The Pentagon’s anti-malaria drug of choice can cause dangerous side effects

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http://www.inthesetimes.com/site/main/article/1926/

 

Features > February 7, 2005

 

In Harm's Way

 

The Pentagon's anti-malaria drug of choice can cause dangerous side

effects

By Brian H. Kehrl

 

" I believe we should be doing everything we can to protect the health

of service members and veterans, " Sen. Dianne Feinstein (D-Calif.)

wrote in a January 21 letter to Defense Secretary Donald Rumsfeld. " I

know you share my concern for the health and well-being of our

nation's military personnel. "

 

The cause of Feinstein's concern wasn't inadequate body or truck

armor, depleted uranium or the anthrax vaccine. Instead, she was

calling on Rumsfeld to expedite a study on the rare but occasionally

severe side effects of the anti-malaria drug Lariam, which has been

given to troops serving in Iraq and Afghanistan. While the Pentagon

terminated the use of Lariam in Iraq in March 2004, after pressure

from the House Armed Services Committee, it seems to be dragging its

heels in researching the drug's effects.

 

Lariam (generic mefloquine) is a commonly used anti-malaria drug

invented by the Army in the 1970s to replace chloroquine, which was

found to be unsuccessful against certain strains of the disease in

Southeast Asia. Introduced onto the U.S. market in 1989, it is highly

effective in both preventing and treating malaria, as well as many

otherwise resistant strains of the life-threatening mosquito-borne

parasite.

 

Protection, however, can come at a nasty price, particularly for

soldiers already overwhelmed by stressful situations. Among the myriad

side effects for Lariam—according to the Food and Drug Administration

(FDA) and anecdotal accounts of patients given the drug—are anxiety,

paranoia, depression, vertigo, hallucinations, nightmares, psychotic

behavior, brain damage, vestibular (inner ear) damage and suicidal

thoughts.

 

The FDA also notes that " caution should be exercised with regard to

activities requiring alertness and fine motor coordination such as

driving, piloting aircraft, operating machinery … These effects may

occur after therapy is discontinued due to the long half-life of the

drug. "

 

According to the Centers for Disease Control (CDC), there are other

malaria treatments available, including chloroquine, doxycycline and

Malarone (combination atovaquone and proguanil HCL). The CDC

recommends chloroquine for use in Iraq because it is less toxic than

Lariam, and there is no known resistance to it in Iraq.

 

At least 18 soldiers have been diagnosed with brain or vestibular

damage from Lariam toxicity since the invasions of Iraq and

Afghanistan, according to Feinstein's office. One of the afflicted

soldiers, Georg-Andreas Pogany, an Army special-forces soldier, was

also charged with " cowardice " —a crime punishable by death—after he

suffered a panic attack when he saw the mangled body of a dead Iraqi,

according to reports from United Press International. (The charges

against Pogany were later dropped.) There were also a slew of spousal

murders at Fort Bragg in the summer of 2002, after which each soldier

committed suicide. Each of the soldiers involved had taken Lariam. The

Army blamed the crimes on marital problems, and denied any

relationship between the suicides and use of the drug.

 

The FDA requires that a warning be issued to any patient prescribed

the drug, but, according to Steve Robinson, executive director of the

National Gulf War Resource Center, many soldiers taking it were never

informed of the potential side effects.

 

Feinstein and the House Armed Services Committee have been driving the

push for a study of the drug's side effects in Congress. In June 2004,

Feinstein began her calls for a study with letters to both Rumsfeld

and outgoing Secretary of Veterans' Affairs Anthony Principi. The

Pentagon responded to Feinstein's request with a promise to conduct

the study, but said that it would take years to complete.

 

But according to Robinson, the Pentagon's study is different from the

one requested by Feinstein. Instead of surveying current troops, they

have chosen to perform a retroactive study on Lariam's effects on

soldiers during the '80s and '90s. Robinson believes the reason for

the change is that the Pentagon hasn't kept proper records on

soldiers' prescriptions, making it impossible to track any correlation

between side effects and use of the drug.

 

Ever since the outbreak of Gulf War Syndrome—and the difficulties that

those conducting a survey of affected soldiers encountered in tracking

down medical records—the Pentagon has been required by law to keep

track of any medication given to service members.

 

" If you don't have anything accurate to base the study on, then how

can you make conclusions? " says Jeanne Lese, co-director of Lariam

Action USA, a Lariam awareness advocacy group.

 

Malaria is a serious concern, and Iraq and Afghanistan both have

particularly high rates of incidence, but, as Robinson says: " We just

want the [Department of Defense] to do their job in protecting our

troops. If you don't look, you won't find. "