Malaria drug for Canadian troops called dangerous

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It's only time before the real effects of the use of mefloquine will be recognized. I'm sure all of us that have taken it have our own thoughts of what it did to us.

Malaria drug for Canadian troops called dangerous
Canada's military apparently unconcerned over anti-malarial drug's side-effects
CBC News Posted: Apr 11, 2012 6:16 PM ET Last Updated: Apr 11, 2012 10:23 PM ET Read 124comments124
li-afghanistan-dawn-troops-.jpg

Canadian soldiers serving in Afghanistan and Africa are among those who have been prescribed the controversial anti-malarial drug mefloquine. Here, soldiers with the 1st Battalion 22nd Royal Regiment prepare for an operation in Kandahar in June 2011. (David Goldman/Associated Press)

Side-effects of war3:48
An anti-malarial drug that has been withdrawn from routine use by the U.S. military because of concerns about potentially dangerous side-effects continues to be prescribed to Canadian troops serving in malaria-prone regions.
The drug, called mefloquine or Lariam, has been associated with psychiatric and physical side-effects that prompted the U.S. military to withdraw it from general use in 2009, but the Canadian Forces continue to prescribe it to soldiers.
Side-effects can range from anxiety, vivid nightmares and depression, to hallucinations and psychotic episodes, and the drug has also been blamed for suicides and long-term health problems.

hookey041112.jpg

Donald Hookey wonders if the mefloquine he was ordered to take in Afghanistan is linked to the rage and nightmares he still experiences. (CBC)
Retired corporal Donald Hookey of Conception Bay South, N.L., has been home for six years from Afghanistan, but he remains haunted by his experience there.
"I don't think that I can honestly say that I've felt normal since I've been back."
Until recently, Hookey blamed his rage and nightmares on post-traumatic stress disorder, but now he wonders if the anti-malarial drug mefloquine given to him by the army continues to exert long-lasting effects.
"It really freaks me out … what I've been reading on the side-effects for the drugs."
Mefloquine was developed by U.S. army researchers during the Vietnam War, but concerns about its side-effects eventually prompted a warning in a 2009 memo from the assistant secretary of defence: "Mefloquine may cause psychiatric symptoms … ranging from anxiety, paranoia and depression to hallucinations and psychotic behaviour … long after mefloquine has been stopped."
Hoffman-Laroche manufactured mefloquine under the trade name Lariam, while a generic version called Apo-Mefloquine is produced in Canada by Apotex.
Risk of permanent effects cited
U.S. army doctor Maj. Remington Nevin, who first gained experience with mefloquine during his deployment in Afghanistan in 2007, says that "there are a certain group of users in whom … these symptoms, the anxiety, the difficulty sleeping, the mood changes, these could be an indication, an early warning sign of a developing, more serious brain condition… a toxicity caused by rising levels of the drug.
"The worst-case scenario is that a soldier that suffers toxicity from mefloquine is left with permanent brain-stem injury."
Personality changes in returning soldiers have been noted by their close family members.
"It's been very easy to attribute this personality change to some experience during deployment, perhaps some combat experience," says Nevin, "but when we see this in individuals that deployed but never had any traumatic exposures and who had an otherwise unremarkable time overseas, I think it becomes increasingly clear that it was the drug that's responsible for these effects."
The U.S. Centres for Disease Control recommended this year in its Yellow Book travel advisory that mefloquine not be considered the drug of choice for military deployments, given that "neuropsychiatric side-effects may confound the diagnosis and management of post-traumatic stress disorder and traumatic brain injury."
Alternative treatments include doxycycline and atovaquone-proguanil (Malarone), which Nevin says are effective and more predictable.
The possibility that mefloquine may have been prescribed to U.S. Staff Sgt. Robert Bales, who has been charged with 17 counts of murder in the death of Afghan civilians, has been raised by retired army psychiatrist Elspeth Cameron Ritchie. The U.S. Defence Department has refused to confirm or deny that Bales took mefloquine, citing medical privacy.
'Get ready to go loopy'
Kevin Berry of Vancouver served in Afghanistan in 2003 as a 19-year-old infantryman. Mefloquine was administered once a week and "they made it abundantly clear we would be charged if we weren't taking it."
The side-effects were well-known, he says.

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Afghanistan veteran Kevin Berry says the side-effects of mefloquine were notorious: 'You wake up shaking, sweating, terrified.'(CBC)
"My section commander had been in Somalia and Rwanda. He said, 'Get ready to go loopy, boys!'
"You wake up shaking, sweating, terrified, you know: what's going on? Am I going crazy? But you look around and — oh, everyone's doing it."
Berry says he quit taking the pills, without telling his superiors, and the side-effects stopped.
Hookey says he wishes he had done the same. "I know guys who didn't take the drugs because they said, 'Screw that, man. I don't know what's in it.' Maybe I should have been one of those guys, huh?"
The Canadian Forces base their use of mefloquine on recommendations of the Public Health Agency of Canada, which says the drug is "generally well tolerated" and that severe reactions such as seizures are rare (reported from one in 6,000 to one in 13,000 users). Long-term neuropsychological effects and reports of suicide ideation or suicide have not be confirmed, the agency says.
But the military’s continuing use of mefloquine "is definitely deviating from the evolving standard of care, or the evolving standard of practices of Western militaries," Nevin says.
"This will be a cost borne not by the militaries but by the various Veterans Affairs Departments," he says.
The Canadian military declined to comment to CBC News about its use of mefloquine.
With files from the CBC's Nancy Wood
Related Stories
Malaria | Disease without borders
External Links
U.S. Dept. of Veterans Affairs, Possible long-term effects from mefloquine
Mefloquine | A case report, Travel Medicine and Infectious disease, by Dr. Remington L. Nevin
Health Canada advisory for mefloquine
Public Health Agency of Canada | Prevention and treatment of malaria
(Note:CBC does not endorse and is not responsible for the content of external links.)
 
We were still using this stuff in 2010. Not on a regular basis, but definitely still using it. I know I definitely had some weird dreams.
 
I dread the day I have to take it.

From speaking to lads who were over in Chad a few years back and were made take it, I have no interest in going near it.
 
We loved taking them for the crazy dreams alone lol. There is a safer alternative available now though.

Guys in my Unit who took it, got night terrors and I know some are having issues with arthritis and under 40.
 
Some of my guys did a CP detail in Chad on a COL and got to take doxy's and has no problems. The French had a bowl of doxy's in the DFAC and the Lads were able to take a weeks supply at a time and didn't take larium.
 
I forgot what I was using in the 2003 to 2007 time frame. But I hated it. If I wasn't having nightmares; I'd be waking up with jizz in my shorts.

Definitely a weird drug.
 
Yea I took that shit......had nasty reaction to it! Always recommend that prevention is better than cure....cover up dawn & dusk!
 
I used to get very vivid, very scary nightmares, mostly related to something claustrophobia-related. It was always weird to me that I'd get those dreams, because I used to be a bigtime caver and I've never had any issues with claustrophobia, and when I woke up and thought about the dream, the situation wasn't scary at all. I attributed it to sleep apnea, but maybe it was the drugs. I don't know. I do know that I'd take the occasional nightmares over malaria.
 
I was given a bottle of Doxycycline pills recently, so my Lariam days are apparently over.
 
There's also two strains of malaria in country though one is less prevalent.

http://wwwnc.cdc.gov/travel/yellowb...rmation-by-country/afghanistan.htm#seldyfm298


Afghanistan
Malaria

Areas with malaria: April–December in all areas <2,000m (<6,561ft).
Estimated relative risk of malaria for US travelers: Highb
Drug resistancec: Chloroquine
Malaria species: P. vivax 80%-90%, P. falciparum 10%-20%.
Recommended chemoprophylaxis: Atovaquone-proguanil, doxycycline, or mefloquine.

Then you have this chart with Pros on the left and Cons on the right
http://www.cdc.gov/malaria/travelers/drugs.html

Mefloquine
(Lariam)
  • Some people would rather take medicine weekly
  • Good choice for long trips because it is taken only weekly
  • Can be used during pregnancy
  • Cannot be used in areas with mefloquine resistance
  • Cannot be used in patients with certain psychiatric conditions
  • Cannot be used in patients with a seizure disorder
  • Not recommended for persons with cardiac conduction abnormalities
  • Not a good choice for last-minute travelers because drug needs to be started at least 2 weeks prior to travel
  • Some people would rather not take a weekly medication
  • For trips of short duration, some people would rather not take medication for 4 weeks after travel
 
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