Psychopharmacology: mefloquine neuropsychiatric toxicity: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopharmacology: mefloquine neuropsychiatric toxicity

Sample item

A traveller takes a weekly oral antimalarial for prophylaxis. After the third dose he reports vivid nightmares, anxiety, dizziness and suspicious thoughts about his companions. Which drug is the most likely cause?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Mefloquine

Mefloquine is associated with neuropsychiatric effects such as vivid dreams, insomnia, anxiety, depression, paranoia and psychosis, and is avoided in people with psychiatric histories. Stopping the drug is advised if such symptoms appear.

Option by option

  • A. Mefloquine (correct)

    Correct. A weekly antimalarial with vivid dreams and paranoia fits mefloquine.

  • B. Artesunate

    Artesunate is used to treat severe malaria and is not used as weekly prophylaxis.

  • C. Doxycycline

    Doxycycline causes photosensitivity and oesophagitis and is taken daily.

  • D. Atovaquone-proguanil

    Atovaquone-proguanil is taken daily and commonly causes gastrointestinal upset.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Mefloquine. Mefloquine is associated with neuropsychiatric effects such as vivid dreams, insomnia, anxiety, depression, paranoia and psychosis, and is avoided in people with psychiatric histories.

Why is "Artesunate" not the answer?

Artesunate is used to treat severe malaria and is not used as weekly prophylaxis.

Why is "Doxycycline" not the answer?

Doxycycline causes photosensitivity and oesophagitis and is taken daily.

Why is "Atovaquone-proguanil" not the answer?

Atovaquone-proguanil is taken daily and commonly causes gastrointestinal upset.

What concept does this question test?

It tests Psychopharmacology: mefloquine neuropsychiatric toxicity in Psychiatry. Stopping the drug is advised if such symptoms appear.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopharmacology: mefloquine neuropsychiatric toxicity?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.