U.S. vet clarifies latest official position on the use and neurotoxicity of mefloquine or Lariam


Whenever I receive information that counters a posting, I air it to keep the information we are collecting as balanced as possible. A retired U.S. Navy commander, CDR Bill Manofsy USN (Ret), has submitted this response to the original post — “Alarm bells sound for the anti-malaria drug known as mefloquine or Lariam.” BONNIE

I do not know where you get your information from, but you are not correct. You are spreading misinformation to the troops in contracdiciton to current U.S. policy. Mefloquine is not the anti malaria of choice in Afghansitan or anywhere else the U.S. military is deployed. In 2009, the Army surgeon general and the Undersecretary of Defense for Health switched to Doxycycline as the primary drug of choice. Mefloquine is to only be used on service members who have a reaction to Doxy.
See the following links to the policy memos:

http://www.pdhealth.mil/downloads/DASG_Memorandum.pdf
http://www.lariaminfo.org/pages/wp-content/uploads/policy-memo-re-use-of-mefloquine-lariam-in-malaria-prophylaxis.pdf

In addition, a paper recently authored in 2010 by doctors at Bethesda Naval Hospital, Walter Reed, and the CDC and published in the AUG 2010 issue of The American Society of Tropical Medicine and Hygene reported on 44 Marines who contracted falciparum malaria while deployed to Liberia in 2003 while taking Mefloquine.

The paper concluded:

“……for the next precipitous deployment into a high transmission area, such as these Marines experienced in Liberia, the use of a drug that is dosed weekly, can take up to 7 to 9 weeks to achieve protective concentrations, and requires four weeks of post-exposure dosing is clearly suboptimal…….

…..Loading-dose regimens of MQ achieve protective drug levels in four days, but using MQ in this manner is not FDA approved. Although clearly supported by the peer-reviewed medical literature, Department of Defense policy does not permit the U.S. military to use medical products in a manner that is not FDA approved. Therefore prescribing a loading dose of MQ cannot be used operationally by the U.S. military…..

….The use of chemoprophylactic drugs such as atovaquone/proguanil or doxycycline, which provide protection after the first dose, would offer more rapidly attainable malaria chemoprophylaxis in deployment circumstances such as those encountered by the 26th Marine Expeditionary Unit…..”

Here’s the paper:

Whitman T.J., Coyne P., Magill A., Blazes D., Green M., Milhous W., Burgess T., Freilich D., Tasker S., Azar R., Endy T., CLagett C., Deye G., Shanks G., Martin G. (2010). “An Outbreak of Plasmodium falciparum Malaria in U.S. Marines Deployed to Liberia”. The American Society of Tropical Medicine and Hygene 83 (2): 258-265. doi:10.4269/ajtmh. 2010.09-0774. PMC PMC2911167. PMID 20682864

To corrobrate the statements regarding the neurotoxicity of Mefloquine, please refer to the papers from Dr. Dow of Walter Reed and from researchers at Brown University regarding connexin blockage on the wikipedia.org page for Mefloquine. [Immediately I see this sub-topic — Walter Reed labels Mefloquine an “acute neurotoxin,” so my concerns continue to be well-founded that CANADIAN, British and Irish troops are still receiving Lariam or mefloquine in deployments to malaria-infected areas. I know of NO order from Canada’s Surgeon General to the Canadian Armed Forces to cease issuing this anti-malaria drug. If I am wrong, I would love to hear it. BONNIE]

For a greater array of peer reviewed research papers on Mefloquine, please access lariaminfo.org. On the right, click on “research on Mefloquine(Lariam). [The research papers listed with topics such as Prevalence of contraindications to mefloquine use among USA military personnel deployed to Afghanistan, Remington L Nevin et al., Army Medical Surveillance Activity, US Army Center for Health Promotion and Preventive Medicine, published in Malaria Journal, Feb 2008. only confirm my concern for anyone taking this anti-malaria drug. BONNIE]

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About Bonnie Toews and John Christiansen

Bonnie's Blog Posts invite our readers and free spirits everywhere to share life's adventures with us. I talk about writing my novels, reading books, chatting with other writers and John's and my journeys around the world. We welcome your anecdotes to our experiences and discussions.
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