Correspondence
Cured of fear of flying

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Abstract

A woman is described who developed fear of flying because she took mefloquine as malaria prophylaxis prior to the flight. Mefloquine, because of its potential neurotoxicity, should not be used for persons with fear of flying.

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Case report

A 48 year old Kenyan woman, living in Belgium for more than a decade, consulted me at the Institute of Tropical Medicine in Antwerp. She planned to visit her family in Nairobi and asked me to write a letter stating that she might need oxygen during the flight. During two previous flights to Nairobi, she experienced difficulties breathing, palpitations, dizziness, weakness and anxiety. Each time the aircrew administered oxygen. She was very afraid to experience again the same problems. She was

Discussion

Side effects of mefloquine include nausea, dizziness, palpitations, sleep disturbances, anxiety and psychosis.2 These side effects are particularly frequent in situations of stress and may appear after the intake of one dose of mefloquine.3 Females and individuals of low body mass index are at greater risk.2 My patient had a normal body mass index but was treated with antiretrovirals. It may be that the ritonavir increased the mefloquine drug levels.4

Mefloquine, because of its potential

Conflict of interest

None.

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