Lariam Dreams (which pills do you pop?)

If you’ve traveled to a tropical country, you’ve probably heard of Mefloquine. It is the most popular prophylactic against malaria, and is often sold under its trade name, Lariam. Lariam can have some serious side effects such as depression, anxiety, paranoia, nightmares and insomnia. You might say, “having nightmares is better than catching malaria and ending up in a hospital or worse.” I’m sure everyone would agree with that.

But when you wake up in a strange foreign land after a Lariam-induced nightmare…and you aren’t quite sure if you are really awake or if your waking state is just another extension of your dream, it can be pretty unnerving.

After such an experience, you might ask yourself if it is really necessary to ingest Mefloquine every time you enter a tropical region. I’ve known people who pop the little pills once a week when they are in Hong Kong or Singapore where the chance of catching malaria is akin to the chance that you will win the lottery. I guess some travelers choose to err on the side of caution when they enter any unfamiliar place.I haven’t even mentioned the host of shots and other pills that some guidebooks and doctors say you might want to consider. Typhoid is a big one. Cholera is another. Neither of these have vaccines that are 100% effective and they can bring about particularly nasty side effects. That doesn’t stop doctors from recommending them and people from getting the shots.

So what do you really need when you are traveling in a developing, tropical country? I guess it depends on how apprehensive you are. For me, Lariam and obscure vaccines are out unless I find that I am entering an area where a particular disease is truly a threat (see the WHO web site if you want to research a country you plan to visit). I also keep up to date on basic immunizations like tetanus and Hep B. And keep in mind, no matter how Lariam happy you get, there are diseases like SARS and H5N1 out there to remind us that health concerns are always going to be a scary part of traveling. And so I ask you, Gadling readers: what do you consider a necessary part of your travel-sized medicine cabinet?

Take Those Malaria Pills!!!

Let’s say you’re on your way to vaca abroad in
some foreign land where the food is strange and even a little smelly, they drive on the opposite side of the road and
perhaps the locals are less inclined to wear deodorant; these are all things you can live with upon your return home.
Now let’s also imagine someone told you about an infected mosquito carrying a tiny pet parasite that could potentially
grow and multiply in your liver, wreak havoc on your red blood cells and multiply some more after the mosquito has
dearly departed  from your flesh. Without the appropriate protective measures you could potentially die from what
seemed like the average insect bite. Chances are you’d break out in a cold-sweat thinking of the dangerous winged bug
and could even be ready to call off your great  adventure through the Amazon basin of Bolivia.

don’t let the scenario above throw off the mood of your entire trip, but I bring this up because not enough people seem
to be taking antimalarial pills before trekking out into the unknown. The LA
Times has an article
pointing out the number of malaria related
deaths (a million die annually) and how a third of travelers
tend to skip out
on taking prescribed antimalarial drugs. It seems many aren’t thinking enough about the disease and
rely on insect repellent and bed netting to protect them when they should be used in addition to the pills. Other doctor
recommended suggestions include limiting outdoor activities from dusk to dawn when mosquitoes bite as well as wearing
long sleeve shirts and pants.

Antimalarial pills should be taken before, during and after visiting high risk areas. Additional malaria information can be found by
visiting the CDC.