Reed Requests the Pentagon Suspend Use of Anti-Malaria Drug Following Reports of Serious Side-Effects

Reed Requests the Pentagon Suspend Use of Anti-Malaria Drug Following Reports of Serious Side-Effects

WASHINGTON - Unsatisfied with the Department of Defense's (DOD) delays, U.S. Senator Jack Reed (D-RI) again called on Secretary of Defense Donald Rumsfeld to suspend inoculating troops with an anti-malarial drug that has been reported to have significant psychiatric side-effects, including psychotic behavior and suicide.

In response to a July letter from Reed requesting that DOD immediately end use of Lariam, a drug used to prevent malaria, DOD wrote that it has "commission several scientific studies to look at the adverse outcomes associated with side effects."

In June, the Department of Veterans Affairs warned doctors to watch for long-term problems from Lariam. The VA wrote that Lariam "may rarely be associated with certain long-term chronic health problems that persist for weeks, months, and even years after the drug is stopped."

Reed, a member of the Senate Armed Services Committee and former Army officer, became interested in the issue after reading several news reports about soldiers becoming violent or committing suicide after taking Lariam.

Following is the text of Reed's November 10, 2004 letter to the Secretary of Defense.

I received Under Secretary Chu's response to my earlier letter regarding the use of the antimalarial drug mefloquine (Lariam) in the military. I am glad to hear that concerns about the use of mefloquine are being taken seriously. Your plans to further study the effects of mefloquine are commendable. However, until such time as mefloquine may be proven the safest and most effective drug available, I believe that our troops should be protected from its potentially severe psychiatric side effects.
Therefore, I urge you to adopt a moratorium on the use of mefloquine until studies have been concluded.

Serious adverse reactions to mefloquine reported in a 2002 FDA Safety Alert included depression, anxiety, paranoia, hallucinations, convulsions and psychotic behavior. The FDA also reported that, in rare cases, mefloquine has been associated with suicidal ideation and suicide. Of further concern, severe side effects may occur even at prophylactic doses and may persist for weeks to months after the drug has been discontinued.

Although some of these side effects may occur only rarely, there is sufficient data to support a decision to temporarily suspend the use of mefloquine in our troops. Even if mefloquine were prescribed to only five percent of our worldwide-deployed forces, approximately 20,000 soldiers would be put at risk. This risk is unnecessary given the availability of safer alternative medications that are within CDC guidelines for the prevention of chloroquine-resistant strains of malaria.

The daily dosage schedule required by the alternative medications may occasionally pose a challenge in deployed forces. However, this problem may in fact be offset by higher levels of compliance, particularly in light of recent reports of serious adverse reactions to mefloquine. Another potential drawback of using alternative medications is cost. Given the vital importance of protecting the health of our Service members and the scope of the overall defense budget, however, I do not believe that cost concerns should prevent our troops from receiving the best available antimalarial drugs.

I would also request that you notify me of the progress of research conducted or commissioned by the Department of Defense on antimalarial medications, including information on subject selection, the procedures used to inform and protect subjects, the specific research questions being addressed, and the timeline for completion.

The brave men and women who protect our country deserve the safest and best medicine available, and I believe that pending your research you should discontinue the use of mefloquine in military personnel.