I'll add to that. One of the real challenges is knowing how to treat it.
Unfortunately, mefloquine is still used in the Peace Corps. I've had the unfortunate luxury of seeing a number of returning Peace Corps volunteers, who sometimes have been medevaced out with psychosis. The question is, do you treat them with an antipsychotic agent, or is that contraindicated? I've also seen people whose symptoms have lasted for some years, depression and anxiety, but we don't know.
I totally agree with Dr. Passey that more treatments are needed. By the way, we realize we have never met until today.
The direction I have been going, in general, for post-traumatic stress disorder is complementary with alternative medicines, integrated medicine, yoga, meditation, and exercise. I recommend exercise to all my patients with post-traumatic stress disorder. I would like to explore how helpful these treatments may be for people with mefloquine-induced toxicity. My hypothesis is that they would help calm down the jangle that you see with people on mefloquine.
I have a couple of other points, briefly. There are some accommodations that can be used, things like sunglasses—there is a lot of photosensitivity. A cane can be used for accommodation. Finally, again, what I have found so helpful is when service members or their spouses.... It's often the spouse who is reaching out and saying, “Ah, this is it. He was okay until he went to West Africa or Afghanistan”, and this is an explanation that makes sense.