Mefloquine (Lariam) for anti-malaria prevention

JJ_BPK · 06-20-2012, 03:49

There are a couple earlier posts on this subject. This is just a reminder.. Ref: lariam

From another QP:

Quote:

To my military brothers and those that may have served or have family members in the last 20+ years that have served:

Brothers / sisters most of us if not all have taken Mefloquine (Lariam) on one or more deployments for anti-malaria prevention. The data is overwhelming of what is surfacing about it's harmful effects on people that took it. I think it is worth your time to read through this info and then do you own research. I would also suggest that you may want to get it annotated in your medical records and in your official files. Please help spread the word amongst our brothers / sisters.

This website is a good starting site, w/links to detailed articles:

Quote:

MEFLOQUINE (LARIAM) ACTION

Dr. Remington Nevin presenting his recent research on the epidemiology and pathophysiology of mefloquine neuropsychiatric side effects. December 2011.

Neuropsychiatric Adverse Events Associated With Mefloquine

Articles about Lariam, links are at the site: http://www.lariaminfo.org/

Documents Uncovered by Judicial Watch Raise Concerns About Use of Drug for Military Personnel, Judicial Watch, May 2, 2012.
Pentagon Stays Silent on Whether Suspect in Afghan Massacre Took Controversial Anti-Malaria Drug, Democracy Now, March 27, 2012.
Did Lariam (Mefloquine) play a role in the Afghanistan massacre? Homecoming Vets at the Crossroads of Humanity, March 27, 2012.
Special Considerations for US Military Deployments, from the CDC Yellow Book traveler advisory in its new, 2012 edition. Published online by the CDC in July 2011.
Senator Dianne Feinstein Calls for Review of Anti-malarial Drug. August 18, 2011
New study will examine Mefloquine as a Treatment for Malignant Glioma (Brain Cancer) . Mefloquine is designed to block a protein that helps to clean the waste in the cells and to destabilize the cell membrane. Blocking this protein may cause tumor cell death. (Study registered in September 2011)
Meeting Report: Doxycycline for Malaria Chemoprophylaxis and Treatment: Report from the CDC Expert Meeting on Malaria Chemoprophylaxis. Am J Tropical Medicine and Hygiene, April 2011
Collateral Damage, Sunday Business Post, Ireland. April 10, 2011
Bad Medicine, Sunday Business Post, Ireland. April 10, 2011
Experts: DOD malaria drug policy for detainees is malpractice (PDF). January 23, 2011
Irish Defence Forces to sue government. January 16, 2011
Seton Hall Law Report Shows U.S. Military Routinely Administered Controversial Drugs to Detainees in Guantanamo Bay (press release). The full report is also available. December 2, 2010
The neuroscience community has started putting things together and is going after mefloquine: Anti-malaria drug mefloquine induces motor learning deficits in humans, Frontiers in Neurosci. 2010 Nov 19;4:191.
The Few. The Proud. The Broken. GQ, March 2010.
Toxic Cocktail: Army struggles with mental health care by Jason Notte, TheStreet.com, Sept 16, 2010.
Policy Memorandum on the Use of Mefloquine (Lariam) as Malaria Prophylaxis, Office of the Assistant Secretary of Defense, Sept. 2009.
August 2009: Lariam (mefloquine), manufactured by Roche Pharmaceuticals, is no longer being sold under that trade name in the United States. Generic mefloquine, however, is widely available here and in other countries. The name of our organization and website have been changed to reflect the change to generic mefloquine.
"I want an apology." Watch the compelling story of Mike Kuligowski, the grieving father of Specialist Adam Kuligowski, who committed suicide in April 2009 while taking the anti-malarial drug mefloquine. He was given mefloquine by the Army. Four short videos.
Fort Campbell (KY) Tries to Stop Soldier Suicides,” Kristin M. Hall, ABCNews/US. Adam Kuligowski (see story) was taking mefloquine before his death. Broadcast April 25, 2010.
Mefloquine prescriptions in the presence of contraindications: prevalence among US military personnel in Afghanistan, 2007. Remington L. Nevin, MD, MPH, Pharmacoepidemiology and Drug Safety (2009).
Drugs to Prevent Malaria in Travelers [summary]. Comprehensive review finds mefloquine to be the only FDA-approved antimalaria drug associated with death. Jacquerioz FA, Croft AM, Cochrane Review, Oct. 2009.
Two Anti-Malaria Drugs Have Fewer Side Effects. Malarone and doxycycline have fewer adverse effects than mefloquine. ABC News (Reuters), Oct. 7, 2009.
Obituary: Sue Rose, Founder, Mefloquine (Lariam) Action, Sept. 8, 2009.
Lost to Lariam? by Kari Lydersen, Chicago Reader, Sept. 09.
Epileptogenic potential of mefloquine chemoprophylaxis: a pathogenic hypothesis, Remington L Nevin, Malaria Journal 2009, 5 August 2009.
Drugs, death, and the manufacture of doubt, by Dan Olmsted, posted on “Age of Autism” blog. MANY comments about Lariam follow the article. [ April 2009]
“The Army has dropped Lariam,” reports Kelly Kennedy, Army Times, March 22, 2009. Re Army Surgeon General’s Orders of Feb. 2, 2009 (see below).
“Create a Consistent Drug Policy,” letter to Stars&Stripes (second letter), Dr. (Maj.) Remington Nevin, March 25, 2009.
Anti-malaria drug limited due to risks, Jeff Schogol, Stars & Stripes, Marcy 5, 2009.
Soldiers Committing Suicide by Jason Notte, The Phoenix [Boston], March 11, 2009.
Updated Guidance on Use of Mefloquine (Lariam) for Malaria Prophylaxis, Dept. of Army, Office of Surgeon General, 2 Feb 09 . This Guidance officially makes doxycycline the “drug of choice” for malaria prevention and adds TBI to contraindications for US military contemplating use of mefloquine.
"Lariam: Why is this high-risk drug still prescribed when safer anti-malaria drugs exist?", Sue Rose/Jeanne Lese, in Medication Sense.
"A Lesson Learnt: the rise and fall of Lariam and Halfan," by Dr Ashley Croft, Journal of the Royal Society of Medicine, April 2007. Dr. Croft is one of the world’s experts on Lariam.
"Before Walter Reed. . .". Dan Olmsted updates his report on the military’s abusive treatment of wounded soldiers and their handling of Lariam toxicity, Nieman Reports Watchdog, March 5, 2007.
Analysis: Iraq casualties and causality, Dan Olmsted, UPI, May 23, 2005. Did mefloquine (Lariam) trigger a number of suicides among soldiers serving in Iraq in 2003?
Consumer Reports, “Lariam’s Legacy,” March 2002. “The most-prescribed malaria drug could produce psychiatric side effects in more than one-quarter of all travelers who take it.”

**Eagle5US** · 06-20-2012, 06:58

Here we go again

Guymullins · 06-20-2012, 11:11

Hunters in Africa are now mostly not taking any prophylactic malaria drugs. Larium is dangerous and the others almost useless. I, and most of my pals would rather wait until we feel unwell, then take a course of Coartem, which cures malaria pretty effectively, and with no side effects. I have just returned yesterday from the Limpopo River , a malaria area and will see if I get cold or flu like symptoms in a week. If so, Coartem at about $10 a dose should do the trick. No problem if you dont actually have Malaria, apart from wasting the $10.

**Eagle5US** · 06-20-2012, 12:03

Quote:

Originally Posted by Guymullins

Hunters in Africa are now mostly not taking any prophylactic malaria drugs. Larium is dangerous and the others almost useless. I, and most of my pals would rather wait until we feel unwell, then take a course of Coartem, which cures malaria pretty effectively, and with no side effects. I have just returned yesterday from the Limpopo River , a malaria area and will see if I get cold or flu like symptoms in a week. If so, Coartem at about $10 a dose should do the trick. No problem if you dont actually have Malaria, apart from wasting the $10.

Though you are from the area, your opinionated "information" regarding the efficacy and safety of current medication profiles is both inaccurate and irresponsible.

I would not be surprised if you, and a number of your colleagues, have a rather significant parasite load and are, in fact, asymptomatic carriers with a symbiotic relationship between yourselves and one plasmodium species or another.

Mefloquin has been used safely for decades. If you give enough people ANYTHING there is going to be a population of recipients who experience side effects. Mefloquin is no different.

All someone needs to do is watch late night TV and you can get a number for a lawyer who will listen to you complain about a drug, surgery, birth defect, allergic reaction, loss of hair, or the fact that the sunset was pink instead of purple on the 3rd weekend of Jun.

Guymullins · 06-20-2012, 16:11

Quote:

Originally Posted by Eagle5US

Though you are from the area, your opinionated "information" regarding the efficacy and safety of current medication profiles is both inaccurate and irresponsible.

I would not be surprised if you, and a number of your colleagues, have a rather significant parasite load and are, in fact, asymptomatic carriers with a symbiotic relationship between yourselves and one plasmodium species or another.

Mefloquin has been used safely for decades. If you give enough people ANYTHING there is going to be a population of recipients who experience side effects. Mefloquin is no different.

All someone needs to do is watch late night TV and you can get a number for a lawyer who will listen to you complain about a drug, surgery, birth defect, allergic reaction, loss of hair, or the fact that the sunset was pink instead of purple on the 3rd weekend of Jun.

If you have a moment, read this from a British newspaper. It is also opinionated and the writer possibly another carrier, but all the same, worth reading. http://www.guardian.co.uk/society/20....lifeandhealth

**Eagle5US** · 06-20-2012, 16:30

Quote:

Originally Posted by Guymullins

If you have a moment, read this from a British newspaper. It is also opinionated and the writer possibly another carrier, but all the same, worth reading. http://www.guardian.co.uk/society/20....lifeandhealth

Opinion.

Opinion regarding someone with KNOWN mental illness - and people looking to blame (and benefit from) someone OTHER THAN the individual who bears the true responsibility.

There are any number of individuals who claim the exact same thing. And I will not argue the point that there are indeed probably a number of folks who have had negative side effects taking Lariam / Mefloquin...as well as there are those with negative effects from any number of other drugs that are out there.

If you read the first sentence of the article it says exactly what I am saying...
THOUSANDS take the drug every year, many WITHOUT any side effects...some C L A I M it causes serious side effects. And indeed for some it may. Doesn't make it a bad drug IF that can be proven to be the case. It means some people can't take it.

This issue is completely secondary to your post stating that most other drugs are useless and your preference to not prophylax against malaria and "wait until you feel bad" is not an option for soldiers; Special Operations or otherwise.

And I will also add that my CSM just got back from a 10day hunting trip in the Limpopo region - and the guide that he went with ENSURED he brought malaria prophylaxis with him (I wrote the prescription) and that he recommends the same to ALL visitors to his game reserve.

When you add your opinion to the medical forum, it should be stated as such so others do not take your information as any sort of factual information.

Badger52 · 07-28-2012, 06:18

Quote:

Originally Posted by Eagle5US

Mefloquin has been used safely for decades. If you give enough people ANYTHING there is going to be a population of recipients who experience side effects. Mefloquin is no different.

Thank you for your measured posts in this thread. A friend is experiencing some of the delayed symptoms that have been observed in, as you point out, the small population over the zillions of doses. He's not the kind to sit up at night & wait for the late-night lawyer ads. He'll proceed to the VA and get it checked out in an orderly & objective fashion and see if there's a correlation.

Thanks.

**Eagle5US** · 07-28-2012, 06:33

Quote:

Originally Posted by Badger52

Thank you for your measured posts in this thread. A friend is experiencing some of the delayed symptoms that have been observed in, as you point out, the small population over the zillions of doses. He's not the kind to sit up at night & wait for the late-night lawyer ads. He'll proceed to the VA and get it checked out in an orderly & objective fashion and see if there's a correlation.

Thanks.

Good plan.
Whether your friend's symptoms are from this drug, another drug, or some as yet undiagnosed pathology...I wish him the best in getting it sorted out.

Navy Flier · 07-28-2012, 20:01

Badger 52,

Be advised that that local VA's across the country are still coming up to speed on what the WRIISC is doing. It is highly probable that your friend's local primary care physician(PCP) may need to contact Josette and the intake team at the New Jersey WRIISC at 800-248-8005 to get educated on what is being done there. The formal assessment will be perfromed in New Jersey once the local VA PCP give the referral to be sent there. That is the procedure so far and the otehr vets have not had any issue so far. VA has been paying the travel expenses of the other vets who have been sent out there.

I tell all the vets who come to me for assistance to not bring up the drug at first....except when they are calling the WRIISC in New Jersey.

If a vet is having a vertigo problem, I direct them to a neurotologist and a neuro-optometrist. As Eagle5US infers, I tell them specifically to talk about thier symptoms and not about any possible cause and let the docs sort it out since there are many other conditions(TBI, Meneire's disease, etc.) that can cause vertigo. It is important they be screen for all of those. It is just my experience that 100% of those who I have directed to these two types of docs who also said they only took mefloquine with no other contributing factors were then diagnosed with central vestibular damage and eye damage.

...in fact one of the first questions I ask anyone who calls me is if they were in the proximity of any bomb blasts. If they were, I tell them to tell that to the docs first. Maybe down the road they can tell them about the drug if they took it. The treatment for TBI is pretty much the same and a lot more recognized. The docs will intake them a lot faster. That is what I am all about anyway...getting these people treated...

My goal is to get the VA fully up to speed. Right now, today, I am quite relieved that all I have to do now is point vets to the New Jersey WRIISC, and the active duty to Balboa, or Bethesda. As the phone calls for help die off, I can then disappear.....which I will gladly do.

Navy Flier · 07-22-2012, 19:50

Dr. Remington Nevin, the army's expert on mefloquine toxicity was invited to present his latest DoD funded research to the Special Operations Medical Association's annual conference in Tampa this past December. Here is a link to the video:

http://www.youtube.com/watch?v=zTUgF3aYGqk

He was invited to the conference by the USASOC command surgeon, Col Peter Benson.

CDR Bill Manofsky USN(ret)

Navy Flier · 07-22-2012, 20:54

The VA War Realted Illness and Injury Study Center has formally recognized mefloquine toxicity by listing it on its exposure web page at the top with Agent Orange and Burn pits.

http://www.warrelatedillness.va.gov/.../exposures.asp

CDR Bill Manofsky USN(ret)