Inter Press Service
Copyright 2002 Global Information Network

Wednesday, November 20, 2002

HEALTH: ARMY CLEARS DRUG IN WIFE KILLINGS BUT DOUBTS PERSIST
By Katherine Stapp

NEW YORK, Nov. 20 (IPS) -- A popular anti-malaria drug has come under scrutiny in the United States following reports that it may provoke suicidal and even homicidal behavior.

The drug, sold under the brand name Lariam and manufactured by the Swiss pharmaceutical giant Hoffman La-Roche, has been widely prescribed for Peace Corps workers, travellers and soldiers deployed to malaria-prone areas since the mid 1980s.

But in the last few years, thousands of people who took Lariam have complained of disturbing side effects, like vivid hallucinations, depression, anxiety, aggression and paranoia.

Relatively little attention was paid to their stories until last summer, when five soldiers stationed at the Fort Bragg army base in North Carolina killed their spouses in separate incidents.

At least two of the accused had recently returned from Afghanistan, where they had been given Lariam.

Two of the soldiers have since committed suicide. The others are in jail awaiting trial.

Last week, a U.S. army investigation concluded that Lariam was probably not a factor in the killings. The team, which included two experts from the U.S. government's Centers for Disease Control and Prevention, blamed marital stress and the hardships of overseas duty. But its report conceded that the army's mental health services are "flawed" and that army culture tends to discourage families from seeking professional counselling.

Some experts with long experience with the drug's dark side are skeptical about the finding that Lariam likely did not play a role in the killings.

"While they state that Lariam cannot be the explanation for the cluster of deaths -- obviously it cannot because not all of the soldiers took Lariam -- they do not say that it can be ruled out in the cases of those soldiers who did take it," said Susan Rose, a consultant to Lariam litigators and an assistant public health professor at George Washington University.

"They state they did not interview the soldiers who took it, or close family members," she added. "They go on to duck the issue by stating that it is beyond the scope of the EPICON (investigation team) charter to comment on 'the safe and appropriate use of mefloquine in deploying service members'.."

Mefloquine is the generic name of Lariam, which was originally developed by U.S. army researchers.

Following the killings, Hoffman La-Roche added a warning to Lariam's label. In a letter sent to 100,000 U.S. doctors and pharmacists last month, it says that "suicidal ideation has also rarely been reported", but that "no relationship to drug administration has been established".

Although the army absolved Lariam in the Fort Bragg killings, the drug's problems are far from over. Last month, a couple from Texas filed suit against Hoffman La-Roche for failing to caution them about Lariam's potential side effects.

"Every time I closed my eyes for more than two minutes, I was seeing these movies," Jane Daehler said in a recent television interview. "It was horrible things, bad things."

Daehler was on a trip to Africa when her symptoms surfaced.

"She became completely confused, manic, agitated," said her husband Bob. "She was paranoid."

Most medical experts point out that Lariam is safe for the vast majority of people who take it. At least 25 million people have been prescribed the drug since 1985, and it is still the anti-malaria drug of choice of the U.S. and Canadian armies.

But when side effects do appear, they can be dramatic and terrifying. Users describe morbid, Technicolor dreams, hallucinations of monsters and dead bodies, and violent or suicidal impulses.

Many European countries are now opting for alternative malaria drugs like Malarone, which is equally effective and was recommended by the World Health Organization for use in Afghanistan.

Rose wonders why, when other drugs are available, the U.S. and Canadian officials continue to insist on Lariam -- which was also blamed as a factor in the beating death of a Somali teenager by Canadian peacekeepers in 1993.

The 14-year-old was killed on the same day that the soldiers took their weekly anti-malaria pill , a day of the week the troops had sardonically dubbed "Psycho Tuesday."

"Considering that one-third of people who take Lariam have neuropsychiatric side effects, the army continues to do a poor job protecting the health of its soldiers by refusing to grapple with the problem of Lariam's side effects," Rose said.