On September 19th, 2013, CBS News reported that the senior doctor for special operation branches of the United States Army ordered to immediately cease administration of the antimalarial drug mefloquine (brand name Lariam). The Surgeon General’s Office of the Army Special Operations Command stated that some troops may have been wrongly diagnosed with post-traumatic stress disorder or traumatic brain injury when they were actually experiencing neurological side effects from mefloquine.
Generic mefloquine is a drug indicated for the prevention of malaria, and was sold under the brand name Lariam until 2009. The US FDA added a boxed warning to the drug label of mefloquine that listed potentially permanent neurologic and psychiatric adverse events in July of this year. Possible side effects include development of anxiety, paranoia, hallucinations, depression, confusion, unusual behavior, dizziness, balance problems, convulsions, and insomnia. FDA warned that these symptoms could persist for months or years after taking the medication.
Mefloquine was administered to elite branches of the Army as one of the drug choices in the preventative treatment against malaria. As other antimalarial drugs have become available, the use of mefloquine as a first-line treatment option has declined. A review of troops negative affected by the drug has been initiated, and should be completed by January of 2014.
Using FAERS data (from 11/01/1997 to 12/31/2012), aggregated and standardized by the AdverseEvent RxFilter process, we identified 2,390 serious adverse events which listed Lariam or generic mefloquine as a suspect drug. Of these reports, 2,250 listed Lariam or generic mefloquine as the primary suspect.
The most commonly reported side effects were anxiety, depression, and dizziness. We identified 690 hospitalizations and 84 patient deaths where Lariam or generic mefloquine was indicated as the primary suspect.