Lariam Caused Son's Suicide

[thedrifter]

Family: Lariam Caused Son's Suicide
Associated Press
September 29, 2002


WASHINGTON - A Marine from Long Island, N.Y., who served in Somalia in 1993 committed suicide seven years later, and his family now believes the anti-malarial drug he was prescribed by the military contributed to his death.
His parents say James Patrick Farrell had no symptoms of mental or emotional problems during high school or in the years before his service in Somalia. He appears to have been a model Marine.

"Patrick was a very likable guy," his mother, Bette, said recently. She and her husband, James, described their son as a handsome, popular student at Manhasset High School, where he graduated in 1984. A captain of the football team, Farrell once played against Vinny Testaverde's Sewanhaka High School team.

But after Farrell returned from Somalia in October 1993, his behavior was marked by delusions, depression, anxiety and confusion, his family said. They said he did not see combat in Somalia, so they could not establish a connection between his behavior and battlefield trauma.

They now suspect the drug Lariam triggered his instability and self-inflicted death on Jan. 31, 2000. He was 33 years old.

The Farrells said they first suspected a Lariam connection when they read about suicides and domestic killings near Fort Bragg, N.C., this summer. "When I saw it, I knew it," Patrick Farrell's brother, Kevin, said of the United Press International report that appeared in the newspaper Newsday. "I didn't have to read it twice."

Three of the soldiers suspected in the Fort Bragg incidents had taken Lariam while deployed in Afghanistan, UPI reported. Two killed themselves.

There is no way to prove whether Lariam caused Farrell's suicide. Drugmakers and government regulators point out that the actions that occur after a person takes a drug are not necessarily caused by the drug.

But by the time Farrell was given Lariam in 1993, the military and the manufacturer, Swiss drug giant Hoffmann-La Roche, were already reporting severe -- and long-lasting -- psychiatric side effects and suicidal thinking among users.

In July, Roche changed Lariam's official product label to include a warning of rare reports of suicide, but said they could not confirm any connection between the deaths and taking the drug. Roche also said for the first time that mental problems could last "long after" taking Lariam.

Soldiers, government workers and travelers have used Lariam since 1989. Around 5 million Americans have taken it, according to Roche, which is licensed by the Army to manufacture it. From 1990 to 2000, Lariam was the government's drug of choice to prevent malaria. In 2000, the Centers for Disease Control and Prevention added doxycycline and Malarone as recommended drugs.

The military continues to hand out weekly Lariam pills to troops in malaria-plagued regions, often over the alternatives, which must be taken daily.

The Farrells said no doctor ever suggested that Lariam could have caused Patrick's problems. The doctor treating him declined to comment.

A Food and Drug Administration official said in an interview last summer that the risk of side effects must always be weighed against the benefits of preventing malaria.

"Suicide in one in perhaps -- I don't know -- 1 million or however many cases you can actually calculate for Lariam may have to be acceptable on the basis for the risk for malaria," said Dr. Leonard Sacks, a medical officer with the FDA.

The Army declined to comment on the Farrell case. The Marine Corps did not return calls seeking comment.

"There are hundreds of thousands of soldiers who have taken mefloquine [Lariam's generic name]," Army spokesman Lt. Col. Ryan Yantis said in August. "We have no indication at this time that this drug is anything other than safe and effective in its proper use."

Farrell's father had served in the Marines and Patrick Farrell enlisted in 1989 after a couple of tries at college. He appears to have flourished, receiving his associate's degree and becoming a certified diver.

In a recommendation for a "meritorious corporal" award, Farrell's commander described him as "a highly motivated, industrious Marine" and "recruit poster-quality." He commended Farrell's "superior intellect and positive personal traits [that] ensure his success as a leader."

Farrell, an electrical equipment repairman, volunteered to serve in Somalia. The Marines prescribed Lariam during his four-month duty there, according to his medical records.

He returned in October 1993 and received an honorable discharge in November.

Family members said his problems were apparent immediately.

"He was different. He had a look. He was not the same guy," his father said. Kevin Farrell said his brother "just had a dead look in his eye."

He was described as unable to socialize or hold down work, failing even to show up for an interview his father had arranged for him at a construction company.

He would disappear for months at a time and once wound up broke in a men's shelter in Albany.

Once home, Farrell drank heavily and was incoherent.

"He would drive around the same roads he had known all his life and he would get lost," his sister Jennifer said.

Farrell received counseling at the Long Island Jewish Medical Center, where his medical records indicate doctors documented severe depression and psychosis during 1998 and 1999.

A therapy record from March 1, 1999, says he told doctors about a "long, convoluted paranoid delusion" and suffering from depression, psychosis, unstable moods and delusional thinking.

The Farrells described two such delusions: Patrick believed that his mother had been gang-raped and his brother had been castrated. "He was always talking about stuff that never happened," Jennifer said.

"There was no sense to it at all," James said about his son's talk.

For the last three years of his life, Patrick Farrell rarely left the house.

On Jan. 31, 2000, he went into his upstairs bedroom with his father's 30-year-old lever-action Winchester rifle. He had been complaining about pain in his head.

A neighbor heard the shot and, through a window, saw Farrell's body briefly propelled by the force of the bullet, his family said.

Bette found his body.

In May, UPI reported that evidence suggests Lariam has caused such severe mental problems that in a small percentage of cases it has led to suicide. FDA databases contain reports of a dozen suicides associated with Lariam between October 1997 and March 2002. Other suicides suspected of being associated with Lariam have occurred as long as two years after the drug was taken.

No suicides had been reported with doxycycline, a common antibiotic prescribed 25 times more often, at 9 million times each year, according to data from IMS Health, a healthcare information company.

Hoffman-La Roche and the military had considered such issues a decade ago. A study published in the Journal of Tropical Medicine and Parasitology in 1993 said that two of 359 Marines given Lariam became so depressed and suicidal they had to be hospitalized. But the study said that U.S. military doctors concluded their symptoms were not due to the drug and the soldiers "were withdrawn from the study."

The study then concluded that Lariam was "well-tolerated" by the Marines.

A year earlier, a report by three scientists employed by Roche found that "serious and occasionally prolonged psychiatric and neurological effects occur in patients" taking Lariam, but that "such events are rare."

Researcher Stefany Moore in Washington contributed to this story.

Sempers,

Roger

[thedrifter]

Worse than the disease?
Worse than the disease?
As investigators debate its role in a series of military killings, anti-malaria drug mefloquine carries a long, strange history, DAVID AKIN reports
By DAVID AKIN

Saturday, September 14, 2002 ? Print Edition, Page F7

It was Master Sergeant William Wright's job in Afghanistan to teach villagers how to find underground water and dig wells.

He had arrived in March, part of the U.S. Army's 96th Civil Affairs Battalion. By May, his tour of duty had ended and he had persuaded his superiors to let him leave a day early so he could surprise his wife, Jennifer, and their three children at their home on the Fort Bragg army base near Lafayetteville, N.C.

But when he arrived home, he was surprised to find his wife sleeping with another man.

Sgt. Wright, who had never been known to act violently, promptly packed up his things and moved out of the house and into army barracks. But he returned home, police say, on June 29, and Jennifer Wright was never seen alive again.

A few weeks later, Sgt. Wright confessed to the strangulation of his former high-school sweetheart. Jennifer Wright, as it turned out, was the second of four Fort Bragg wives to be killed by their husbands in the span of a few weeks.

The killings had a few links. All the couples, say friends and families, had experienced marital troubles. Three of the four accused husbands had served in Afghanistan.

But there was another common denominator: Three of the four men, including Sgt. Wright, had taken mefloquine, a commonly prescribed anti-malarial medication marketed under the trade name Lariam by Swiss drug giant F. Hoffman-Roche Ltd.

Roche concedes that Lariam can cause severe neuropsychiatric disorders, including manic behaviour, acute psychosis with delusions, and aggressive mood swings, in a very small number of cases, about one in 10,000. Investigators have not yet concluded whether Lariam played any role in the Fort Bragg killings, but they are considering it.

The Canadian Somalia Commission of Inquiry also looked at Lariam when it investigated the 1993 beating death of a Somali teenager at the hands of Canadian troops. Many soldiers were given mefloquine while on duty in Somalia.

The commission, which was shut down prematurely by the federal government, was unable to sort out the difficult and complex science of mefloquine and the brain's chemistry. Ultimately, it decided that it could not say if mefloquine played in the events that led to the death of Shidane Arone.

But the commission certainly heard from soldiers and army medical staff that mefloquine provoked numerous psychological side effects among the troops in Somalia. "Ten patients experienced nightmares. . . . One patient heard voices and talked to himself. All were switched to [another anti-malarial agent] with no subsequent problems," its 1997 report said.

One Canadian army major said that the men in his unit used to joke that "if you get somebody angry, he's just going to walk into the old church tower and waste 20 people" and then say, "Oh, sorry, bad mefloquine trip."

Canadians in Somalia got their weekly dose of mefloquine on Wednesdays. The U.S. soldiers took their Lariam pill on Tuesdays, prompting some members of the U.S. forces to dub that day of the week "Psycho Tuesdays."

Canada's Department of National Defence has been prescribing mefloquine for its ground soldiers and navy personnel since 1992, a year before the drug was approved by Health Canada for civilian use. By all accounts, the Canadian mission in Afghanistan was unmarred by any incidents like those of the Somalia scandal -- but the troops did take mefloquine, and some reported strong nightmares and other psychological oddities.

Armies and mefloquine have grown up together -- like most anti-malarial drugs, it is the product of army medical research. Private-sector drug companies rarely initiate malaria research for the simple reason that there is little money to be made in wiping out a disease that affects the world's poorest people. But armies have an incentive to keep their soldiers healthy in the jungle.

"The motivation to pursue research on a malaria vaccine was not so much altruistic as it was imperial," Robert Desowitz wrote in his 1991 book The Malaria Capers. The malaria parasite was first discovered by a surgeon in the French army, and it was a surgeon in the British army who deduced that mosquitoes carried the disease. As the first great colonial powers of the modern world, the French and the British deployed significant resources to combat malaria.

But as their global presence faded, the United States filled the vacuum.

With malaria killing more U.S. soldiers than North Vietnamese bullets, finding a drug that could protect them become a top priority for the U.S. Army's medical researchers by the end of the 1960s.

In 1971, scientists at the Walter Reed Army Institute of Research in Baltimore discovered that quinoline-methanol, a chemical cousin to quinine known as mefloquine, was an excellent chemoprophylactic (a chemical condom) to shield those who took it from malaria.

The World Health Organization, Roche and the Walter Reed researchers agreed to jointly develop the drug and, by 1985, Roche was ready to manufacture it, receiving regulatory approval first in Europe and then later in North America.

It was seen as an important weapon to combat one of the world's leading health problems. Malaria infects more than 500 million people a year and, of those, nearly three million die, according to the World Health Organization.

But anecdotes of bizarre Lariam-influenced behaviour surfaced within a few years of the drug's commercial use.

In 1998, a schoolmaster in England stole ?36,000 of school-trip money and then blamed the side effects of Lariam for his aberrant behaviour. Vanessa Brunt, who her family said was a healthy and happy 22-year-old student at Cambridge University, committed suicide in 1999 after receiving doses of Lariam. And this year, a former Democratic Congressman in Philadelphia was charged with defrauding friends and supporters of $10-million (U.S.). He told the judge in the case that he couldn't tell right from wrong because of the side effects of Lariam.

Even as early as 1993, H. A. H. Mashaal, the World Health Organization's senior malariologist from 1957 to 1982, put out the call for a broad review of mefloquine's use and related adverse effects.

But all of this doom and gloom about mefloquine is, according to some researchers, nothing more than the media's uninformed overreaction.

Last year, a group of Canada's top malaria and infectious-disease researchers wrote in the Canadian Medical Association Journal that "real and perceived intolerances to mefloquine have received substantial and occasionally irresponsible coverage in the Canadian media. As a result, many Canadian travellers refuse to take mefloquine, even when it is clearly the most appropriate choice."

They say mefloquine can be a literal lifesaver in certain parts of the world. Roche, too, is standing by its product, although it mailed out warnings this year to U.S. health-care practitioners in which it spelled out some of the potential neuropsychiatric reactions.

As for Master Sergeant William Wright, he remains in jail in North Carolina and faces a trial in the killing of his wife. Prosecutors are sure to point to a jealous husband who strangled his wife in a fit of rage. His lawyer, though, may dust off a pile of scientific studies and point the finger at one of the world's most popular anti-malarial drugs.

Anti-malaria arsenal

Experts say it is vitally important that anyone who travels to a region where there is a risk of malaria talk to their doctor well before travelling, usually six to eight weeks. There is no one drug that is suitable for all, nor is there there a malaria vaccine, though researchers at Oxford University began testing a potential one this summer in Gambia. This list contains the drugs' generic names, followed in brackets by trade names.

Chloroquine (Aralen). For more than 40 years, this has been the most widely used anti-malarial drug. As a result, though, malaria parasites in African and some parts of Asia are now resistant to it.
Mefloquine (Lariam). Now recommended as the first defence by Health Canada, the World Health Organization and the U.S. Centers for Disease Control. Has been a source of controversy due to its rare neuropsychiatric side effects (see main story). Highly effective in sub-Saharan Africa. Less so in some parts of southeast Asia.
Doxycyline (Vibramycin or Doryx). Generally now the choice for a patient who is unable to take chloroquine or mefloquine. Not suitable for pregnant or breast-feeding women, or for young children.
Atovaquone plus proguanil (Malarone). Only recently licensed in Canada, it is as effective as mefloquine and has significantly fewer side effects, but is a significantly more expensive drug.
Primaquine. Somewhat less effective than first-line drugs. Also requires a special blood test before it can be prescribed.

Not recommended
These drugs are no longer sanctioned in Canada, but travellers may see them sold in other countries.
Proguanil (Paludrine). Not recommended for malaria protection by Health Canada.
Pyrimethamine plus sulfadoxine (Fansidar). No longer available in Canada because it can cause severe skin reactions.

Sources: Health Canada; Dr. Jay Keystone, Toronto General Hospital's centre for travel and tropical medicine; The Globe and Mail

[thedrifter]

The San Francisco Chronicle
Copyright 2002

Sunday, September 15, 2002

TRAVEL MEDICINE

Tricky anti-malaria drug still travelers' first choice
Ulysses Torassa
E-mail Ulysses Torassa at utorassa@sfchronicle.com.

The controversial anti-malaria drug Lariam is back in the news, with speculation that it might be connected to the recent rash of murders and suicides at Fort Bragg, N.C. Three soldiers, each of whom had reportedly been given Lariam (mefloquine) during their tour of duty in Afghanistan, killed their wives this year. Two of them took their own lives as well.

Lariam's manufacturer, Roche Pharmaceuticals, said it was alerting doctors that a small number of people have committed suicide after taking it. (The label already lists suicidal thoughts and other psychiatric problems as potential risks). And last month, the U.S. Food and Drug Administration approved labeling Malarone (atovaquone/proguanil) to say that it has fewer side effects than Lariam.

Both medications are proven to prevent cases of malaria, a sometimes deadly mosquito-borne disease endemic in much of Africa, parts of Asia and South America. Chloroquine was once the drug of choice, but resistant strains of malaria have spread to most of the world. Another preventive treatment, doxycycline, has unpleasant side effects and must be taken daily. Lariam needs to be taken only weekly and has become public health officials' first choice.

But the drug has been dogged by reports that it triggers neurological disturbances, vivid dreams and even psychosis in some who have taken it. A former congressman blamed Lariam for a series of bad business deals that culminated in multiple fraud charges.

Lariam has its defenders. It is cheaper than Malarone -- $10 versus $33 for a week's worth -- and taking it weekly instead of daily means less chance of missing a dose. And officials cite studies that found a relatively low incidence of adverse episodes. Millions of people -- myself included -- have taken it without any problems.

Tom Skinner, a spokesman for the Centers for Disease Control and Prevention, said the agency is reviewing its recommendations for malaria prevention and expects to issue an update early next year. Meanwhile, the CDC stands by its recommendation of Lariam as the first choice for travelers to areas where malaria has become chloroquine resistant. It also lists Malarone, doxycycline and others as useful alternatives.

Army investigators have said they are "pretty sure" Lariam did not play a role in the Fort Bragg killings.

But anti-Lariam activists such as Jeanne Lese of San Rafael want patients to sign an explicit consent form detailing the risks before the drug is prescribed.

"People are . . . not being warned, because the doctors aren't aware there is a problem," said Lese, co-director of Lariam Action USA.



Evening Standard - London
Copyright 2002
Tuesday, September 17, 2002
Drug problem: the Lariam debate

Controversy has surrounded Lariam since it was launched in 1989, and has been linked to several suicides around the world. Its maker, Hoffman-La Roche estimates that only one in 10,000 users will become so ill from side-effects as to require hospital treatment - although other studies have suggested that as many as one in 140 users may suffer temporarily disabling side-effects.

Malaria kills over two million people every year, making it one of the world's deadliest diseases.

Over 30,000 European and American travellers are infected every year with the disease, which spreads from person to person by mosquitos. Early symptoms are often mistaken for flu (a mild fever, chills, headaches, general malaise). Later symptoms include fever, delirium and confusion.

Cerebral malaria is fatal in 20 per cent of cases.

Lariam is 97 per cent effective in preventing malaria, and is recommended for most African countries, all around the Amazon basin, some parts of Central Asia, and South East Asia.

Doctors point out that contracting malaria could be worse than the side effects of Lariam. But in most cases, there are other anti- malarial drugs available.

Possible side-effects of Lariam include convulsions, depression, hallucinations, dizziness, psychosis, loss of balance, headaches, insomnia, abnormal dreams, anxiety, depression, panic attacks, agitation, fatigue, muscle weakness and loss of appetite. The drug is not recommended for anyone with epilepsy, who is pregnant, for scuba divers, or for anyone who has a history of psychological problems or depression.

Psychological effects are known to occur after stopping taking the drug.

Before being licensed, drug trials were conducted largely on soldiers - who were young, male and healthy. Eight out of 10 adults who experienced the most serious sideeffects were women, who tend to weigh less, but take the same dose as men.

A study by Peter Barrett from the Medical Advisory Service Travellers Abroad found that 40 per cent of people experience some kind of side-effect such as nausea, dizziness, strange or vivid dreams, anxiety, depression or seizures.

While most of these effects are short-term, the way the drug works is not fully understood, and in some people the symptoms may last for months or years.

[thedrifter]

Sydney Morning Herald
Copyright of John Fairfax Group Pty Ltd
Thursday, September 19, 2002
News And Features
Malarial Malaise
Ruth Pollard

The resurgence of the mosquito-borne illness has forced pharmaceutical companies to find new ways to combat the disease. But one drug has possible fatal side effects. Ruth Pollard reports.

THE United States Army is investigating whether it is linked to a series of murders and suicides at its Fort Bragg base in North Carolina, lobby groups oppose its use and its manufacturer, Roche, is sending letters to US doctors warning of its reported links to suicides.

The controversy over the anti-malaria drug mefloquine, sold in Australia as Lariam, has not only reopened debate about the safety of the drug, but has doctors wondering whether, for some travellers, anti-malaria drugs are needed at all.

Mefloquine was developed by the US Army because some strains of malaria were becoming resistant to chloroquine in the late '70s. The drug has come under attack because of the serious, but rare, neuropsychiatric side effects it causes.

One in every 10,000 people who take mefloquine to avoid developing malaria while in areas where mosquitoes are rife experiences severe neuropsychiatric disorders. That rises to one in 1000 to 2000 when it is used as a treatment for malaria because it is used in higher doses, experts say.

Mefloquine is mainly prescribed for people travelling or living in Africa and South America. In South-East Asia and the Pacific, malaria has become resistant to the drug, so doxycycline, another anti-malaria drug, is usually prescribed.

Dr Andrew Fuller, an infectious diseases physician at Melbourne's Alfred Hospital, has seen the neuropsychiatric side effects of mefloquine: "I had a patient who thought he was Jesus Christ. I have a dozen patients who have had symptoms for anything from months to years. I don't prescribe the drug much there are other options, other drugs available."

That said, mefloquine is considered a highly effective preventative for malaria, one of the world's most deadly communicable diseases. Most who take it experience only mild side effects, or none at all.

Investigations are under way in the US over whether there is a connection between mefloquine and four soldiers who killed their wives, and the two who subsequently committed suicide at Fort Bragg. All four had reportedly served in Afghanistan and were allegedly taking mefloquine.

Its manufacturer in the US, Hoffman-La Roche, plans to send written notices to doctors warning that the drug has been linked to reports of suicide, although it has said there was still no evidence that mefloquine can cause people to kill themselves.

"Rare cases of suicidal ideation [thoughts] and suicide have been reported but no relationship to drug administration has been confirmed," it has said.

Mefloquine was first used to prevent malaria in 1985, and since then 14.5 million people have been prescribed the drug for malaria prevention, and 1.6 million for treatment, according to a study in the British Journal of General Practice earlier this year.

Since then "Lariam Action" support groups have been formed in Australia, New Zealand, Britain, the US, Canada, Ireland, Denmark, and Switzerland. Lariam-related lawsuits have been filed (though some have been withdrawn) in Ireland, Canada, Denmark, and the US.

The British study, which reviewed 516 published cases of adverse effects from mefloquine, found alcohol, recreational drugs, hormonal contraception and other medications can be related to severe or prolonged adverse reactions to mefloquine. It warned those with a history of liver or thyroid abnormality in the previous two years should avoid mefloquine.

But it also said: "Mefloquine is a safe and exceptionally useful drug for the mass prophylaxis and treatment of those resident populations in malaria-endemic areas which traditionally abstain from alcohol and hormonal contraception."

One Australian doctor, Bob Cass, the chief medical adviser of the Travel Doctor Group, has called for a total rethink on the prescription of anti-malaria drugs to travellers going to countries with endemic malaria.

"In most major regional centres in, for example, Thailand, including Bangkok, Chiang Mai and Chiang Rai, the risk of contracting malaria is very low, and it is much lower than the risk of side effects from anti-malaria drugs," Cass told the Herald.

"On the other hand, trekking in monsoonal months is a risk, and you need to take prophylaxis."

Cass said doctors should assess where a person was travelling to, and what the individual would do while there, plus any pre-existing health conditions such as depression, epilepsy or bipolar disorder, before prescribing anti-malaria drugs.

"You cannot simply have someone come into your surgery, tell you they're going to Africa, or the Amazon, then open a travel medicine guide, run your finger down the page and say 'malaria and these are the drugs you need to prevent it' it is not as simple as that."

Cass sees many people who travel on their honeymoon. He starts them on a course of mefloquine six weeks before the wedding to see if they tolerate the drug. "If they don't, then we have time to try something else."

And his advice regarding alcohol and mefloquine? "If you are going to get drunk on the day you are meant to take your medication, don't take it delay it a day or two it stays in your blood for a long time, so a couple of days won't make much of a difference."

Roche Australia's medical director, Dr David Kingston, told the Herald the company was not changing or reissuing prescribing guidelines for mefloquine. "Our current guidelines already cover all the warnings ... of severe neuropsychiatric reactions," he said.

These events were rare and usually occurred in people with a history of depression or psychosis, he said. Malaria is a life-threatening disease, and the risks had to be weighed up.

Kingston acknowledged that the product information did not mention suicide, saying there was no scientific evidence linking mefloquine to suicide.

The director of the adverse drug reactions unit at the Therapeutic Goods Administration, John McEwen, said the product information that comes with mefloquine in Australia had "clear statements about ... psychiatric side effects".

"We will be contacting the FDA regarding this in the next month or so ... we are always prepared to relook at an issue if there is a reason to do so. Though it does look to me like factors in the US other than medical factors are driving this debate," he said, alluding to the US Army investigation.

A senior lecturer in Westmead Hospital department of medical parasitology, Dr John Walker, said there was a continuing question mark over mefloquine. "People need to be fairly cautious, particularly if they abuse the sorts of things [alcohol and other drugs] that cause adverse reactions."

But he said it would be drawing a long bow to implicate the drug in the US army murders at Fort Bragg.

"We are talking about people who are trained killers it is clouding the issue to implicate the drug in these deaths," he said. "Tens of thousands of people have taken mefloquine successfully for decades has anyone else been wandering around taking mefloquine and killing their wives?"

Walker warned of the enormous discrepancy in knowledge among doctors when it comes to tropical medicine. "It is vital that you look for pre-existing conditions or other signs that indicate people will be in danger of experiencing side effects if they take these drugs."

Karl Rieckmann, the director of the Australian Army Malaria Institute, worked on the early mefloquine studies in the '70s at the Walter Reed Army Institute in the US. Professor Rieckmann said that while he preferred to take the other commonly prescribed anti-malaria drug, doxycycline, he felt more confident about mefloquine than he did decades ago.

"As long as people keep up their hydration levels and avoid alcohol, and as long as it is not [not] prescribed to people with liver or thyroid problems or a previous history of neuropsychiatric problems, it appears to be safe," he said.

And while the army had always advised soldiers to avoid drinking alcohol when taking any anti-malaria drugs, he acknowledges that this advice may not always be followed.

Mefloquine, which has a high resistance in Asia and the Pacific where most Australian peacekeepers are based, is prescribed only as a second-line drug.

"We have always, for many years, used doxycycline, because Asia is where mefloquine resistance started," said Rieckmann.

Armies often considered compliance a big issue doxycycline was taken daily, whereas mefloquine was taken weekly, which some people found more convenient, he said, explaining one reason for its popularity in the US.

As for the investigations regarding murders and suicides at Fort Bragg in North Carolina?

"Maybe the soldiers had been out on a drinking bout?" Rieckmann said. "One thing people must remember no anti-malaria drug is
completely effective or completely safe."

Sempers,

Roger

[thedrifter]

VETERAN'S NEWS and VIEWS.....: Lariam and Ft. Bragg
dated 8/8/02


From: lariaminfo@yahoo.com (Lariam Action USA)
To: vetcenter@aol.com


Lariam Action USA is trying to reach Somalia vets and any other
servicepeople who believe they have had an adverse reaction -- short or
prolonged -- to Lariam (mefloquine), a common antimalarial agent. Its side
effects range from simple nausea and dizzyness to depression and anxiety
attacks and paranoid behaviors, to suicidal ideas and even suicide.
Lariam was given to US troops in Somalia, Zaire, and elsewhere. It is
currently being used in Afghanistan. United Press International has been
doing a series on Lariam and vets. The most recent story (Aug 7)asks if
Lariam could be a factor in the killings at Ft Bragg. You can read these
stories at www.upi.com (search "lariam').

I am looking for vets who think they had an adverse reaction to Lariam and
would like to talk about it. If this described you, please contact me asap at
lariaminfo@yahoo.com. Regards,
Jeanne Lese, Lariam Action USA, HREF="http://www.lariaminfo.homestead.com">www.lariaminfo.homestead.com

[thedrifter]

http://www.military.com/NewsContent?file=FL_shot_100502

Sempers,

Roger