ArticleInternational journal for parasitology. Drugs and drug resistance2014
Idiosyncratic quinoline central nervous system toxicity: Historical insights into the chronic neurological sequelae of mefloquine.
Article in International journal for parasitology. Drugs and drug resistance, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- The effect of mefloquine dose on outcome of uncomplicated falciparum malaria treated with artesunate-mefloquine: a WWARN systematic review and individual patient data meta-analysis.Malaria journal · 2026Pooled it
- Review
- Rehabilitation of High-Level Dynamic Balance Skills in an Individual With Significant Nonprogressive Cerebellar Atrophy: Case Report.Archives of rehabilitation research and clinical translation · 2025Article
- Synthesis of New Enantiopure Aminoalcohol Fluorenes as Promising Antimalarial Compounds.ChemMedChem · 2025Article
- Accelerating antiviral drug discovery: early hazard detection with a dual zebrafish and cell culture screen of a 403 compound library.Archives of toxicology · 2025Article
- The Nociceptive and Inflammatory Responses Induced by the Ehrlich Solid Tumor Are Changed in Mice Healed ofJournal of parasitology research · 2024Article
- Experimental Evidence for Diiodohydroxyquinoline-Induced Neurotoxicity: Characterization of Age and Gender as Predisposing Factors.Pharmaceuticals (Basel, Switzerland) · 2022Article
- The Ototoxicity of Antimalarial Drugs-A State of the Art Review.Frontiers in neurology · 2021Review
- A serious nightmare: psychiatric and neurologic adverse reactions to mefloquine are serious adverse reactions.Pharmacology research & perspectives · 2017Article
- Accidental hydroxychloroquine overdose resulting in neurotoxic vestibulopathy.BMJ case reports · 2017Article
- Antimalarial drugs and the prevalence of mental and neurological manifestations: A systematic review and meta-analysis.Wellcome open research · 2017Article
- Adverse effects of mefloquine for the treatment of uncomplicated malaria in Thailand: A pooled analysis of 19, 850 individual patients.PloS one · 2017Article
- Prolonged Neuropsychiatric Symptoms in a Military Service Member Exposed to Mefloquine.Drug safety - case reports · 2016Article
- Mefloquine-associated dizziness, diplopia, and central serous chorioretinopathy: a case report.Journal of medical case reports · 2016Article
- Neuropsychiatric Adverse Reactions to Mefloquine: a Systematic Comparison of Prescribing and Patient Safety Guidance in the US, UK, Ireland, Australia, New Zealand, and Canada.Neurology and therapy · 2016Article
- Prolonged neuropsychiatric effects following management of chloroquine intoxication with psychotropic polypharmacy.Clinical case reports · 2015Article
- Malaria Prevention, Mefloquine Neurotoxicity, Neuropsychiatric Illness, and Risk-Benefit Analysis in the Australian Defence Force.Journal of parasitology research · 2015Review
- Rational Risk-Benefit Decision-Making in the Setting of Military Mefloquine Policy.Journal of parasitology research · 2015Review
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Mefloquine is a quinoline derivative antimalarial which demonstrates promise for the treatment of schistosomiasis. Traditionally employed in prophylaxis and treatment of chloroquine-resistant Plasmodium falciparum malaria, recent changes to the approved European and U.S. product labeling for mefloquine now warn of a risk of permanent and irreversible neurological sequelae including vertigo, loss of balance and symptoms of polyneuropathy. The newly described permanent nature of certain of these neurological effects challenges the conventional belief that they are due merely to the long half-life of mefloquine and its continued presence in the body, and raises new considerations for the rational use of the drug against parasitic disease. In this opinion, it is proposed that many of the reported lasting adverse neurological effects of mefloquine are consistent with the chronic sequelae of a well characterized but idiosyncratic central nervous system (CNS) toxicity syndrome (or toxidrome) common to certain historical antimalarial and antiparasitic quinolines and associated with a risk of permanent neuronal degeneration within specific CNS regions including the brainstem. Issues in the development and licensing of mefloquine are then considered in the context of historical awareness of the idiosyncratic CNS toxicity of related quinoline drugs. It is anticipated that the information presented in this opinion will aid in the future clinical recognition of the mefloquine toxidrome and its chronic sequelae, and in informing improved regulatory evaluation of mefloquine and related quinoline drugs as they are explored for expanded antiparasitic use and for other indications.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.