Because of the drugs very long half-life, the Centers for Disease Control originally recommended a mefloquine dosage of 250 mg every two weeks; however, this caused an unacceptably high malaria rate in the Peace Corps volunteers who participated in the approval study, so the drug regimen was switched to once a week.By 1991, Hoffman was marketing the drug on a worldwide basis.By the 1992 UNITAF, Canadian soldiers were being prescribed the drug en masse.By 1994, medical professionals were noting "severe psychiatric side effects observed during prophylaxis and treatment with mefloquine", and recommending that "the absence of contraindications and minor side effects during an initial course of mefloquine should be confirmed before another course is prescribed." Other doctors at the University Hospital of Zurich noted in a case of "a 47-year-old, previously healthy Japanese tourist" who had severe neuropsychiatric side-effects from the drug that
The neuropsychiatric side effects of the antimalarial drug mefloquine are well documented. They include anxiety, depression, hallucinations, acute psychosis, and seizures. The incidence of these side effects is 1 in 13,000 with prophylactic use and 1 in 250 with therapeutic use. The first randomized, controlled trial on a mixed population was performed in 2001. Prophylaxis with mefloquine was compared to prophylaxis with atovaquone-proguanil. Roughly 67% of participants in the mefloquine arm reported greater than or equal to one adverse event, vs 71% in the atovaquone-proguanil arm.
Pet infections
Tapeworm infection usually does not cause pathology in the dog or cat, and most pets show no adverse reaction to infection other than increased appetite. The bulk of infections are asymptomatic and the infections that do result in symptoms are generally mildly so. Pets behavior may reflect the presence of anal discomfort and itching, or pruritus. This could result in the ‘butt-scooching” across the floor, grass or carpeting. It may be accompanied by slight gastrointestinal disturbances, as this is the region where the worms inhabit. Though not a pathology of the diplydiasis, the most unnerving sign of the infection is the presence of proglottids in the animals, or child’s, feces. These proglottids can also be found near the perianal region, in the feces, and in diapers (children). The motile proglottids can actively crawl out of the anus of the infected animal/person and migrate small distances, thus potentially covering this array of neighboring surfaces. It is from these locations that the larval stage of the flea will come along and ingest them. Then the metacestode stage, a cysticercoid, develops in the coelomic cavity (abdominal cavity; main body cavity) of the flea larvae and remains there as the flea matures into an adult. These freshly passed proglottids are motile, allowing them to also be found on the floor and furniture, from a migration out of a pets anus and could be compared to resembling fly larvae, or maggots.The other tapeworm infecting cats is Taenia taeniaeformis, though this form is much less commonly encountered than D. caninum.