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Staying Healthy on the Road Medical info, e.g. malaria, vaccinations, travel medical tips, medical insurance, where to find a doctor.
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Old 3 Jun 2005
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Warning: Lariam & long-distance motorcycling

I received several testimonies recently from friends who got into serious troubles after using Lariam as anti-malarial medication. One experienced paranoia, nightmares, aggressive behavior, depression and suicidal tendencies that lasted for several months after he stopped taking the medication. Now, 12 months later, he still has periods of depression and important memory gaps.

He shared his experience with a group of 30 persons. Two of them replied with their own horror stories. A guy had a paranoia and crisis of anxiety so deep that, one month after stopping the treatment, he ended up in the emergency room in Jordania. A girl said that she's "slowly recuperating from 3-months of Lariam in 2002 (hormonal problems)".

When Merritt and I left for 6 or 9 months through Africa, my aunt (who is a doctor) told us that she would never prescribe Lariam for such a long period of time because of the neurological side-effects.

For those of you who consider using that medication, you might want to read more information on the following web site:

Following links from that web site, I learnt that the manufacturer of Lariam even warns that "caution should be exercised with regards to activities requiring alertness and fine motor coordination such as driving, piloting aircraft, operating machinery, and deep-sea diving, as dizziness, a loss of balance, or other disorders of the central or peripheral nervous system have been reported during and following the use of Lariam."

Alertness and fine motor coordination? Sounds like an euphemism for "Motorcycling in Third-World Countries"! So watch-out...

Pierre (& Merritt too)
Pierre Saslawsky
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Old 3 Jun 2005
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Note: I am not a doctor!


Interesting story, and I feel sorry for your friends.

Just to put another side to the story...

I spent a year in SE Asia between 2003/4, and for a significant part of that I was working on a conservation project with a team of people camping in the jungle (lots of knives and tools flying about, so alertness was important!). Needless to say, everybody was on anti-malarials. Some were on doxycycline, others Lariam (Mefloquine), and a few others were on other types. Reactions ranged widely. A couple of people did have reactions severe enough to warrant them changing medication (some from Lariam to doxy, others from doxy to Lariam), but the majority were fine. Also note that the alternative medicines are also not without their problems, whether it be an increased sensitivity to the sun, or stomach problems -- severe in one case.

I took Lariam for about a year with no problems whatsoever. Not even a vivid dream!

Lariam does have one advantage for folk concerned with reducing the amount of equipment they take, it is once a week rather than every day.

I guess all I'm trying to say is that "YMMV", mine obviously did. Lariam does have problems, but with very, very few exceptions it is better than getting Malaria. Like all things in this business it is a matter of balancing risk.

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Old 4 Jun 2005
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My 2 bits worth. In 1997 I was taking Larium while in Africa for 4 months. I still did get Maleria in Tanzania and yes the anti malaria drugs reduce the chance of getting it but I still got it. The side effects to me was not worth it plus it just masks the symptons. I since have travelled another 30 countrys and do not take any anti malaria drugs any more. If I get malaria again I will know right away and wont be guessing. Then I will get treated on the spot by the local doctors. I was told in the UK larium was banned and taken of the shelf because of wild side effects...I can back the side effects all the way.
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Old 9 Jun 2005
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Strangely, sometimes Lariam has no side effects, when someone DOES have side effects with something else.

One traveller was getting terrible side effects - sounding like Lariam - on something else - and was afraid to switch to Lariam because of all the stories he had heard. He finally switched, and was delighted - NO problems!

as usual, ymmv and everyone is different!

There's a number of posts on the topic - search the whole site on

lariam mefloquine chloroquine

for some relevant information.

Grant Johnson

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One world, Two wheels.
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Old 10 Jun 2005
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From what I read on the HUBB and elsewhere, the side-effects from other medecines are just mild inconveniences compared to Lariam, and they stop after you stop taking the medecine. Not so much so with Lariam that can fry your brains for months afterwards, or even years. It is also, as far as I know, the only malaria medecine that a number of doctors advise against.
Pierre Saslawsky
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Old 13 Jun 2005
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In my personal opinion there is only one side-effect worse, and more permanent, then that of lariam...
It,s called "death in two day,s after catching malaria tropicana".
I have been told by experts that this side-effect lasts a very very long time.

Most of the "side-effects" of lariam come from the USA-market... and if you ever have watched a USA-comercial... youll never take any medicine again..... Aparently you can get a severe stroke and simultaniously a heart-attack folowed by diarea and mild dizzyness if you use vitamine-suplement X.

Seriously, I took lariam for 45 weeks while riding my bike and had no problem what so ever.
But there is much about the stuff in the HUBB. Search and find...

But most important... decide for yourself and NEVER EVER (!!!) advice someone not to take a drug you don,t like.


- www.maartensworld.com -
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Old 13 Jun 2005
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But most important... decide for yourself and NEVER EVER (!!!) advice someone not to take a drug you don,t like.
The issue isn't what I like or what I don't like. The issue is the information that groups of users of that drug have collected in the past several years - information which I thought would be of interest for my motorcyclist friends.

I'm glad Lariam did work for you and others (not everybody who smokes dies from lung cancer) but this drug is far from being innocuous, there are alternatives to it and the web site that I pointed out allows you to make more informed choices.

Hope this helps,
Pierre Saslawsky
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Old 6 Aug 2005
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Interesting observations about Larium. I am a professional pilot, and I am not allowed to take Larium - meaning, if I take it, I am not allowed to fly a plane. This is a long-standing rule (about 15 years now) of the Swiss Civil Aviation Authority. I do appreciate Maartin's point about the Americans worrying about everything, but I think there are some legitimate concerns that need to be considered before taking Larium. It is a question of balancing risks.

I recently took Malarone as a prophylactic while in Chad and Cameroon - I had no problems with it, and it was prescribed to me by my aviation medical examiner.

Given a choice, I personally prefer to take Doxycycline, but in certain countries, it seems that the mosquitos (or the parasites they carry, whatever) are particularily high risk. By example, if I have to go to Kenya, I take Doxy, but to Central Africa, I will choose Malarone.

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Old 5 Jan 2006
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I have previously posted my experiences with Lariam/Mefloquine which can be found here:


Despite my experiences, amongst my friends & colleagues I did continue to advocate the use of Lariam for prevention of malaria where the medical advice to use it is good and the user is aware of the risks. For most people apparently the benefits outweigh the risks.

Please do make sure you don't get dehydrated at any time whilst using Lariam. I don't think this is stressed highly enough. Ensure you do follow the advice to keep alcohol consumption low, please don't drink any, if at all possible.

Of course your doctor may decide the risks are too high and advise a different medicine for prevention of malaria if he/she knows you are going to get routinely dehydrated by riding a bike in a hot country, with little space to carry 15+ litres of water per day, that even if you do, you can't resist a few s after a hot day in the saddle or will sit in the Saharan sun at midday changing a punctured innertube. Maybe he's done a recent course on tropical medicine, diligently reads his journals, and newly published papers, and is also well trained and interested in risk assessment of patients needs for specialist applications, or maybe he plays golf in his spare time? Different doctors may give different advice, it may be worth getting more than one opinion, sometimes they can make errors of judgement & sometimes they can be completely wrong- mine advised to take Lariam again *after* my severe reaction, which was extremely dangerous and completely wrong. (Thanks Dr Hodson, Park Farm, Derby).

Now to be fair, the good doctor needs some input from you too. Make sure he's aware of the conditions that you'll subject yourself to (hopefully you know what to expect!) - unless you've got your feet up on a Nile cruise package tour with a plentiful water supply. Also you should avoid driving and hazardous work until you know how the drug affects you (according to my patient data-sheet) so you may need to start Lariam more than 4 weeks before your trip; 1 week to see if it affects you with dizziness or disturbs your balance, or causes depression/anxiety/hallucinations/delusions/hearing disorders/palpitations, then if it does, 3 weeks to get it out of your system (don't ride your bike at this time), then some time, however long, required to try an alternative.

It seems that since the last time I posted about Lariam, resistance has been developing, so clearly medical advice should now balance the reduced benefit against possibly higher risks caused by dehydration and the hazardous nature of riding a bike.

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Old 7 Sep 2006
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I have a friend who is military doctor and confirmed cases of mental problems brought on by Lariam. These guys were your normal soldiers until they took this drug and then went off the deep end with various psychological problems. Most did recover fully after a period of time.
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