WASHINGTON — A committee of the National Academies of Sciences, Engineering, and Medicine will undertake an 18-month study of the long-term health effects of antimalarial drugs, particularly mefloquine, which was widely used by the U.S. military in Afghanistan.
The committee was posted Friday and is being sponsored by the Department of Veterans Affairs, which considers mefloquine (brand name Lariam) a health exposure for veterans of Operation Enduring Freedom in Afghanistan (Oct. 7, 2001 – Present) and Operation Iraqi Freedom and Operation New Dawn in Iraq (March 19, 2003 – Dec. 15, 2011).
The scope of the project will be to examine available medications for the treatment of malaria and the long-term health effects that might occur, including “latent effects” that might be expected from use by service members during deployment. The committee posting says “special attention will be given to possible long-term neurologic effects, long-term psychiatric effects and the potential development of Posttraumatic Stress Disorder (PTSD).”
Mefloquine was developed at Walter Reed Army Institute of Research in the 1970s and has seen widespread use by militaries around the world during deployments in malaria-prone regions of the Middle East and Africa. Amid concerns about possible serious neuropsychiatric side effects from the drug, the U.S. military began prioritizing the use of other antimalarials in 2009. In 2013, the FDA added a black box warning to mefloquine, noting that side effects – among them nightmares, visual auditory hallucinations, anxiety, depression and suicidal ideation – may persist even after the medication is discontinued.
Other governments have launched their own inquiries into mefloquine. In December, an Australian Senate committee released its report about the drug in part due to outcry by groups like the Australian Quinoline Veterans and Families Association.
Dr. Remington Nevin, who took mefloquine while deployed to Afghanistan and who has since founded the Quinism Foundation to spread education about the risks of the drug, testified before the Australian Senate. Nevin said he has also been asked to testify before the public session of the National Academies committee on Jan. 28.
Nevin said he is concerned about the scope of the study, which will not produce recommendations.
“The foundation is concerned that the VA is using this study as an excuse to further delay long-overdue action on mefloquine,” he said. “The FDA has already acknowledged that mefloquine can have long-lasting health effects including psychiatric symptoms, which can mimic PTSD. The VA must act now to ensure that veterans suffering from these effects are identified. The most effective way to do this is to ensure that veterans of the Gulf War and post-9/11 eras who are being cared for at the VA, or who are being evaluated for disability compensation for PTSD and other psychiatric conditions, are screened for a history of symptomatic exposure to the drug.”
The study committee is composed of 10 members:
- David A. Savitz, Ph.D. (Chair) – Professor of epidemiology and associate dean for research in the Brown University School of Public Health
- Sara Dolan, Ph.D. – Associate professor of psychology and neuroscience and graduate program director at Baylor University
- Marie R. Griffin, M.D., M.P.H. – Professor of health policy and medicine and director of the Master of Public Health program at Vanderbilt University
- James P. Herman, Ph.D. – Flor van Naanen professor, chair of the Department of Pharmacology & Systems Physiology and director of the Neurobiology Research Center and the Stress Neurobiology Laboratory at the University of Cincinnati
- Yuval Neria, Ph.D. – Professor of medical psychology in the Department of Psychiatry and Epidemiology at Columbia University Medical Center, and director of the PTSD Research Program at the New York State Psychiatric Institute
- Andy S. Stergachis, Ph.D., M.D. – Director of the Global Medicines Program in the Department of Global Health at the University of Washington
- Elizabeth A. Stuart, Ph.D. – Professor in the Department of Mental Health and associate dean for education at the Johns Hopkins Bloomberg School of Public Health
- Carol A. Tamminga, M.D. – Professor, chairman of psychiatry and chief of translation neuroscience research in schizophrenia at the University of Texas Southwestern Medical School
- Jonathan Vennerstrom, Ph.D. – Professor in the Department of Pharmaceutical Sciences in the College of Pharmacy at the University of Nebraska Medical Center
- Christina M. Wolfson, Ph.D. – Professor in the Department of Medicine and the Department of Epidemiology Biostatistics and Occupational Health at McFill University and senior scientist in the Brain Repair and Integrative Neuroscience (BRAIN) Program at the Research Institute of the McGill University Health Centre
MORE ON MEFLOQUINE/LARIAM
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- Former Peace Corps volunteers: Malaria meds caused devastating side effects
- Vets say anti-malarial drug they were ordered to take caused devastating side effects
- The Peace Corps and anti-malarial drugs: What you need to know
- Veterans say anti-malarial drug they were ordered to take isn’t in medical records
If you've taken mefloquine and believe you suffered psychiatric or physical side effects as a result, we'd like to hear from you. Please email WUSA9 investigative reporter Jordan Fischer and put "mefloquine" in the subject line. Let us know when and where you took the drug, for how long and under what circumstances.