I’m traveling to India in a few weeks and therefore must take Malaria medicine. The options my doc gave me are doxycycline and mefloquine, the latter being linked with depression, anxiety, etc., and the former being an everyday antibiotic. Antibiotics are tough b/c they say so much energy, but I don’t want to be depressed. Has anyone ever taken these things and attempted to continue training? Any advice would help.
I’ve taken Larium, the commercial name for Mefloquine. I’ve used it before prolonged exposure to malaria carrying mosquitos in the jungles in Southeast Asia (Vietnam, Thailand, etc.) and for travel through and around Saharan and sub-Saharan Africa. I was in the jungle in Southeast Asia non-stop for over two weeks with no structures to sleep in- sleeping on the ground, in the jungle. I was constantly wet during those 2+ weeks. Someone told me we were bitten by malaria infected mosquitos many times throughout the day.
Larium did product some very weird dreams while you were sleeping. I’ve never taken any recreational drug or drank alcohol, but tha must be what it is like. It was quite a “powerful” experience and the dreams were odd and vivid and frequent for the first few days. By the time I got in country they were largely gone.
I have friends who have taken mefloquine as an alternative to Larium because the side effects of Larium were “too intense” according to them. That struck me as odd since the side effects of the Larium really weren’t all that bad- the dreaming was weird, but it didn’t disturb my sleep, you just remembered weird dreams.
Perhaps Larium may be an alternatve to your concerns over Mefloquine. As with any medical advice here on Slowtiwtch, consult your physcian…
Best of luck.
Just make sure you are getting something that fits with the resistance pattern in the area you are traveling to. I don’t think anybody remembers this stuff off the top of their head, but the CDC site is very complete:
http://wwwn.cdc.gov/travel/yellowBookCh4-Malaria.aspx#647
That being said, if doxy is an option for you, 100mg per day of doxy is pretty dang benign.
Thanks Tom,
I always like to hear advice from the first hand. Unfortunately, most of the time the doctors have not taken the med. My friend took mefloquine last year on a similar trip and had some funky experiences, and he doesn’t recommend it. My objection to the antibiotic is that it is everyday for 16 weeks, which bites into a good chunk of my summer. However this sounds, I also weigh the possible negative side effects the drugs will have on my training once I return as I am racing Louisville at the end of the summer and would like to do very well.
mefloquine is a scary drug, the only thing you can say for it is that it’s better than getting malaria. I was treated with it for cerebral malaria, together with an antibiotic IV. Between the drugs and the disease, it was quite a trip.
Since then I’ve taken mefloquine/Lariam prophylactically: no serious side effects, didn’t even have the weird dreams.
Doxycycline can increase photosensitivity, ie stay out of the sun. I’ve gone through a course of it for a different disease, it wasn’t any worse than any other antibiotic. Of the two I’d be inclined to this one, since the side effects of the other can be truly terrifying.
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603030.html
In whatever case, the drugs don’t provide immunity. Make sure to carry and use lots of repellent, long-sleeve shirts, pants, wear socks: and get inside around dusk and after dark. Take your own mosquito net for the bed.
I’d suggest taking the drugs. The effects of malaria are far worse than antibiotics; and it stays with you forever.
took doxycycline in Thailand, Malaysia, and Cambodia. Heard stories (perhaps anecdotally) of psychotic breaks on Larium. Don’t think mefloquine was an option for the area.
Doxy is an antibiotic, it’s a pretty low dose. I think I took along some pro biotics (the ones you don’t have to refrigerate) to replace some of the healthy flora. Ditto on the sun sensitivity.
As said, the most effective prevention is long sleeves, avoid being exposed at dusk and dawn. Can also use mosquito coils and… what’s the stuff you soak your clothes in, . Also deet.
I’ve taken doxycycline for travels in Africa and the northern Middle East. I never had a bad experience with it, had no side affects other than being told that it will make your skin more susceptible to sunburn which I didn’t experience. I have heard bad stuff about the other option you’re considering, but have not used it personally. Adam
Malarone (atovaquone / proguanil) is another option if cost isn’t an issue. It doesn’t have the potential psychosis as lariam dose. It is once daily tablet like the doxycycline would be whereas the lariam is once weekly dosing. Of these, all 3 are okay. The side effects will depend on you individually so it will be hard to tell if you will even have trouble with lariam. The doxy may have more stomach upset than the others (which might not be good since you will be in India trying their amazing cuisine), but that is typically with Antibiotics.
Good Luck
-andrew
Hi,
i’m taking Malarone and Chloroquine 3 or 4 times per year for 3 to 6 weeks span and never had any side effect, like Kev said, it depends on the person … I know that it is recommended to take what the doc suggest (if he knows his thing) because some countries have developped a resistance to these meds over the years. I know Haiti has a strong resistance to Lariam , and i think West africa too.
Many of my colleagues take these meds only during and after the rainy season where the mosquitoes are ganging up … if you have a good cream like the watkin’s insect repellant and sleep under a net (less than 30 $) … you should be ok.
Doxycyline nearly killed me in Thailand.It seems a heavy dose of Tetracyclene when I was a kid made me allergic and I didn’t know until I got back to Oz and did some research.I was in Thailand for three months to do a bunch of races and after a week or so started to feel pretty weak.It got worse and worse and soon I was a shiverring mess in my friends bar while everyone else was sweating.My girlfriend was really starting to freak out when I told her my pee was now brown and my crap was yellow.In the middle of the night on about the third day of my symptoms she turned the light on and my eyes and skin had turned yellow.My liver was shutting down.
The local cops(who we had befriended)took me to the nearest town and we went to the local hospital.They assumed I was just another stupid tourist who had drunk too much Mekong wiskey(good shit) but when I passd out in the waiting room they took me in for a bunch of tests.The look on the face of the doctor was enough to scare me when she asked,"do you have insurance?"I said yes and she told us that I was too sick for their hospital and an ambulance was on it’s way to take me to the next city 70k away.
My situation got worse in the ambulance and my poor young girlfriend was now in charge as they told her I was fading away.The reaction at the hospital was marginally more positive and as I drifted in and out of consiousness I remember them asking her for contacts for my next of kin and were setting about calling the Australian Consulate to prepare them for my imminent demise.
I came to a day and a half later in an awesome private room wth my girlfriend asleep in on the couch next to my bed.I had dodged bullet but my liver function tests were still off the charts and nobody knew what to do.I was put on a huge cocktail of drugs and spent the next week in hospital slowly recovering.After the hell I had felt for the initial few days that hospital suite felt like a five star hotel room.The food was great,I had cable t.v and we got room service three times a day.Awesome!!
A month or so later I did a bunch of research and found out that for a small group of people doxycyline can be fatal.Apparently the mines in New Guinea have lost a few expats to the drug.They were not as lucky as I because they were not able to get to a hospital soon enough.
Hope you enjoyed my little tale of woe.
If you have any questions about altitude sickness I tell you the story about the time I needed to be treated by four,backpacking Aussie nurses in La Paz,Bolivia after spending too much time riding my MTB at over 4,500 meters.It took them over a week to get me well enough to be flown out of the country.
Too much fun!!!
.
Renamed…DeLarium.
I took mefloquin courtesy of Uncle Sam during a few trips to the mideast. Aside from the crazy dreams which I guess you could also contribute to what was going on locally, I also had some intestinal issues (commonly referred to as the “Hershey Squirts”). This was pretty common, luckily MRE’s work to reverse that.
Quit taking it when it got to hot / dry for the bugs, but I imagine it’s a whole different story in India, probably worth a few trips to the bathroom to avoid malaria.
Good Luck!
Where are you going in India?
If you are only in Mumbai or Goa there is no need for meds.
I took the docy when I went to Venzuela and my only side effects (that I recall, it was in 1998) was that my skin became very very dry. Nothing funky.
I live in an area where there is malaria,ross-river fever,enchephylitis,dengue fever and English backpackers.
The most common illnesses reported at the local base hospital are backpacker related infections.
True story!
.
My wife took Larium/Mefloquine, and went pretty kooky, and there are numerous stories of people getting very serious side-effects. I’d avoid if you can.
Spent a year in Vietnam and was constantly in the jungle, swamps, plains, mountains–i.e., extreme exposure to malarial mosquitoes. We all took Doxy regularly–unless you’ve an allergy to this antibiotic there should be no problem. Doxy will not kill or prevent the malaria–it merely suppresses it by beating it down. Once you’re clear of the area you go on the Melfloquin which will actually cleanse your system by killing any Malaria present in your body. This is the regime we used in Joint Task Force Full Accounting (looking for MIA in Vietnam) and it worked for us. I have to say though that I did not personally go through the whole regime of Melfloquin when i came out of country. I started to have the most vivid technicolor horrific dreams to the point where i really didn’t even want to go to sleep because i knew what i was going to have to endure. i decided the risk of malaria was better than that shit so i stopped after a week or so of that med and took my chances with the disease.
your mileage may vary–best of luck
v/r
Been to India for work several times, including Bangalore, Calcutta, Mombai, Chennai and new Delhi. Depending on where you are going, and the amount of mosquitos there and what you are going to be doing. I was there for work, but can say the mosquitos were WAYYY worse in Calcutta than Delhi or BGL, and they were 1000X worse at night, so it depends on your needs. I think I got maybe one or two bites in the 5 weeks I have been over there.
Anywho, I took Malarone and had virtually no side effects, except some minor insomnia, which went away within a few days of taking it. Bring DEET regardless!
I hope you are getting vaccinated for all the other stuff too, such as Hep A, Hep B, tetanus, rubella boosters, etc. I felt like a human pin cushion for the first 2 weeks before my first trip with all the shots.
Hi Kev,
I’ve had two extended periods of mefloquine usage: 6 months in SE Asia and 3 months in Africa. I had zero side effects both times, not even the vivid dreams that some people experience. While I wasn’t training during these trips I was very active, doing a lot of hiking and climbing, and as far as I could tell the mefloquine had no effect on me. And as other posters have noted, it sure beats contracting malaria.
best of luck!..don’t get hep A. don’t mix your bottled water with ice. One sure way of getting hep A. I wouldn’t be worried about getting malaria. I have been there numerous and got bitten. I let the mosquitoes bite me first and then i kill them!!!