Mefloquine and malaria prophylaxis

In the UK, mefloquine (Lariam-Roche) has been marketed since 1990 for both malaria prophylaxis and for acute treatment of falciparum malaria. In 1991, we concluded that prophylaxis with mefloquine was appropriate for those travelling to areas where strains of Plasmodium falciparum resistant to chloroquine and proguanil are common. Since then, UK recommendations have changed several times. Recently, mefloquine's use as a prophylactic has been questioned because of reports of neuropsychiatric unwanted effects. This article discusses the place of f2p4oquine in malaria prophylaxis in light of these concerns.