disappointingly few side effects. Maybe some mild insomnia. When I first started taking it, me and another volunteer were convinced that we were hallucinating mosquito sounds when we tried to sleep, but this might have been psychosomatic. I remember my dreams a little better, but only a few have been especially vivid. I did recently have one involving a bunch of people I know dying, but it was a pretty standard bad-dream, and it wasn’t nearly as terrifying as the pre-mefloquine reoccurring dream I had during Peace Corps training where it turned out I was dead and training was purgatory.

So I happily pop my Mefloquine every Thursday. So far, no brain damage.

There is a 3rd way…something special called Malarone. But the Peace Corps (and the Army) don’t like to use it. It’s too expensive! U-S-A! U-S-A!

2 Comments

pdro says:

dude you don’t have to take that stuff. i didn’t in bolivia. owen wilson didn’t in india during darjeeling limited filming (i learned this at a new yorker talk with him on saturday night). anyway i think bono will save you from malaria.

03 Oct 11 @ 5pm

Rahul says:

tetracyclines are one of the few things that will mess you up if you take them after expiring

27 Oct 11 @ 8pm