Product Liability Experts Investigating Psychiatric Side Effects Of Anti-Malaria Drug

Medical experts and senior armed forces personnel have condemned the use of the anti-malaria drug Lariam, which is also known as mefloquine, while giving evidence at a Commons Defence Select Committee.

The drug has been found to lead to psychiatric side effects, including suicidal thoughts, hallucinations and psychotic behaviour, in 2007 but was still being described to British armed forces personnel, leading to an inquiry into the use of the drug by the Ministry of Defence.

Speaking at the latest evidence session, medical experts and former senior armed forces figures condemned the use of the drug in a military setting.

Expert Military and Group Action lawyers at law firm Irwin Mitchell have been contacted by a number of armed forces personnel who have experienced some of the side effects after taking Lariam and are investigating the problems they suffered.

Lt Colonel Ashley Croft, a doctor who served for more than 25 years in the Royal Army Medical Corps, told the inquiry: “Mefloquine is the least safe of the available anti-malarials currently used.”

He explained to the inquiry that he raised concerns about the use of the drug but the response was “a mixture of incomprehension, indifference and sometimes hostility.”

Dr Remington Nevin, a former US Army doctor and expert on the psychiatric effects of Lariam, told MPs that since 1989 the drug manufacturer, Roche, has issued guidance for those prescribed the drug to discontinue if symptoms such as anxiety and depression become apparent.

Roche also developed clear guidance that Lariam should only be given to individuals after a risk assessment was performed by a medical professional.

Dr Nevin also highlighted that in a military setting, where pre-existing mental illness may be more common, complying with the manufacturer’s warnings and guidance on assessment before prescription can be challenging.

Former army officer, Lt Colonel Andrew Marriott described the use of Lariam as “institutional incompetence” for failing to address the issue.

Kevin Timms, a specialist group actions lawyer at Irwin Mitchell, leading the case, said:

Expert Opinion

“The continued use of Lariam post-2007 has clearly been unacceptable resulting in a large number of military personnel suffering psychiatric injury.

“It is extremely concerning to hear that Lariam was prescribed to armed forces personnel in contradiction to the guidelines set out by the manufacturer and that concerns raised by army doctors were not taken seriously. Guidance for the use of drugs has to be taken seriously as it is well known that some drugs can have devastating side effects for users if not taken in accordance with the instruction leaflet, which has been the subject of significant investment, trials and investigation by the manufacturer.

“The rules that apply to the prescription of drugs in a civilian context applies with equal force in a military context. The MoD should have reviewed its policy on the prescription of anti-malarial drugs long ago. Whilst it is noted that they follow guidance provided by Public Health England for use and prescription to civilians, this does not go far enough when military personnel on deployment are subject to additional pressures which could trigger a life-changing side effect from the use of Lariam under deployment conditions.

“We have been contacted by a number of military personnel who suffered psychiatric issues after being prescribed Lariam and we are investigating the circumstances around its prescription. They understandably want answers about the use of the drug and to understand why Lariam was preferred over other, safer options.

“We hope that this inquiry will be thorough and transparent and that the MoD will provide answers concerning the use of Lariam as well as implementing steps for the future that will help to protect the mental health of military personnel.” Kevin Timms - Solicitor

External written evidence from former soldiers and the families of those who suffered from the side effects of Lariam was also provided. One soldier who was deployed to Sierra Leone in 2001 said the nation was described as the most hostile environment in which the British Army was operating.

He explained that the impairments to personal performance that arise from taking Lariam dramatically increased the inherent risk of accident, injury or other significant incident, however this was considered an acceptable risk for armed personnel, but not air crew and other technical specialists operating in Sierra Leone.

Evidence was also submitted by Ellen Duncan, the wife of Major General A D A Duncan CBE DSO, who described the prescription of Lariam as “a most insidious form of friendly fire”.

Other, more expensive anti-malarial drugs, Malarone and Doxycycline, are available to the MoD and do not have the same side effects.

Lariam is either banned or treated as a drug of last resort by military forces in Canada, Denmark, France, Germany, the Netherlands, Norway, and the US.

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