Previous bad reaction to Malarone, considering my options now

I will go and see a doctor, update all my other shots etc etc. I’m just looking for some additional advice and experiences. You are not my doctor etc etc.

Last time I took Malarone I went cuckoo. I had crippling panic attacks and I think hallucinations or something.* Malarone is supposed to be the antimalarial that doesn’t make you crazy, so that’s a little upsetting. (The craziness was listed as a side effect, it’s just supposed to be rare.)

My doctor there, at the time, said I’d be better off taking my chances with malaria than stay in the state I was in. I then threatened the poor man, because crazy. :frowning:

So what I’d like to know: if Malarone had this effect on me, will the other meds likely be worse? I don’t really want to take the chance. Obviously, malaria would also be a nasty option, but I want to have an idea of what my chances are.

What about people who live permanently in malaria zones, what do you guys do?
*Not really hallucinations, I think, but sort of like horrible, horrible daydreams that seemed realistic, or as if it were at least likely to happen, and that I had no control over? Is that a thing?

I am not a doctor, and I am especially not your doctor.

Where are you going and what strain it malaria is there? I may take my chances in, say, South America, but I wouldn’t even consider it for a second in West Africa, where you WILL get malaria and it WILL be falciparum, which can kill you in 48 hours. I know of too many Peace Corps volunteers who decided to stop taking their meds and died to mess with falciparum.

If you do decide to wing it, make sure you know the symptoms like the back of your hand. Always, always, always carry treatment on your person (actually, do that anyway). I kept mine in a sock, which stayed with me any time I was more than 10 minutes from home. If you have any high fever, begin treatment immediately. Don’t wait for tests (which aren’t very accurate, anyway). If possible, make a slide with a blood smear (you need a kit, the technique is easy) before treatment so that you can get the strain diagnosed later at a reliable lab. That will help determine what follow up care you need.

What locals do, of course, is run a good chance of dying the first time they contract it as a toddler. If they survive that (and the brain damage that comes from chronic malaria as a kid), they likely develop extremely limited resistance to the local strain (though the strain the next town over might still kill them), and malaria becomes a chronic disease, sapping their energy and leading to repeated hospitalization, but rarely killing them.

No doctor in the world know how to treat westerners with malaria. Western doctors don’t know what they are looking for. Local doctors don’t understand why malaria is more serious in foreigners. You really need to know all the ins and outs of symptoms, treatment, and possible complications, because if you contract it, you are going to have to be the one to direct your diagnosis and treatment.

Anyway, I’d take doxycycline. It’s no fun, but it’s better than malaria.

Thanks sven, that’s really helpful!

I’m going to Angola, so I reckon I’ll just have to try my luck again with the meds. I absolutely will make sure to know the symptoms (I know them generally, but I’ll check out the local strains) as you recommend.

So the doxycycline, could you say why you like that one? I’m hoping someone knows a med that is really different from Malarone, but similarly unlikely to cause crazies. It’s just helpful before going in to the doc, to have an idea and make suggestions. But it might be a little specific…

Doxy is an antibiotic. It’s what they give people who might get crazy with other meds.

The drawbacks are that you need to take it daily, it can cause sun sensitivity, and it can cause an upset stomach. But it works and won’t make you nuts.

Any non-craziness would be great, I’ll take tummy trouble over insanity any day! Thanks a million even sven, I have something to discuss with the doc when I go in.

My husband took doxy when we were in India last year. IIRC the other drawback is that you have to take it longer when you return. But yeah, that’s not that big a deal when you’re looking at other real side effects.

FWIW we found the CDC page on various malaria drugs to be pretty useful:

Doxy, DEET, and cover up.