Malaria drugs, yes or no?

[dstehouwer]

Who has experience with or an opinion about the malaria drug Lariam? It is a drug that can be used against malaria when you’re visiting a malaria-area longer than a few weeks, in contradiction to Malarone, which is used for short visits to malaria areas, or can be used as an emergency medication, so we’ve been told.

We are a couple now travelling on our Honda Africa Twins in Mexico, and are travelling south. Soon we have to decide wether or not to take malaria medication preventively.

At first, we decided just to take the Malarone with us to use only in case of emergency, so when we get malaria and can’t go to a hospital fast enough, and not take any other medications for the following reasons:
- Lariam is known for possible side effects like hallucinations, depressions, etc. (although just a few percent of people is suffering from these side effects, it doesn’t sound like a nice drug to us…)
- Malaria drug can prevent malaria, but it is not guaranteed, so you have to be careful anyway
- Malaria is more difficult to detect in a hospital once you’re using a malaria drug

But, now we are in doubt whether or not to use Lariam as a preventive drug, because at the moment we find it almost impossible to prevent mosquitoes from stinging us, so how can we prevent getting malaria later on when we are in malaria area’s?

If you have experience with this subject, please let us know your opinion and experience. Thanks for your advice!

Greetz, Daan and Mirjam (www.farawayfromflakkee.nl)

[brclarke]

I took Lariam on a visit to south India back in 1999.
I didn't have any side-effects other than sometimes a bit of a stomachache right after taking the pill. On the other hand I've heard of some folks having quite wicked side-effects.

Personally, I would take other steps to avoid all mosquitoes, as they carry a variety of diseases. I think south of Mexico you are much more likely to catch dengue fever than malaria, and there is no vaccine or treatment for that.

[djadams]

I think it's worth taking a preventative - none is completely effective, but every little helps - as you say it's impossible to prevent all bites.

On our trip through Africa, we used Doxycycline as a preventative, very cheap and none of the harsh side effects that some people suffer with Larium. The one side effect it does have is that you mustn't take it on an empty stomach, or you will probably throw up - it happened to us when we'd not had enough breakfast before taking our daily tablet... Another advantage of Doxy is that it's an antibiotic, which can help against stomach upsets at the same time (not that taking antibiotics long term is ideal in any way, just nicer than getting malaria...).

Lots of different options, but for long term use, I felt that Doxy was the best way forward for us. And we're both still alive...

[chris]

I took Larium on my trans Africa trip 11 years ago. No side effects other than great (IMHO) sexual fantasies in my dreams on the night I took my weekly tablet (every Tuesday, if I recall correctly) Sadly, no dreams on any other nights

Didn't get malaria either.

HTH
Chris

[travelHK]

I took larium for an pretty long trip in amazone and didn't have any side effect but few year later I did get malaria after a short trip in Guayana , I will always recommande to take what ever the local doc are recomanding and wear long sleeve at night.

[misterpaul]

I took doxycycline in Africa, and I've taken larium in SE Asia. I followed the instructions and haven't had any bad side effects from either.

I'm not keen on taking medication long term but I'm one of those people who the mosquitos love, so chose to take the pills. If you're lucky and don't get bitten so much, then maybe going with some testing kits and treatment doses of medication is better for you.

If you decide to take the pills make sure you choose one that covers you for the region you're travelling to. Not all pills will cover you everywhere.

For some further reading there's lots of good info on the Centres for Disease Control and Prevention website:

CDC - Malaria

[damien1985]

iv taken doxy for a six week period for the last five years while all over africa.i find it good, its easy to take and all it does is increase your emune system activity, theres no side effects and in my opinion is an easy if not perfect solution
damien

[Tenere99]

I've never used anti-malarials in 25 years of travel and never caught malaria. Having said that I have had dengue twice, apparently the third time can kill you. It's all good.

[markharf]

Whereas I've generally used anti-malarials wherever I go and have had acute malaria twice....but never dengue. There's a takeaway lesson here, for anyone interested, sometimes put as follows: the plural of "anecdote" is not "data."

In other words, if you go on the internet for information and make life-altering decisions on the basis of someone saying "I've been doing it this way all my life and nothing bad has ever happened, so do it my way and you'll be fine," or "I've taken all possible precautions and none of them ever did me a bit of good," or even "Everything has always worked perfectly for me, so do exactly as I've done and you'll achieve overlander nirvanna," you stand a good chance of being deeply disappointed. Or sick, or dead, or whatever.

These choices are best based on statistics, not anecdotes. Ask yourself, what are the chances of getting ill, and what are the likely consequences if I do? And ask, what are my options and what positives and negatives attach to each? Then make the best decision you can.....but try to have a backup plan, since it's all about probability, not certainty.

Hope that's helpful.

Mark