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To: Ben Greenhouse <b.greenhouse@ut*.ca*>
Cc: John Dunk <screwloose@el*.co*>,
     Roderick Farb , techdiver@aquanaut.com,
     mdm@zk*.de*.co*
Subject: Re: Question: Malaria prevention drugs and diving.
Date: Wed, 19 Nov 97 15:43:25 -0500
From: "Maria D. Maggio" <mdm@zk*.de*.co*>

> Am I thinking of the wrong anti-malaria drug, or is doxycycline the one that 
has lately been reported to have bad side-effects such as severe hallucinations

I think you're thinking of mefloquine (which is sold under the trade name
of Lariam) which has the possible side-effect of hallucinations and
other nervous system reactions.  Doxycycline is what is recommended for 
folks travelling to an area with chloroquine-resistant strains of malaria 
but for whom mefloquine is contraindicated. Quite a few people think divers 
fall into this category as there have been cases where side effects of
mefloquine have been confused with DCS. 

To answer the original question, there have been issues with people
on mefloquine, but I've been on it for 12-24 weeks per year for the
last 5 years (I travel to PNG at least once and sometimes twice
per year), have dived heavily, and other than some slight
gastric disturbances when not taking it with food, haven't had
any problems or side-effects other than some pretty wild and
vivid dreams. I've thought about using doxycycline instead, but
I feel like I've tolerated mefloquine without problem for so long,
that I think the risk is low enough for me. Your mileage may vary,
so you'll need to weigh the risks  and benefits for yourself.
I would talk to the CDC for their recommendation for the area
you're travelling, but also consider alternatives with your physician.

			-Maria
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