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Journal of Parasitology Research
Volume 2015, Article ID 260106, 8 pages
http://dx.doi.org/10.1155/2015/260106
Review Article

Rational Risk-Benefit Decision-Making in the Setting of Military Mefloquine Policy

Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 782, Baltimore, MD 21205, USA

Received 24 July 2015; Accepted 7 October 2015

Academic Editor: Boyko B. Georgiev

Copyright © 2015 Remington L. Nevin. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Mefloquine is an antimalarial drug that has been commonly used in military settings since its development by the US military in the late 1980s. Owing to the drug’s neuropsychiatric contraindications and its high rate of inducing neuropsychiatric symptoms, which are contraindications to the drug’s continued use, the routine prescribing of mefloquine in military settings may be problematic. Due to these considerations and to recent concerns of chronic and potentially permanent psychiatric and neurological sequelae arising from drug toxicity, military prescribing of mefloquine has recently decreased. In settings where mefloquine remains available, policies governing prescribing should reflect risk-benefit decision-making informed by the drug’s perceived benefits and by consideration both of the risks identified in the drug’s labeling and of specific military risks associated with its use. In this review, these risks are identified and recommendations are made for the rational prescribing of the drug in light of current evidence.