Topping off this thread.
We will be visiting India for a longer period and I am not sure I want to take Malarone for that long. We'll be in Madras, Cochin, Goa, Mumbai in Feb/March on a cruise and then 2 weeks later in Delhi, Rajastan, Agra & Varanasi in March. That covers a period of over 1 1/2 months - I am not sure what to do.
Any advice?

We were due to be in Sierra Leone for 1 year in 2007 (we left after 2 months) we had comprehensive medicals and vacination programs before we left on our assignment with VSO. We were given a years supply of Larium and did not hesitate to take it. Why? Because I had contracted Malaria twenty years previously whilst in Vietnam and belive me the two weeks I spent in hospital was not a pleasant experience. A few side unpleasant side effects (and yes, I do appreciate that in rare cases some of those side effects can be serious)is nothing compared with this disease, which is still the one of, if not, the biggest killer in the world.

I do not pretend to know all of the answers and with the greatest respect to those on this board, few non-doctors do. Even amongst the medical profession the knowledge is often limited and usually out of date. The only place you can can get realiable up to date advice is from a specialist travel doctor /clinic.
The only way to be perfectly safe, is to spray and cover up completely. I always use 50% deet but even that is not 100% effective (mozzies seem to find me particualry tasty!).

The other thing that I do is to take a "treatment course" of meds (i.e. different to the ones I am taking regularly) so I can start a course of treatment asap if I am far from medical facilities.

Whatever you decide cover up and spray and above all, enjoy your self - the risks are minimal

Preventing mosquito bites is the best first defense.

Personally, I do not take anti-malarials when in India (I live in the US).

There are several mosquito borne illnesses with Malaria being just one.

Again, protect yourself against their bite in the first place - clothing (loose rather than tight to the skin), repellents, mosquito netting on your bed if needed.

It's pretty cool in N. India right now so the mosquitoes will be much less.

Paul, do read the cdc and nhs recommendations regarding malaria in India. Note that the cdc has a new address: wwwn.cdc.gov/travel

Also, consult with a travel med professional.

You mention that you will be in Indai 6 weeks and don't want to take malarone that long. You might also consider another effective anti-malarial, doxycycline. Doxy has been taken for years by adolescents with serious acne, and is considered quite safe. (Of course all medicines have possible side effects). You do have to continue doxy for one month after leaving the malarial risk area.

While I regularly recommend that people consult with a travel med doc, a well-informed travel med specialist can talk with you about the lower and high risk areas you are visiting and can help you make an informed choice about malaria prevention.

As Jaya says, make sure you use an effective mosquito repellant.

crellston, Jaya & Kathie - thank you all for your advice. I do have a call out to the travel MD I had used in the past. The CDC web site is not that informative - it doesn't break down India in diffferent levels of risk and also they do not make any recommendation per se (liability issues?). Of the top of my head I am thinking Doxycycline...

When I go to India, I'm more worried about eating or drinking something that will land me in the bathroom for 3 days (or longer) than getting malaria!

Paul, the cdc does tell you which anti-malarials are and are not effective (chlorquinine and chlorquinine combinations are not effective; larium, malarone and doxcycline are effective). Beyond that, it does not make recommendations for a specific anti-malarial as it is really dependent on the particular traveler. That's where your consultation with your doctor comes in.

I spent three weeks in India --New Delhi/Bangalore regions-- and just came back. I definitely got bit by mosquitos (not too many but couple bites a day). I have no idea whether or not they carried malaria because they didn't tell me :), but as I was on malarone I didn't particularly worry. So sometimes it is the peace of mind issue. Jaya, I had zero stomach complications but it may be because I exclusively used mineral water during the entire stay and never ate anything uncooked (and boy, was I tempted everywhere I went!!).

Take all the anti-malarials you want - but please, just for me, do a search about negative side effects of Larium. I won't upset myself by lurid descriptions of the nightmares I endured. I still remember then. Just for Dog, eh? I'm serious.

Dogster is correct. My PCP gave me options of potentially feeling dizzy or having nightmares!! I took the feeling dizzy one :) I should add that I didn't experience ANY side effects.

I meant to say 'negative psychological side effects' of Larium.

Larium is the anti-malarial with the most side effects, the most severe side effects, and the best-publicized side effects. Approximately 30% of people taking larium have some psychological side effects from taking larium. For most people, these side effects are nightmares or depressed mood or some anxiety or irritability. For a few, however, they may experience severe psychological side effects such as acute anxiety, paranoia, or even frank psychosis or severe depression with suicidality. That said, about 60% of people taking larium do so without major side effects.

Doxycyline and malarone have fewer side effects and less severe side effects. Fear of side effects is not a good reason to avoid anti-malarials.

For any medication you take, you should carefully research side effects and know what to do if you develop side effects.

Unfortunately, because of the side effects of larium that people hear about, some people are of the belief that all anti-malarials have severe side effects which must be worse than malaria. This is not true. Of course, the worst possible side effect of malaria is death.

My Larium episode was one of the scariest experiences I've ever had. I guess I'm one of the 40%. Never, never, never again.

As Kathie knows, I don't go for this relentless over-prescription of travel meds - but that's MY thing. There are cultural considerations here, lol. Do what you feel comfortable with. Just be happy, be safe and please don't take Larium. I worry.

Thanks everyone.
One thing is settled - I will take meds. What is not settled whether it will be Doxy or Malarone (definitely no Larium).