Probe at US Army Base Focused on More Than Malaria Drug

August 29, 2002
The Associated Press

Washington - Alarmed by a series of domestic killings and suicides at Fort Bragg in the state of North Carolina, the US Army is sending in a team of health specialists to study a range of possible explanations.

The Army disputed reports it is focusing mainly on the possibility of a link to use of the anti-malarial drug, Lariam, although officials said it was among the issues to be examined.

"Contrary to news reports speculating that the team will focus primarily on anti-malaria prophylaxis/medications taken by soldiers, the team will consult with local medical and unit/installation leadership at Fort Bragg on a wide variety of possible contributing factors," an Army statement said.

The inquiry at Fort Bragg will last most of this week, the Army said. Consultants in psychology, social work and psychiatry will join Army epidemiologists and chaplains as well as officials from the government's Centers for Disease Control and Prevention.

The Fort Bragg killings began June 11, when a Special Forces soldier fatally shot his wife and then himself, two days after he had returned from Afghanistan. Three more killings and a homicide followed.

Army officials say there is no evidence that Lariam, the anti-malarial medication, played any role. Yet questions about the drug persist.

The manufacturer of Lariam, Roche Laboratories, acknowledges reports of suicide and suicidal thoughts attributed to Lariam, also known as mefloquine. But spokesman Terence Hurley said they are extremely rare.

Mefloquine use can lead to "depression and psychosis," said Dr Stefan Hoyer, a malaria expert and WHO adviser to Cambodia's National Malaria Center. "It is a rare event, but it can happen."

The malaria center uses mefloquine as a part of a combination drug treatment for malaria in rural areas. The therapy takes three days, compared to the weeks for which people sometimes take Lariam for prevention against malaria. There is a higher chance of side effects when mefloquine is taken as malaria prevention due to the longer exposure to the drug, Hoyer said.
Such use of mefloquine is not recommended for visitors to Cambodia because the chance of contracting malariaŅa mosquito-borne parasiteŅis very slim for tourists, he said.

Roche, a division of Hoffmann-Laroche Inc, itself a unit of Swiss-based Roche Holding AG, said some cases of severe neuropsychiatric disorders have been reported in connection with Lariam use. They include anxiety, depression, panic attacks, hallucinations, aggression and psychotic reactions.

The World Health Organization puts the incidence of serious neuropsychiatric effects from the drug at five in 100,000. Of the millions of travelers given mefloquine each year, one in 6,000 to one in about 10,000 will experience some kind of serious adverse reaction, the WHO says. (Additional reporting by Brian Calvert)