Have you ever heard of the malaria drug mefloquine (brand name: Lariam)? It is linked to grisly crimes like Army Staff Sgt. Robert Bales’ 2012 murder of 16 Afghan civilians, the murders of four wives of Fort Bragg soldiers in 2002 and other sensational events. The dangers of mefloquine made headlines after the Fort Bragg incidents and have resurfaced after related incidents in 2005, 2008 and 2012. However, despite making front page news, the public and medical establishment are disturbingly clueless about the drug which is still prescribed to people traveling to malaria-plagued areas whether military or civilian.
The toxic neurological effects of mefloquine begin immediately and do not go away when the drug is stopped. Effects can last for “weeks, months, and even years,” after someone stops using it, warns the VA. Medical. Military authorities say the drug “should not be given to anyone with symptoms of a brain injury, depression or anxiety disorder,” reported Army Times which encompasses “many troops who have deployed to Iraq or Afghanistan.” In fact, depression and anxiety are the hallmarks of PTSD.
In 2009, the Army Surgeon General and Deputy Assistant Secretary of Defense sent directives making mefloquine a last choice drug for troops and last year the Army banned it for the approximately 25,000 Green Berets, Rangers, Civil Affairs and Psychological Operations soldiers. (It was already banned in Air Force pilots.) But until 2011, mefloquine prescriptions were actually growing in the Navy and Marine Corps — from 1,200 prescriptions in 2008 to 2,000 prescriptions in 2010, as reported by the Associated Press. And, since the neurological effects of mefloquine can continue indefinitely, troops and veterans may still be under its effects even if the drug has stopped being prescribed.
Mefloquine was developed by the Walter Reed Army Institute of Research (WRAIR) in the 1960s and 70s after a drug resistant strain of malaria did not respond to medications and sickened troops during the Vietnam War. Though mefloquine was developed with our tax dollars, all phase I and phase II clinical trial data were given to Hoffman LaRoche and Smith Kline free of charge, in what was the first private-public partnership between the U.S. Department of Defense and Big Pharma. It was approved by the FDA in 1989.
Mefloquine was first tested on prisoners and soldiers who are not necessarily able or willing to refuse participation in clinical trials. It was also widely given to Guantánamo detainees. Phase III trials, that are supposed to be conducted on larger patient groups of up to 3,000 people, were not conducted at all, wrote the Journal of the Royal Society of Medicine in 2007 and “there was no serious attempt prior to licensing to explore the potential drug-drug interactions.”
As seen with other drugs that have neuropsychiatric effects, like the antidepressant Cymbalta and seizure drug Neurontin, the military, government and Big Pharma blamed the effects on the patients, not the drugs. When the wives of four Fort Bragg soldiers were murdered during the summer of 2002 — one was stabbed 50 times and set on fire — military investigators blamed “existing marital problems and the stress of separation while soldiers are away on duty,” not mefloquine. Right. Three of the four soldiers also took their own lives.
The military, government and Big Pharma similarly blame the current suicide epidemic among military personnel on factors others than the ubiquitous psychiatric drugs in use — even though 30 percent of the victims never deployed and 60 percent never saw combat. A recent five year study by Big Pharma-funded academic government and military researchers about military suicides, for example, does not even consider the drugs given to an estimated one in four soldiers, almost all of which carry warnings about suicide.
It is also worth noting that the alarming side effects linked to mefloquine — which patients, doctors and public health officials reported for at least a decade — were not acknowledged until profits ran out and mefloquine became a generic, as has happened with other risky drugs.
When sentiment turned against mefloquine in 2009, its manufacturer, Hoffmann–La Roche ceased marketing it in the U.S. Now the words “mefloquine” and “malaria” draw no search results on its U.S. website.
Why is mefloquine prescribed at all? Unlike other malaria drugs, it only needs to be taken once a week, not every day. And it is reportedly cheaper than other malaria drugs. Many users, who include business travelers, embassy staff, tourists and aid and Peace Corps workers, report only mild symptoms like memory loss and vivid nightmares, which do not stop them from taking the drug. Since awareness of mefloquine’s dangers, most users are now required to read and sign an informed consent form.
Mefloquine’s Checked Past
The incident of the four Fort Bragg soldiers charged with killing their wives during the summer of 2002 is not the only time mefloquine has been in the news. There was also the case of Staff Sergeant Andrew Pogany who volunteered to serve in Iraq in 2003. He experienced panic and PTSD symptoms in the war theater and was sent back to Fort Carson and charged with “cowardly conduct as a result of fear.” Pogany and his attorney were able to prove that his reaction probably stemmed from mefloquine and he received an honorable discharge. Pogany, understandably, became a vehement advocate for the rights of soldiers with PTSD — especially those who have been given psychoactive drugs that only make PTSD symptoms worse.
The wife of a 17-year marine veteran I interviewed in 2011, who chose to remain anonymous, reported a similar story. After being deployed twice to Iraq and once to Afghanistan, her husband developed extreme PTSD.
“He went from being loving on the phone, to saying he never wanted to see me and our daughter again,” the wife said. “He said not to even bother coming to the airport to meet him, because he would walk right past us.”
When the couple did reunite, the husband was frail and thin, and “the whites of his eyes were brown,” said the wife. The formerly competent drill instructor became increasingly and inexplicably unpredictable, suicidal, and violent and was incarcerated in the brig at Camp Lejeune for assault in 2011. I asked the wife to ask him during her visits if he had been given mefloquine. She said he reported that he had.
In the non-ﬁction book, Murder in Baker Company: How Four American Soldiers Killed One of Their Own, mefloquine is also raised as a possible factor in the brutal death of Army Specialist Richard Davis.
When asked about mefloquine in the crime in an interview, the author Cilla McCain said:
“Although it was never mentioned in court, I think if this same case were to happen today, it would definitely be considered as a defense. These soldiers were overdosing on mefloquine in massive amounts because there wasn’t proper oversight. In reality, proper oversight is impossible in a war zone but steps could have been taken to make sure that overdosing didn’t occur. Even without over dosage, the mefloquine issue is a volatile one at best and I’m positive we will be hearing more about the damage it has caused for years to come. Some scientists are linking mefloquine directly to the historical rise of suicides in the United States.”
While mefloquine is still in use in the civilian and military worlds, patient and professional groups are increasingly speaking out about its underreported dangers. And in 2013, the Surgeon General’s Office of the Army Special Operations Command advised commanders and medical workers that soldiers who have been thought to be suffering from PTSD or other psychological problems or faking mental impairment may be mefloquine victims.
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