Question to the Department of Health and Social Care:

To ask Her Majesty's Government, further to the answer by Lord O'Shaughnessy on 7 November (HL Deb, col 1689) that a link between mefloquine and severe and persistent psychiatric symptoms has not been established, what assessment they have made of Lariam’s inclusion in the British Medical Journal’s Visual Summary for Psychotic disorders list as a possible cause of psychotic symptoms and the warnings in the Roche patient information leaflet that Lariam may cause serious mental problems.

As with all medicines, the Medicines and Healthcare products Regulatory Agency (MHRA) keeps the product information for mefloquine (which includes the patient information leaflet and the summary of product characteristics) under review. Mefloquine is effective in the prevention and treatment of malaria. The current product information states that neuropsychiatric adverse reactions may occur during treatment and includes warnings and precautions to minimise these risks. It also states that such adverse reactions may persist for months, or longer, even after discontinuation of the drug. It has not been established, however, that such adverse reactions may be permanent.

The reference to mefloquine in the British Medical Journal article on 8 November 2017, entitled Early psychosis for the non-specialist doctor, is consistent with the possible adverse reactions included in the mefloquine product information.