I've never been a very big medicator; in fact, I'm of the opinion that most ailments can be cured with a lot of water, a lot of sleep, and maybe a jog if you feel the need to sweat something out. However, I'm willing to bet that Malaria is somewhat of a more formidable opponent that your average winter cold. At the suggestion of my friendly vaccinator (whom I got to know well as I sat for the first rounds of Yellow Fever, Hep A and Typhoid), I decided to use an antimalarial for this first week.
The options are not inviting.
Mefloquin is a lariam-based antimalarial that you take weekly starting 1-2 weeks before your trip - which is clearly not an option for me. Mefloquine is the most common, the strongest, and a comparatively cheaper antimalarial treatment. The potential side effects, however, are pretty off-putting. They include, in no particular order, nausea, dizziness, headache, weakness, insomnia, "strange dreams," nightmares, depression and anxiety. Mefloquin has also been suspected of causing long-term liver damage. Hmmmmm. As appealing as hallucinogenic dreams are, I decided to seek an alternative.
Doxycycline is a daily tablet which one must begin 1-2 days before a trip to a malaria prone region. The cheapest of the antimalarials, one must continue the medication for a month after returning and should refrain from taking a tablet with dairy products or before bed. Doxycycline's side effects include nausea, vomiting, diarrhea, dizziness, headache, photosensitivity (recall the title of the blog), vaginal infections, and intracranial hypertension. Once again, I passed.
Malarone is a daily tablet with "low incidence of side effects." Dosage begins 1-2 days beforehand - much better timing for me. The down side, in this case, is that Malarone is a whopping $6/tablet. Hardly sustainable for a year.
The ideal antimalarial (in my untrained opinion) is Chloroquin. A weekly tablet, the side effects are milder than those of doxycycline and mefloquin (though it may cause blurred vision), and one tablet costs the same as the daily malarone. The downside, for me, is that the strains of malaria found in West Africa are resistant to chloroquin. Bummer.
In the end, I opted to take malarone for this short term trip. I figure once I'm on the ground in Monrovia I'll see what everyone else is doing.
If anyone reading this has any suggestions (or better yet, experience with any of these drugs) then feel free to post them up!