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Old 06-20-2012, 03:49   #1
JJ_BPK
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Mefloquine (Lariam) for anti-malaria prevention

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.”

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Old 06-20-2012, 06:58   #2
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Here we go again
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"I have hung out in dangerous places a lot over the years, from combat zones to biker bars, and it is the weak, the unaware, or those looking for it, that usually find trouble.

Ain't no one getting out of this world alive. All you can do is try to have some choice in the way you go. Prepare yourself (and your affairs), and when your number is up, die on your feet fighting rather than on your knees. And make the SOBs pay dearly."
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Old 06-20-2012, 11:11   #3
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It is bad stuff

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.
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Old 06-20-2012, 12:03   #4
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Quote:
Originally Posted by Guymullins View Post
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.
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Primum non Nocere
"I have hung out in dangerous places a lot over the years, from combat zones to biker bars, and it is the weak, the unaware, or those looking for it, that usually find trouble.

Ain't no one getting out of this world alive. All you can do is try to have some choice in the way you go. Prepare yourself (and your affairs), and when your number is up, die on your feet fighting rather than on your knees. And make the SOBs pay dearly."
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Old 06-20-2012, 16:11   #5
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Quote:
Originally Posted by Eagle5US View Post
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
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Old 06-20-2012, 16:30   #6
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Quote:
Originally Posted by Guymullins View Post
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.
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"I have hung out in dangerous places a lot over the years, from combat zones to biker bars, and it is the weak, the unaware, or those looking for it, that usually find trouble.

Ain't no one getting out of this world alive. All you can do is try to have some choice in the way you go. Prepare yourself (and your affairs), and when your number is up, die on your feet fighting rather than on your knees. And make the SOBs pay dearly."
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Old 06-20-2012, 16:51   #7
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Quote:
Originally Posted by Eagle5US View Post
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.
Are you familiar with Coartem? And do you know that most , malaria prophylactics (other than Lariam) are ineffective in Africa due to drug resistance of the parasite? There are even reports that Coartem is becoming less effective in the Far East because patients are taking just enough to make them feel better, but not enough to kill off the parasite infestation completely.
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Old 06-20-2012, 17:06   #8
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Quote:
Originally Posted by Guymullins View Post
Are you familiar with Coartem? And do you know that most , malaria prophylactics (other than Lariam) are ineffective in Africa due to drug resistance of the parasite? There are even reports that Coartem is becoming less effective in the Far East because patients are taking just enough to make them feel better, but not enough to kill off the parasite infestation completely.
I am not going to get in a pissing contest with you, and I can assure you that as a requirement I research malaria prophylaxis for various regions of the world on a regular basis. Tolerance is rampant across the globe - that doesn't mean that anti-malarials are ineffective.

As far as Riamet / Coartem: yes, it is an "anti-malarial" that is ineffective for preventing malaria...but is used to treat malaria once diagnosed (including Falcip). It was routinely used when I was in Southeast Asia by civilian agencies but is not on the military formulary.

But that (again) has nothing to do with your previous post.
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Primum non Nocere
"I have hung out in dangerous places a lot over the years, from combat zones to biker bars, and it is the weak, the unaware, or those looking for it, that usually find trouble.

Ain't no one getting out of this world alive. All you can do is try to have some choice in the way you go. Prepare yourself (and your affairs), and when your number is up, die on your feet fighting rather than on your knees. And make the SOBs pay dearly."
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Old 06-21-2012, 07:45   #9
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Quote:
Originally Posted by Eagle5US View Post
I am not going to get in a pissing contest with you, and I can assure you that as a requirement I research malaria prophylaxis for various regions of the world on a regular basis. Tolerance is rampant across the globe - that doesn't mean that anti-malarials are ineffective.

As far as Riamet / Coartem: yes, it is an "anti-malarial" that is ineffective for preventing malaria...but is used to treat malaria once diagnosed (including Falcip). It was routinely used when I was in Southeast Asia by civilian agencies but is not on the military formulary.

But that (again) has nothing to do with your previous post.
Is that the post where you diagnosed me and my buddies as being malaria carriers from many thousands of miles away?
Lariam has been discontinued by many large and knowledgeable organisations because of its inherent dangers. Coartem is a highly effective cure for malaria, although your military doesnt seem to think so. Many of the remainder of malaria treatments have become ineffective over time. We seem to agree on most of this, so where is the pissing contest? Over my state of health?
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Old 06-21-2012, 08:08   #10
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I provided no such diagnosis, but did say that I would not be surprised if in fact you were asymptomatic carriers as many people who live in endemic areas and do not utilize prophylaxis (it's not really practical) carry a parasite load as a normal function of their system. When we go into areas and eradicate their parasite load, they do in fact then become ill because their bodies are not used to functioning without parasites in their system.

You continue to assert your OPINION as medical fact, which it is not.

If Lariam was so dangerous, it wouldn't have recently been approved for use during pregnancy for malaria prophylaxis.

Now, this is THE LAST word on this subject from you unless you can produce your entomology degree, infectious disease research certificate, or some other document demonstrating your status as a health care provider with the ability to prescribe medications.
Further, I did not say that "out military doesn't think that Coartem is an effective cure for malaria". Being that Novartis still carries the patent on that medication, it is not cost effective to be placed on our formulary when there are other medications that work as well, for cheaper. After the patent runs out and the generics for Coartem flood the market, then it too will cost pennies per dose instead of dollars and the US Military may then look at adding to our formulary.

There may be a time in the future when Mefloquin is also advertised on late night TV for a class action lawsuit. Until then, the US Military will continue to use it and our people will continue to take it as directed.
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"I have hung out in dangerous places a lot over the years, from combat zones to biker bars, and it is the weak, the unaware, or those looking for it, that usually find trouble.

Ain't no one getting out of this world alive. All you can do is try to have some choice in the way you go. Prepare yourself (and your affairs), and when your number is up, die on your feet fighting rather than on your knees. And make the SOBs pay dearly."
The Reaper-3 Sep 04

Last edited by Eagle5US; 06-21-2012 at 08:11.
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Old 06-21-2012, 09:06   #11
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Quote:
Originally Posted by Guymullins View Post
so where is the pissing contest?
Dissent and differing opinions are always welcome if they are coming from a known source and handled in a respectful manner between colleagues. Reckless recommendations without the appropriate disclaimer about the inherent Assumptions you make in your decision are potentially dangerous.

This thread really went off track when YOU stated
"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."

Statements like the above are exactly the type of posts that are unwanted on this site. Either there is ignorance to the multiple presentations (specifically the ASYMPTOMATIC presentation) of the disease processes being discussed, or you are uneducated and cavalier about your own health. That is your choice, and you are free to make it for you and your friends. Our membership expects the admins and moderators to vette information posted in this medical section. A significant number of the readers do not have a substantial medical education, so posts like yours could possibly be taken as an acceptable alternative or recommended treatment protocol. What may have worked for you and your friends does not equate to what is recommended for our entire membership.

Eagle5US's posts are well written and explain in detail why your post was challenged. If you will reread them, without being defensive, you will see his point. If you can't, then you probably shouldn't be posting recommendations in this forum anyway. Have a good one....

Last edited by Sacamuelas; 06-21-2012 at 09:16.
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Old 07-22-2012, 19:50   #12
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recent SOMA presentation on mefloquine

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)

Last edited by Navy Flier; 07-22-2012 at 21:12.
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Old 07-22-2012, 20:54   #13
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Arrow VA WRISSC lists mefloquine exposurr with Agent Orange and others

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)

Last edited by Navy Flier; 07-22-2012 at 21:16.
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Old 07-28-2012, 06:18   #14
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Quote:
Originally Posted by Eagle5US View Post
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.
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Old 07-28-2012, 06:33   #15
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Thumbs up

Quote:
Originally Posted by Badger52 View Post
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.
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"I have hung out in dangerous places a lot over the years, from combat zones to biker bars, and it is the weak, the unaware, or those looking for it, that usually find trouble.

Ain't no one getting out of this world alive. All you can do is try to have some choice in the way you go. Prepare yourself (and your affairs), and when your number is up, die on your feet fighting rather than on your knees. And make the SOBs pay dearly."
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