What malaria meds may be doing to our troops

by: Anna Berlinrut, Mid-Atlantic MFSO Board Representative

Nine days after Staff Sgt. Robert Bales allegedly massacred 17 unarmed civilians in Afghanistan, including young children, a top-level Pentagon health official ordered an emergency review of the military’s use of mefloquine an anti-malaria drug, commonly known under the trade name of Lariam (made by Hoffman-LaRoche).

The normal dosage of Lariam is one pill before going into an area known to have malaria-infected mosquitoes and one pill each week the patient is in that area. Normally, tourists take only a couple of Lariam pills during a vacation. But our troops in Iraq and Afghanistan take many more pills — the average deployment for Marines is seven months and the average Army deployment is twelve months. Many troops have been deployed over five times in the war zones in more than a decade of war.

Scientific journals reported dangers associated with Lariam to tourists as early as the 1980s. A study in the British Medical Journal (August 31, 1996) found a significant excess of adverse neuropsychiatric events of intermediate degrees of severity associated with the use of mefloquine compared with alternative drugs.

A 2006 study conducted at Walter Reed Medical Center found that rats given a single dose suffered impairment of motor function and degeneration of brain stem nuclei, as well as activity that suggested sleep disorders. The data also suggested the drug could lead to permanent damage to the central nervous system.

The FDA’s website reports: Mefloquine may cause psychiatric symptoms in a number of patients, ranging from anxiety, paranoia, and depression to hallucinations and psychotic behavior. Rare cases of suicidal ideation and suicide have been reported.

“Lariam Action” support groups have been formed in the U.K., the U.S., New Zealand, Canada, Ireland, Denmark and Switzerland by victims of side-effects of this drug. The Roche (Australia) product information website lists side-effects including panic attacks,“epileptic type” seizures, headaches, visual and auditory hallucinations, aggression and thoughts of suicide which have been reported to continue long after Lariam has been stopped.

A recently released report by the U.S. Army entitled “Generating Health and Discipline in the Force” describes a fighting force more prone to inexcusable violence and an “epidemic” of Post-Traumatic Stress Disorder (“PTSD”). An average of 18 veterans commit suicide every day. Military analysts credit more than a decade of war with repeated deployments as a cause. The report notes that the average infantryman in World War II in the South Pacific experienced a total of 40 days of combat during the entire war. Our troops are in constant danger from IEDs and snipers in a very different type of war. But could Lariam also be a cause of personality changes?

The Army nearly stopped using mefloquine in 2009 because of its dangers and the fact that it should not be given to anyone with symptoms of a brain injury, depression or anxiety disorder, which describes many troops who have deployed to Iraq or Afghanistan. The Army’s new choice for anti-malarial protection is doxycycline, a generic antibiotic. The Air Force is no longer giving it to Air Force pilots.

Elspeth Cameron Ritchie, a former Army psychiatrist wrote in the Time magazine “Battleland” blog, “One obvious question to consider is whether he [Bales] was on mefloquine .” “This mediation has been increasingly associated with neuropsychiatric side effects, including depression, psychosis, and suicidal ideation.”

The Army has refused to say whether Staff Sgt. Bales was taking mefloquine, citing medical privacy issues, but they did leak that Bales had at least one traumatic brain injury and that he was using alcohol the night before the massacre. The Army apparently picks and chooses what information it considers to be a privacy concern.

Knowing the side-effects of mefloquine, should it ever be given to our troops?