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Letter to the Editor

Methodological Concerns Regarding the Relation Between Mefloquine and Serious Psychiatric Events in Females

Martin L. Tepper, MD, MHSc, FRCPC, and Barbara A. Strauss, BScN, RN, MSc

Published: January 16, 2006

Article Abstract

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Sir: van Riemsdijk et al.1 report the results of a case-control study of serious psychiatric events related to mefloquine use among Dutch travelers. A highlighted result is a (startling) odds ratio (OR) of 47.1 (with very wide 95% CI of 3.8 to 578.6) for such events in females taking mefloquine.

While the basic case-control methodology of this study appears sound, we have concerns that would erode confidence in this study: (1) The overall response rate from cases and controls is felt, by the authors, to be high enough ("almost 70%") to avoid selection bias.’ ‹

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