The Mefloquine Controversy: Is this anti-malaria drug dangerous to your health long-term?

INTRODUCTION: After years of collecting data about the anti-malaria drug mefloquine (Lariam), I can now write a summary report based on the most significant findings of dedicated doctors concerned about what is happening to a large number of travellers as well as military troops assigned to countries where malaria dominates. Malaria is a terrible disease and the most virulent form kills the victim who does not receive a non-resistant form of treatment, but there are modern safer alternatives to give to the population at large.   BONNIE TOEWS

 

PROOF SOLDIERS WERE ISSUED MEFLOQUINE ALONG WITH OTHER ANTI-MALARIA DRUGS 

Major scientific investigations since 1992 clearly indicate adverse effects of mefloquine (Lariam) are severe enough to warrant banning the anti-malaria drug as a preventative treatment for travellers or troops embarking into zones where malaria dominates. Because of a genetic predisposition to brain damage when taking this drug, it is impossible to assess who will suffer the worst of mefloquine’s adverse effects, including liver and thyroid damage leading to death.

One of the foremost experts on the investigation into the pros and cons of mefloquine is Dr. Remington Nevin. As recent as October 10, 2010, Dr. Nevin reveals these findings:

Dr. Remington Nevin, public health physician and epidemiologist currently serving as a Major in the U.S. Army Medical Corps.

“Although mefloquine has generally been considered safe for use, it has become increasingly clear that — similar to what is seen with the breed-specific neurotoxicity of the anti-parasitic drug ivermectin among Border Collies —  among certain people, likely as a result of a particular genetic variation in the MDR1 gene, mefloquine accumulates in the brain, where it results in dose-dependent injury to the brainstemand emotional centers.

 

“When these neurotoxic injuries occur, the results can be dramatic and frightening. The medical literature documents a seemingly endless array of harmful adverse reactions, including mania, panic disorder and depression, psychosis  and  suicide, occurring among the miserable minority who prove susceptible to these harms. Many of these reactions result in long-term, chronic disability; similar to what is seen with post-traumatic stress disorder (PTSD).”

 

Essentially, there is an invisible lethal predisposition for individuals who are treated with Lariam or mefloquine. No one knows if they will suffer adverse effects until they take it. Then it’s too late.  

 

Dr. Nevin continues: “In recognition of these dangers, which have taken fully 20 years to become generally accepted, many experienced western militaries, including France and the United States, now all but prohibit the use of mefloquine among their forces. In those rare instances where mefloquine is still used, it is now prescribed only with extreme care; both to rule out the presence of contraindicating neuropsychiatric conditions, and to be sure that those given the drug receive the detailed warnings about prodromal neuropsychiatric symptoms necessary to use the drug safely.”

 

In 2002, Ashley M. Croft and Andrew Herxheimer of the Surgeon General’s Department in Great Britain’s Ministry of Defence, published a paper in the online March 25 issue of BMC Public Health. They found that the Centers for Disease Control in the U.S. and their Canadian equivalent, CATMAT, did not recognize the contraindication to taking mefloquine recommended by the World Health Organization (WHO) based on the drug manufacturer’s own case studies published in 1992 by Hoffmann-La Roche.

 

From the U.S. Army’s first use of mefloquine as a prophylaxis in 1985 to 2002, they reported “approximately 14.5 million people were prescribed the drug for malaria prevention, versus 1.6 million for treatment.”

 

Their analysis of 516 spontaneous reports collected at the time suggests there is a mefloquine syndrome consisting of excessive sweating accompanied by malaise, nausea, diarrhea, agitation, concentration problems and nightmares. In talking to today’s Canadian Afghan vets who took mefloquine through their deployments during the past nine years, diarrhea is a consistent and apparently long-term complaint.

 

Even more alarming is the connection Croft and Herxheimer make between mefloquine and liver and thyroid damage. From their 516 published case reports of mefloquine adverse effects, they conclude many of the adverse effects of mefloquine are a post-hepatic syndrome caused by primary liver damage. They suggest symptomatic thyroid disturbance occurs, either independently or as a secondary consequence to the liver damage.

 

Mefloquine induces liver enzymes, which Croft and Herxheimer say occur when mefloquine users become dehydrated. This imposes an added burden on the liver, and contributes to a severe reaction to the drug. “Many long-haul travellers using mefloquine are mildly dehydrated from in-flight alcohol and air conditioning, followed by hot and dry conditions, and more alcohol consumption, at their holiday or business destination.”

 

They further note the liver biopsies of two travelers – one man and one woman as part of the 516 cases they studied. Both were on mefloquine just before they died and showed significant liver damage. “The mefloquine syndrome presents in a variety of ways including headache, gastrointestinal disturbances, nervousness, fatigue, disorders of sleep, mood, memory and concentration, and occasionally frank psychosis. Previous liver or thyroid disease, and concurrent insults to the liver (such as from alcohol, dehydration, an oral contraceptive pill, recreational drugs, and other liver-damaging drugs) may be related to the development of severe or prolonged adverse reactions to mefloquine.”

 

  

NOTE: For those who do take mefloquine, it is recommended that they must drink lots of water to prevent dehydration. They must NOT drink alcohol while on the anti-malaria treatment nor take such rememdies as motion sickness pills like Gravol or anti-diarrhea medication like Amodium as these remedies further block the drug from safely passing out of the brain and through the body. Better still, since you don’t know if you’re one of the ones with a genetic predisposition to develop adverse effects, refuse to take mefloquine. The alternatives doxycycline or malarone do not involve high risk to the user. BONNIE

 

REFERENCES: 1. BMC Public Health. 2002; 2: 6.
Published online 2002 March 25. doi: 10.1186/1471-2458-2-6. PMCID: PMC101408
Copyright © 2002 Croft and Herxheimer; licensee BioMed Central Ltd.  The search strategy for finding the case reports is described in the review.[26] An annotated bibliography of the 516 published reports can be found at http://www.liv.ac.uk/evidence

2. Dr. Remington Nevin – http://web.me.com/remington.nevin/Remington_Nevin/Blog/Blog.html

LATEST FINDINGS: Dr. Nevin makes his presentation about his recent research on the epidemiology and pathophysiology of mefloquine neuropsychiatric side effects. Related research available at: http://www.remingtonnevin.com. Further information on vestibular testing available at: http://www.vestibular.org.