Malaria Prophylaxis for Patients with Controlled Depression

Introduction to Malaria Prophylaxis

The British Medical Journal recommends that mefloquine should not be given to those with a history of serious psychiatric disorder, including depression, due to its significant neuropsychiatric risks 1
The British Medical Journal also reports that the drug causes neuropsychiatric side effects including anxiety, depression, sleep disturbances, nightmares, hallucinations, and overt psychotic attacks in a significant proportion of users 1

The British Medical Journal and other medical guidelines suggest doxycycline as the second-line choice for patients unable to take mefloquine, as it is recommended as an alternative for those visiting high-risk areas but unable to take other antimalarials 1, 2
Doxycycline requires daily dosing of 100 mg starting 1-2 days before travel and continuing for 4 weeks after leaving the malarious area, with the main limitation being photosensitivity—patients must avoid excessive sun exposure 1, 2

The British Medical Journal states that chloroquine has limited efficacy in most malaria-endemic regions due to widespread resistance, particularly in sub-Saharan Africa and Southeast Asia 1
The British Medical Journal also notes that while chloroquine has fewer neuropsychiatric side effects than mefloquine, its poor efficacy makes it unsuitable for most travel destinations 1