CBS News: 60 Minutes II
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Wednesday, January 29, 2003

News; International

60 MINUTES II
Dan Rather, Scott Pelley, Bob Simon, Charlie Rose, Vicki Mabrey

The Felony Murder Rule has put many people behind bars for murder who didn't actually kill anyone; Roche Pharmaceutical's anti-malarial drug, Lariam, may have much worse and a much higher frequency of side effects than Roche's studies indicate; Regina Carter is the queen of the jazz violin.

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MABREY: Last summer, four soldiers from Ft. Bragg were accused of killing their wives. Two of the men committed suicide; the other two are awaiting trial. So many brutal crimes, so similar, so close in time raised questions, and the Army sent a team to investigate.

Some people at Ft. Bragg were suspicious right from the start that the anti-malarial drug Lariam may have played a part in the murders. Lariam was invented by the U.S. Army and is routinely given to soldiers deployed overseas. But Lariam can cause what are called neuro-psychiatric adverse events. In plain language, it can cause you to lose your mind.

No one questions Lariam's effectiveness in preventing the deadly disease malaria. Millions of tourists and other world travelers have taken it with no problem. But a significant number of people have seen and felt firsthand the dark side of Lariam.

BOB DAEHLER: Oh, look at all those over there too.

MABREY: It was supposed to be a dream vacation, a safari to Kenya a year-and-a-half ago for Dr. Robert Daehler and his wife, Jane, seen here on home video. What you won't you see is how, deep in the African bush, she suddenly transformed before his eyes.

BOB DAEHLER: She just became completely psychotic in the van, started taking her clothes off. She had called people back from the dead. And they had a doctor at this lodge that came into the van, and she looked at Jane, and she said, did she take Lariam? She said she had seen this in many Americans.

MABREY: So had three other doctors in Africa, who confirmed the diagnosis. Jane Daehler was flown home, strapped to her seat with a bed sheet. But home meant a month in a psychiatric hospital, in and out of psychosis, with terrifying hallucinations.

JANE DAEHLER: ... to the point that they were horrific. I thought that people were trying to kill me all the time. I thought that my family was going to be killed.

MABREY: According to its own internal documents, Roche Pharmaceuticals, Lariam's maker, has received over 3,000 reports of psychiatric problems associated with the drug, from nightmares, depression and hallucinations to paranoia, psychosis, and aggression.

But could Lariam lead to something worse? That was the question raised last summer when this man, Master Sgt. William Wright, and three other Ft. Bragg soldiers were accused of killing their wives, all within a period of just about six weeks.

We know for a fact that Wright and another soldier were given Lariam, and Wright is considering using that as part of his defense. One of his fellow Green Berets thinks Lariam did play a role.

John Lown, now an ordained minister, visits Wright in jail every week.

When you first started to see him, what was he like?

REV. JOHN LOWN, FORMER GREEN BERETS MEDIC: He was very confused; he was very paranoid. And boy, I was like this is not the Bill that I knew.

MABREY: And how is he now, compared with when he first went into jail?

REV. LOWN: Oh, about the fifth week after that, he was coherent; he was fine. He even said, well, I'm thinking a lot better now.

MABREY: What do you think has caused his change?

REV. LOWN: Personally? I think it was the medication. It took about two months for the stuff to clear out of your system.

MABREY: Lown said his unit even had names for the days they took Lariam, "manic Mondays" or "wild Wednesdays." His wife, Debbie, says she and the other wives would see an immediate change in the men.

MABREY: What kind of symptoms did they tell you they saw?

DEBBIE LOWN, WIFE OF REV. JOHN LOWN: That their husbands were very negative, aggressive. A couple of them even complained how they'd be woken in the middle of the night, shook, called names, one running down the street without his clothes on, hollering, screaming.

MABREY: But how do you know it's not just the stress of what they were under job-wise?

DEBBIE LOWN: He's been on other deployments where Lariam was not required, and he didn't have those kind of problems.

MABREY: Like her husband, Debbie Lown is convinced Lariam was a factor in some of the Ft. Bragg murders. She had even complained to military authorities as far back as 1996.

DEBBIE LOWN: I said, I'm not asking you to stop giving them the Lariam. I'm just asking you to better inform the soldiers of what they're taking; tell their wives because they'll save marriages that way; they'll save lives that way.

MABREY: Jane Daehler agrees just knowing it's the Lariam can make all the difference.

JANE DAEHLER: If it wasn't for him, I honestly think that somebody could have put me in a mental institution and thrown away the key.

MABREY: Before the trip, her husband, Bob, a physician, says he was careful, since his wife had been treated for depression in the past and was on what he says was a low, preventative dose of Prozac.

He checked with a Travel Clinic, the Centers for Disease Control web site, and his physicians' drug guide. This is what he read, information written by drug companies for doctors and approved by the Food & Drug Administration. The key part is the warning section. That's what doctors pay attention to.

And this one, for Lariam, says, "Lariam should not be prescribed in patients with active depression or with a history of psychosis or convulsions."

BOB DAEHLER: Right. And Jane did not...

MABREY: You read that before you left?

BOB DAEHLER: Yes, that's what I read. And Jane did not have active depression. She did not -- it was 10 years earlier. She did not have psychosis ever. She never had seizures.

MABREY: And then...

BOB DAEHLER: Nor did i. There was no reason why either of us couldn't take this drug.

MABREY: But what was not in the warning section, what may have raised a red flag for the Daehlers, are those disturbing side effects: depression, hallucinations, psychotic or paranoid reactions, aggression, all listed towards the end.

BERNARD FISCHMAN, ATTORNEY FOR DAEHLERS: They buried the lead. They took the important information that would've tipped off a doctor and stuck it down there in a part that's not part of the warnings.

MABREY: Attorneys Bernard Fischman and Paul Smith represent the Daehlers in a lawsuit they've filed against Roche, arguing that the company failed to properly warn them.

But can't Roche argue, we have it in here. We tell you there are, less frequently, adverse events: depression, hallucinations, psychotic episodes...

PAUL SMITH, ATTORNEY FOR DAEHLERS: It doesn't call any attention to the real nature of this problem. There's no mention of psychiatric problems under the warning section of that package insert.

BOB DAEHLER: There's alternatives that can be taken. There's just no reason that Americans should be taking Lariam.

MABREY: Doxycycline, a common antibiotic, and Malarone, approved two years ago, are both effective in preventing malaria and have fewer psychiatric side effects than Lariam.

Roche, the drug company, claims that Lariam causes serious psychiatric side effects in only one in 10,000 people. But Dr. Paul Clarke, an infectious disease specialist and the medical director of a large network of travel clinics in Great Britain, organized his own study after he and
other British doctors saw problems with much greater frequency.

DR. PAUL CLARKE, INFECTIOUS DISEASE SPECIALIST: It was confusion; it was disorientation; it was anxiety and panic attacks. There were episodes in which people indeed had unusual symptoms that could be described as psychotic.

MABREY: Their research confirmed the hunch. Not one in 10,000, but closer to one in 140 suffered disabling side effects like the ones Dr. Clarke had seen in his patients.

Why such a huge difference in the numbers? Because of the key difference between the term "disabling" in Dr. Clarke's study and the term "serious" as used by the drug company.

In Roche's study, "serious" meant you had to be dead, in the hospital, or have a long-term disability to count. It's an industry standard all drug companies use. But with that narrow definition, Dr. Clarke says, Roche's study may have failed to identify up to 70 times more patients with troubling side effects.

These were disabling, these were crippling for these people?

CLARKE: They were disabling as we defined it, which was that you were unable to carry out the functions for which you went out on your travels, which is actually serious. To any ordinary person, it's serious.

MABREY: Based in part on Dr. Clarke's study, British authorities began to recommend using Lariam less often. Despite his concerns, though, he still says Lariam can be a useful drug.

CLARKE: It's very easy to take once a week. It gives you very good protection. You get good compliance. And if you've taken it in the past and never had a problem with it, I, for one, would be very sorry to see it go, because it's a good drug.

MABREY: You just want people to be better informed?

CLARKE: Yes.

MABREY: We wanted to ask both the FDA and the CDC about how well the American public is informed of Lariam's potential dangers, but both government agencies chose not to do an interview. The FDA did send us a statement, saying that Lariam's benefits far outweigh its risks.

Roche also declined our request for an interview, but sent us this statement, saying, in part, that no prescription drug is free of side effects. Roche also said there's no way for a physician to predict "'every' person 'at-risk' for psychiatric" side effects.

Linda Perry considers her husband a perfect example of that.

Did your husband have any prior history of depression or mental illness?

LINDA PERRY, WIFE OF MAN WHO SUFFERED LARIAM SIDE EFFECTS: Absolutely none.

MABREY: In 1998, Linda and Chuck Perry left their Midwest ranch and their seven children to go on an African safari for their 30th wedding anniversary. Linda, a registered nurse, checked with her doctor, pharmacist, and local health department. For malaria protection, they all recommended Lariam.

PERRY: The first warning I ever got was from the safari guide in Africa. She says to me, well, why do you take Lariam? It's a hallucinogen very much like LSD. And I said the CDC recommends it. And she said, well, we never take it.

MABREY: After four doses of Lariam, the Perrys were having night sweats and vivid nightmares. But everyone, including the CDC had stressed taking the full dose of the drug, which meant taking it for four weeks after the trip. That's when Chuck Perry's real problems began.

PERRY: He didn't know where he was. He ran out in the yard. I can remember tackling him in the yard, saying, what are you doing, what are you doing? You know, oh, the neighbors are after me, somebody's after me. And it was just bizarre, just bizarre.

MABREY: You had never seen anything like this from him before?

PERRY: Never. He's the rock of the earth, salt of the earth.

MABREY: Chuck Perry was hospitalized and tested repeatedly. A team of doctors became convinced that Lariam was responsible.

And told you you could do what?

PERRY: They didn't know what -- we didn't know what to do. Let him rest? They didn't know. Nobody knew what to do.

MABREY: Six months after returning home from Africa, Chuck Perry committed suicide.

PERRY: We had no way to know that this drug would be so powerful that it could alter his personality so much and damage him so much that he would, in fact, do that in some type of delusion or hallucination. That's what we didn't know.

MABREY: But Roche did know something about Lariam and suicide. Over the past year, two UPI reporters, Dan Olmsted and Mark Benjamin, unearthed these internal documents. They show that by the time Chuck Perry killed himself, the company knew of at least seven suicides and 13 suicide attempts by people living outside the United States, all associated with Lariam.

But nowhere in its product information was there any mention of the word "suicide."

After two years of trying to attribute Chuck Perry's suicide to other causes, Roche quietly settled a wrongful death suit with Linda Perry last May. Two months later, Roche dramatically changed its product information.

Psychiatric side effects are now in the warning section, including, for the first time, "rare cases of suicide." But Roche says there is no proof linking its drug to suicide, and points out that Chuck Perry is the only reported American suicide of the more than five million who have taken Lariam in the U.S.

That doesn't address the other suicide reports outside the United States, but Roche says those cases are well below the suicide rate in the general population.

When we requested current figures, Roche declined, saying that accurate numbers on all reported events are hard to come by.

CLARKE: What is not clear is how many people may have been permanently damaged, if any, or indeed may have gone as far as a psychotic episode, which might have led to some other ghastly accident.

MABREY: But could it have led to murder at Ft. Bragg? In early November, the Army released its findings, which said that Lariam, in the Army's words, does not explain the clustering of violent deaths there. As a result, the military probably won't change its policy on Lariam's use.

Should it be given to soldiers with guns?

CLARKE: I would not give it to them, and I would -- because we do have alternatives, and we do know they're effective.

MABREY: Unlike the U.S., Great Britain, Germany, and Australia did not give their soldiers Lariam in Afghanistan, opting instead for those alternatives. But as the United States prepares for the possibility of war with Iraq, some of our American troops already are being given Lariam.

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I'm Scott Pelley. We'll be back next week with another edition of 60
MINUTES II.

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