Alternative antischistosomal drugs are required since praziquantel is virtually the only drug available for treatment and morbidity control of schistosomiasis. Manual microscopic reading is the current "gold standard" to assess the in vitro antischistosomal properties of test drugs; however, it is labor-intensive, subjective, and difficult to standardize. Hence, there is a need to develop novel tools for antischistosomal drug discovery. The in vitro effects of praziquantel, oxamniquine, artesunate, and mefloquine on metabolic activity and parasite motility of Schistosoma mansoni (newly transformed schistosomula [NTS] and 49-day-old adult worms) were studied using isothermal microcalorimetry (IMC). Results were compared to morphological readouts of viability. Results obtained for the four drugs tested with phenotypic evaluation by microscopy and IMC showed a good correlation, but IMC also identified drug effects that were not visible by microscopic evaluation, and IMC precisely determined the onset of action of the test drugs. Similar sensitivities on NTS and adult schistosomes were observed for praziquantel and mefloquine, while slight differences in the drug susceptibilities of the two developmental stages were noted with oxamniquine and artesunate. IMC is a useful tool for antischistosomal drug discovery that should be further validated. In addition, our data support the use of NTS in in vitro antischistosomal drug assays.Schistosomiasis, caused by blood flukes of the genus Schistosoma, is an important health problem affecting 779 million people mainly in sub-Saharan Africa (36). Praziquantel is virtually the only drug available and is increasingly deployed in mass drug administration programs, advocated by the World Health Organization (11). The annual estimated need for praziquantel in Africa exceeds 400 million tablets (http://www .who.int/wormcontrol/newsletter/PPC7_Eng_min.pdf). Two alternative drugs, oxamniquine and metrifonate, exist; however, they are rarely used today as they have a rather narrow activity profile and multiple doses have to be administered (12, 37). The extensive use and reliance on one single agent have raised concerns about the emergence of praziquantel resistance (3,8), and indeed, schistosome strains with increased drug tolerance have already been isolated from patients as well as selected in the laboratory (9, 26). Therefore, there is growing consensus that novel antischistosomal drugs should be discovered and developed (8,15,33).Antischistosomal drug discovery at many academic institutions (e.g., the Special Programme for Research and Training in Tropical Diseases; screening centers in London, United Kingdom, and Cairo, Egypt; the University of California, San Francisco, Sandler Center in San Francisco, CA; and the Swiss Tropical and Public Health Institute [Swiss TPH] in Basel, Switzerland) is based on in vitro whole-organism drug screening assays followed by in vivo tests in infected mice (15, 31). Stages used for in vitro assays are 1-to 7-day-old schistosomula (newly transfor...