Mefloquine Madness

These are my woes:

being wide-awake when I should be fast-asleep

then falling asleep only to be trapped in a horrible, ridiculous dream that causes great distress

and when I finally do wake up, I don’t want to go back to sleep.

It’s the worst. 

Mefloquine (“Mef” for short) is an anti-malaria drug. This is the Cliff’s Notes version of how it works:

A malaria-infecteed mosquito will bite you and insert the virus into your body. The virus goes to the liver and hangs out there for a while until you start feeling Malaria symptoms (high fever, fatigue – flu-like, but worse). The idea of this prophylaxis is that it will keep the malaria that is already swimming around in my blood dormant. So yes, I have malaria but as long as I take this medication, I will not experience symptoms (It is expected that I continue taking my prophylaxis until well-after I return home to be sure the virus doesn’t affect me upon completion of my service).

Mefloquine is pretty potent stuff. It’s half-life is 21 days. It’s preferred by Peace Corps because (they say) volunteers who take Mefloquine will NOT get malaria, whereas those volunteers who take another prophylaxis (Doxy or Malarone) are are more likely to get malaria because they will forget a dose (where the half-life is only 1 day). The side effects of Mef are ridiculous – enough to make you wonder: maybe malaria isn’t so bad, compared to this? Of course, I’m not curious enough to find out.

The side effects include: vivid (sometimes sensual, sometimes violent) dreams, hallucinations, insomnia, mood swings (to name a few).

I have experienced all of these. Insomnia affects me most nights (to the point where I sleep in shifts throughout the day/night). I am quick to experience anger and frustration for what seems like no reason. Vivid dreams do not seem so awful, but after dreaming that I brutally murdered people (and I knew it was just a dream, I tried to wake myself up from sleep, but I couldn’t. It was like I had to play the murders through – like a movie, where I wasn’t allowed to leave the theater) made me sick to my stomach and, quite frankly, scared the bejesus out of me. Insomnia is actual preferable in some bad dream cases. Hallucinating is the scariest side effect – not only are you seeing something that isn’t real, you can’t escape it. You can’t just close your eyes and it will disappear. It will be there until your mind allows it to leave.

I am supposed to take one 250mg pill each week. The real dosage is one pill every three weeks, but some people (Peace Corps headquarters) think that it would be easy to forget a pill if it is taken so infrequently. So, I’m popping these bad boys weekly and I can only wonder how that affects the side effects that I am experiencing.

At any rate, I have already spoken to the Peace Corps Malawi doctors about switching to another drug. For now, I am reducing my dose (breaking the pill in half). If side effects persist, I’m going to have to switch to a different drug.

Just giving you the inside scoop on anti-malaria drugs – I’m sure you are a better person for knowing this tid-bit of information.