TOLERANCE OF MEFLOQUINE BY SWISSAIR TRAINEE PILOTS

Due to presumed adverse performance impact, a World Health Organizatio n clause currently restricts the use of mefloquine malaria chemoprophy laxis in individuals requiring fine coordination and spatial discrimin ation. We conducted a double-blind, placebo-controlled, cross-over stu dy to quantitatively assess the effects of mefloquine at steady state on performance in 23 trainee airline pilots. Flying performance was as sessed using a flight simulator, psychomotor function was evaluated, s leep and wake cycles were monitored, and symptoms and moods were asses sed using standardized questionnaires. A simplified postural sway mete r recorded sway in three test positions. In the mefloquine loading dos e phase, there was one withdrawal due to dizziness, diarrhea, and flu- like symptoms, and three volunteers reported nonserious, sleep-related adverse events. There was no significant difference in flying perform ance, psychomotor functions, or mean sway for any test position. Nonsi gnificant reductions in mean total nocturnal sleep (mefloquine = 450 m in versus placebo = 484 min) and poorer sleep quality were detected in the mefloquine phases. The mood findings indicated a predominance of positive states, with vigor the predominant mood in all phases. No sig nificant performance deficit was documented under laboratory condition s during use of mefloquine at steady state.