The South African Pharmacy Council warned on Friday of the possible suicidal psychological side-effects of the popular malaria drug Lariam.
”We have not really alerted the public or placed advertisements to tell the public of the possible side-effects of Lariam. It is the duty and responsibility of pharmacists themselves to do this,” said the council’s registrar, Jan du Toit.
Du Toit was responding to questions about the distribution of the drug, which can lead to suicidal behaviour if given to patients with a history of illnesses such as psychotic disturbances, anxiety and depression.
He said that pharmacists had ethical rules governing them, and must make sure that when patients left their pharmacies, they were ”fully informed” about the correct use and possible side-effects of any drug prescribed to them.
The medical director of South African Airway’s Netcare Travel Clinics, Dr Andrew Jamieson, said that with business travel expanding into Africa, ”thousands of South Africans” travel to malaria-plagued countries and use Lariam.
”The medicine is associated with neuro-psychological side-effects in some people … and people with these underlying problems experience a worsening of the problem when using Lariam,” he said.
For example, when people travel to remote areas, it prompted anxiety, and this could be exacerbated even further by the use of the drug, with many a holiday ruined because of ”personality changes where people become aggressive or even lock themselves in their hotel rooms”.
”Travellers must be screened adequately and the drug should not be handed out indiscriminately,” he said.
Jamieson acknowledged that sometimes it was difficult to determine a person’s medical history. Many people, for example, said they were not being treated for any psychological illness, but admitted to taking Prozac for depression, which is a psychological illness.
The government’s national malaria programme manager, Patrick Moonasar, said that the Department of Health recommended the use of Lariam as an effective malaria prophylactic.
”It is a safe drug for usage for people with normal temperaments and who are psychologically well. But there are contra-indications, in, for example, anyone with mental instability or depression.”
Moonasar said the department had recently printed an updated prophylactic guide which would be distributed to pharmacies across the country. He said there were alternatives available should people not be able to take Lariam.
Both he and Du Toit did not want to be drawn into whether business imperatives for pharmacists might lead to an ethical hiatus, with Du Toit saying he ”firmly” believed pharmacists would not sell the drug indiscriminately.
”I am also not aware of any complaints we (the Pharmacy Council) received regarding Lariam,” Du Toit said. – Sapa