In 2013, the manufacturers of Lariam (mefloquine) issued a “Direct Healthcare Professional Communication on Lariam for malaria chemoprophylaxis and the risk of neuropsychiatric adverse reactions” and “Guide for Healthcare Professionals” to healthcare professionals. The relevant wording in the Guide for Health Professionals issued by Roche is as follows: "Psychiatric symptoms such as nightmares, acute anxiety, depression, restlessness or confusion have to be regarded as prodromal for a more serious event" and "Patients on malaria chemoprophylaxis with mefloquine should be informed that if these reactions or changes to their mental state occur during mefloquine use, to stop taking mefloquine and seek medical advice immediately so that mefloquine can be replaced by alternative malaria prevention medication."
The Defence Forces policy on the use of Lariam for malaria chemoprophylaxis is in line with these updated guidelines since their introduction.