I'm on clarithromycin for an upper-respiratory infection. One of the side effects is nightmares. I've been taking the pills for two days now, and both nights I've had nightmares - very vivid ones. Not your usual "got-to-get-to-class-oh-now-I'm-naked" ones, either. More along the lines of being in a dark Gothic cathedral surrounded by a black mist and moving shadows.

What the heck is going one here? What is the mechanism at work? Is it messing with my brain chemistry? Why would any medication cause nightmares?

It just seems bizarre to me.

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

Wow, believe it or not I know people who would take just for that reason.

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Gimme a minute to read through Jay's latest observations...

Oh, I believe it. I do find it interesting... but that's probably because I'm only on a 7-day course. If I had to take the things for a month or two? Not so much.

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

Nightmares are on the side-effect list, along with a range of other excitatory neurological things: tinnitus, dizziness, anxiety, insomnia, paraesthesia, delirium. So, yes, it does appear to be messing with your neural chemistry, a little.
I get something similar with mefloquine. I don't know the mechanism.

Grant Hutchison

Yeah, I've been lucky. No hallucinations. Yet. Just a dry mouth, a horrible metallic taste, and the sleeping horror.

Mefloquine looks terrible. Permanent neurological damage? I'll stick to tonic water.

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

Only until you've seen someone die of cerebral malaria. Then it looks like an extremely attractive bet.

Grant Hutchison

True. But why not take quinine instead?

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

Doesn't work anymore

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Gimme a minute to read through Jay's latest observations...

Really? I see on Wikipedia that it's still prescribed for malaria sometimes. Not the most reliable source, granted, but there you go.

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

Quinine's not used for prophylaxis, because it's actually pretty toxic stuff. It's still indicated for the treatment of malaria, when the benefits outweigh the risk.
For prophylaxis, the mainstay used to be chloroquine and proguanil (a pretty benign combo), but chloroquine resistance has become common in many parts of the world. For a while, the only suitable prophylactic drug in areas of chloroquine resistance was mefloquine. Nowadays there's also Malarone (which makes me feel just as bad as mefloquine), and doxycycline.

Grant Hutchison

Wow. That explains that. Aphasia? Really? Yikes.

Thanks for the explanation - I've done gone and learned somethin'.

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

Okay, I was misinformed back in my military days. That's what the medics told me when I asked why we could have gin and tonics instead.

I used to take chloroquine back when I had to worry about malaria. You weren't allowed to climb up on the aircraft for several hours after taking it due to the dizzyness side effect. Quite surprising how intense it would hit you with no warning.

The Captain would come on over the intercom and make sure the whole ship took it at the same time. If you were found to be not taking it you were subject to court martial, not captian's mast. (Article 15 to you Army types)

Edit to add: Might have been primaquine instead. Close to three decades ago, you know.

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Gimme a minute to read through Jay's latest observations...

Well, it's probably simpler to tell you that. Darn good question, by the way.

Hee-yikes! Was that the captain's policy (it is at his discretion, right?) or was it actually mandated?

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

Mr. C, from the veiw point of an enlisted man, both of those are the same thing. I never wanted to find out.

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Gimme a minute to read through Jay's latest observations...

Heh. Read you loud and clear. Probably a good position to stick to.

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Quaeso quousque humi defixa tua mens erit? Nonne aspicis, quae in templa veneris?

The malaria medication episode of M*A*S*H was on yesterday--I forget the drug names, but they ran out of one drug and had to replace it with another, which not only didn't do the same thing but caused anemia in blacks. Klinger and Token Jewish Guy also came down with anemia, and the episode ends with a title card telling us that, indeed, the same enzyme or whatever that makes the drug cause anemia in black people also exists in "people of Mediterranean descent."

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Gillian

"Now everyone was giving her that kind of look UFOlogists get when they suddenly say, 'Hey, if you shade your eyes you can see it is just a flock of geese after all.'"

"You can't erase icing."

"I can't believe it doesn't work! I found it on the internet, man!"

Sounds like the class of potential sickle-cell anemia sufferers.

CNN Health Library

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Sickle cell is an adaptation to combat malaria.

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Gimme a minute to read through Jay's latest observations...

It certainly seems to be maintained in the gene pool because it protects against malaria, to some extent.
Those with sickle cell trait (one gene for sickle cell) are resistant to infection with malaria, and are usually fairly healthy. However, those with sickle cell disease (two genes for sickle cell) die unpleasantly at a young age, if they are without medical support.

So the gene neither dies out nor dominates, but reaches an equilibrium which depends on the prevalence of malaria.

Grant Hutchison

Yeah ,they found out that that horrible Tay-Sachs disease works the same way with TB.

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Gimme a minute to read through Jay's latest observations...

Tell the doc about your nightmares and ask if there's something that can be substituted or added.