Intended for healthcare professionals


Comparison of adverse events associated with use of mefloquine and combination of chloroquine and proguanil as antimalarial prophylaxis: postal and telephone survey of travellers

BMJ 1996; 313 doi: (Published 31 August 1996) Cite this as: BMJ 1996;313:525

Blogging on mefloquine and sleep disturbance

Yesterday I sent a rapid response bemoaning the difficulties I had
finding good information on the nature of the insomnia caused by
mefloquine. I postulated that a systematic collection of evidence from
patients who had taken mefloquine might provide me with the information I

As the editor of the BMJ, I would never contemplate publishing such a
letter in the paper version of the journal. It would seem the grossest
indulgence. Some might think that to be the case with a rapid response as
well, but my feeling is that the web is a medium very different from
paper. It's much less formal, much more human. These characteristics
probably derive from its immediacy, there being no financial cost to
posting the response, and everybody being able easily to ignore what's
posted if they want to.

What I'm doing is called "blogging" (web log writing). People write
their experiences directly onto the web, providing new voices, immediate
thoughts, and alternatives to traditional publishing. (In this case the
blogging is somewhat undermined by the fact that I probably write more
than anybody else of the content of the paper BMJ.) Blogging is a craze or
possibly even a new medium. Some people are making money from it. Both the
Financial Times and Sunday Times have web logs written by senior

I've attached some comments on blogging to the end of this rapid
response, but first I want to return to mefloquine and insomnia.

Yesterday I wondered if I would not be able to sleep properly for the
next six weeks while taking the drug. This morning I was woken by my
daughter and the dog at 9.30 am, two to three hours later than I usually
wake. I'd slept for 10 hours, two hours more than usual. During the night
I'd had to wake to let in my son, who was returning from a party, but I
went straight back to sleep.

What's happening? Is this mefloquine? It is supposed to cause "sleep
disturbance" as well as "insomnia." Or is it all to do with me having
flown home from San Francisco five days ago or with having drunk a fair
bit last night? What, I wonder, will happen tonight?

Probably nobody but me cares, but it may mean something that my need
for information has coincided with my discovery of blogging.

Here are those further thoughts on blogging-from Louise Kehoe.

Welcome to The Blog

The fresh format and interactive quality has made a web log too good an
opportunity to miss, says Louise Kehoe

Published: April 9 2002 16:58 | Last Updated: April 9 2002 19:33

"I am a convert to blogging (web log writing). When I first came
web logs a year ago I was derisive in this column. I saw them as
derivative, mostly comprising links to articles written by other people
with brief comments. I thought of them as the digital equivalent of
scrapbooks containing pictures and articles cut out of magazines and

My new-found enthusiasm is based in part on finding a few high-
examples with original thoughts. I am also drawn in by the format and
interactive nature of the web log.

At their best, web logs have a fresh, raw quality and provide a
perspective on the topics they cover. Although I do not share the
purist's zeal for displacing commercial online publishing with these
personal logs, I see them adding "more voices" to the web at a time when
commercial investment in new media is retreating. I am also intrigued by
the opportunity to interact more directly with readers."

Will we see more blogging in the BMJ?

Richard Smith, Editor, BMJ

Competing interests: No competing interests

22 April 2002
Richard Smith