Psychosis chloroquine

Toxicity At low doses, chloroquine causes gastrointestinal irritation, skin rash, and headaches. High doses may cause severe skin lesions, peripheral neuropathies, myocardial depression, retinal damage, auditory impairment, and toxic psychosis. Chloroquine may also precipitate porphyria attacks. 

When severe psychosis following treatment with chloroquine and hydroxychloroquine occurs it is usually during treatment for malaria, but it can follow treatment for connective tissue disorders. Hallucinations have been reported after hydroxychloroquine treatment for erosive lichen planus (152). 

In one center, toxic psychosis was reported in four children over a period of 18 months (SEDA-16, 302). The children presented with acute delirium, marked restlessness, outbursts of increased motor activity, mental inaccessibility, and insomnia. One child seemed to have visual hallucinations. In each case, chloroquine had been administered intramuscularly because of fever. The dosages were not recorded. The children returned to normal within 2 weeks. 

In another major review the risk of depression, psychosis, a panic attack, or a suicide attempt during current or previous use of mefloquine was compared with the risk during the use of proguanil and/or chloroquine or doxy-cycline (513). The study population (n = 35 370) was aged 17-79 years (45% men). There was no evidence that the risk of depression was increased during or after the use of mefloquine, but psychoses and panic attacks were more frequent in current users of mefloquine than in those using other antimalarial drugs. 

Dizziness headache vomiting diarrhea yellow staining of skin toxic psychosis insomnia bizarre dreams blood dyscrasias urticaria blue and black nail pigmentation psoriasis-like rash acute hepatic necrosis convulsions severe exfoliative dermatitis ocular effects similar to those caused by chloroquine Quinine Dihydrochloride and Sulfate... 

Psychiatric There is still concern about the potential of artemisinin derivatives to cause neurotoxic effects, and severe and irreversible brain damage has been reported in some animal and human studies. Mania developed in an adolescent with a family history of chloroquine-induced psychosis after treatment with a/p-arteether [24 ]. 

Fever and malaria can induce a psychosis, but in this case, fever was an unlikely cause, as fever-induced psychosis is usually polymorphic and associated with some alteration of consciousness and orientation, which were absent there was also no past history of an altered mental state after febrile illnesses. Falciparum malaria leading to psychiatric sequelae usually presents with cerebral malaria, which has well-defined neurological signs. Antimalarial drugs such as chloroquine, mefloquine, and quinine can cause psychoses, and given substantial evidence of neurotoxicity after exposure to artemisinin compounds. 

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