Frågedatum: 1990-07-30
RELIS database 1990; id.nr. 7371, DRUGLINE
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This question concerns a 76-year old woman who has been prescribed Paludrin (proguanil) 100 mg x2 a



Fråga: This question concerns a 76-year old woman who has been prescribed Paludrin (proguanil) 100 mg x2 as a malaria prophylaxis for 2 months. Recently, she came back from a visit to Africa and Brazil. After she came home, she developed an infection with cough and high fever. At the same time her family noticed that her personality had changed.

Could this personality change be a side effect of the Paludrin medication?

Sammanfattning: There are no reports to presume that a change in personality could be caused by proguanil.

Svar: Proguanil is used for causal profylaxis of falciparum malaria, to suppress other forms of malaria and to reduce transmission of infection. The schizotocidal activity of proguanil on erythrocyte forms is too slow for the treatment of acute malaria and rapid blood schizontocides like chloroquine should be used (1).

Proguanil is considered one of the safest antimalarial drugs and is well tolerated in recommended doses which is 200 mg daily for adults. Larger doses, especially >600 mg daily may cause vomiting, abdominal distress, diarrhoea, renal irritation and reversible haematuria (2). The development of mouth ulcers has been mentioned as well (3).

After an extensive literature search, no reports were found to presume that proguanil could cause a change in personality. Also, there are no reports to the National Board of Health and Welfare about a psychological effect due to proguanil.

Possibly, the personality change could in this case be caused by other drugs or might be induced by her physical condition and age. For instance mental effects have been reported with chloroquine, like psychotic episodes, anxiety and personality changes (4). 1 Martindale, The extra pharmacopoeia. 1989; 29th ed: 515 2 Gustafsson LL, Handbook of drugs for tropical parasitic infections. 1987; page 106-108 3 Meyler´s, Side effects of drugs. 1988; 11th ed: 588 4 Martindale, The extra pharmacopoeia. 1989; 29th ed: 508

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