Harper Government can no longer deny the toxicity of the anti-malaria drug mefloquine (Lariam) mimick PTSD in the breakdown of serving forces’ and veterans’ mental health.


Dr. Remington Nevin has been working tirelessly to prove how the anti-malaria drug mefloquine (Lariam) has contributed to the mental breakdown of serving military members and veterans posted to areas where malaria is prevalent, in particular parts of Africa including Angola, Somalia, and Rwanda and the Middle/Far East such as Iraq and Afghanistan. Outbursts of violence, where a military person has suddenly turned and killed innocent people or committed suicide with no rational explanation, can be directly attributed to this terrible drug. Here is Dr. Nevin’s latest report published in PSYCHIATRIC NEWS UPDATE, a publication that has become the “voice of the American Psychiatric Association and the Psychiatric Community.” BONNIE

The Mefloquine Toxidrome: A Common
Confounder of Mental Illness Among
Returning Veterans?

Dr. Remington Nevin, public health physician and epidemiologist formerly a Major in the U.S. Army Medical Corps and currently at the Johns Hopkins University.

Dr. Remington Nevin, public health physician and epidemiologist formerly a Major in the U.S. Army Medical Corps and currently at the Johns Hopkins University.

by Remington Nevin, MD, MPH

Clinicians evaluating returning U.S. military
veterans with certain psychiatric complaints need
to be aware of the potentially confounding role of
antimalarial neurotoxicity, said Remington Nevin,
M.D., M.P.H., of Johns Hopkins University, at a
workshop in the Military Track at APA’s 2014 annual meeting
today, co-chaired by former psychiatry consultant to the Army
Surgeon General, Elspeth Cameron Ritchie, M.D., M.P.H., a
retired Army colonel.

Nevin’s work contributed to the FDA’s issuing an updated
boxed warning for mefloquine in late July 2013, advising that
psychiatric effects from the drug could last years after use and
that certain neurological effects could be permanent. As early
as 2012, travel medicine guidance from the Centers for
Disease Control and Prevention had cautioned against the use
of mefloquine in military settings, noting that the
neuropsychiatric side effects of the drug could confound the
diagnosis and management of PTSD and TBI.

Although mefloquine use has been significantly curtailed and
even banned outright by some U.S. military units since the
2013 boxed warning, the lasting effects described by the FDA
mean many military veterans may still be experiencing
symptoms from mefloquine years after their last use of the
drug.

Nevin noted that the syndrome of toxicity caused by
mefloquine shares many features in common with agoraphobia
and with many trauma- and stressor-related disorders, and
may occasionally even have been mistaken for PTSD.
Fortunately, the new DSM-5 criterion H, which excludes the
diagnosis if “attributable to the physiological effects of a
substance,” will help to ensure diagnostic specificity,
particularly in military cohorts where exposure to the drug
may frequently have overlapped with directly experienced
traumatic events in Criterion A.

Nevin noted that in addition to taking a detailed antimalarial
drug history when evaluating veterans with certain anxiety
disorders, psychiatrists may wish to adopt a multidisciplinary
approach including referring their patients to neuro-otologists,
neuro-optometrists, or ENT physicians if symptoms indicate.
Documenting neurological sequelae of the toxidrome,
including disequilibrium, nystagmus, and vertigo, thought to
be caused by subtle neurotoxic brainstem injury, can
frequently aid in establishing the diagnosis of mefloquine
toxicity even in the presence of common confounding
psychiatric etiologies.

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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.
This entry was posted in Afghanistan vets, Canadian Armed Forces, Canadian Peacekeepers, caregivers, CNN News, depression, emotional trauma, estrangement from family, federal government, Homecoming Vets, mental illness, post traumatic stress disorder, social workers, suicide, veterans' affairs, veterans' assistance programs, VRAB and tagged , , , , , , , , , , , , , , , . Bookmark the permalink.

One Response to Harper Government can no longer deny the toxicity of the anti-malaria drug mefloquine (Lariam) mimick PTSD in the breakdown of serving forces’ and veterans’ mental health.

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