Anti-Malaria Drugs- Mimicking PTSD. Do We Have Better Ones Now?

By Faye Higbee

The malaria drug Mefloquine was given to American troops prior to deployment for years, but was linked to brain stem lesions and psychiatric symptoms. An article in Military times two years ago reported that one sailor who deployed to Africa was originally diagnosed with PTSD until doctors took a stronger look at his medical history and learned that he was given an anti-malaria drug called Mefloquine.

The military gave out 50,000 prescriptions for the drug in 2003. That finally dropped to 216 in subsequent years, and it’s used only when troops can’t tolerate a different malaria drug. But with the fact that symptoms mimic PTSD and can actually cause brain damage, it should not be in use at all. A new drug has been approved for use by the FDA. Will it be better?

The side-effects of the drug can last for years. And unfortunately, as late as 2018, the UK Defence Ministry was also giving it to their troops, according to an article in the Pharmaceutical Journal.  Are the militaries of countries used as lab rats? Or are they just not checking the side effects before their dispensing of the drugs?

In 2016, the Military Times reported,

“It demonstrates the difficulty in distinguishing from possible mefloquine-induced toxicity versus PTSD and raises some questions regarding possible linkages between the two diagnoses,” wrote Army Maj. Jeffrey Livezey, chief of clinical pharmacology at the Walter Reed Army Institute of Research, Silver Spring, Maryland.

Once the U.S. military’s malaria prophylactic of choice, favored for its once-a-week dosage regimen, mefloquine was designated the drug of last resort in 2013 by the Defense Department after the Food and Drug Administration slapped a boxed warning on its label, noting it can cause permanent psychiatric and neurological side effects…

While a case study is a snapshot of one patient’s experience and not an indication that everyone who took or takes mefloquine has similar issues, one randomized study conducted in 2001 — more than a decade after the medication was adopted by the military for malaria prevention — showed that 67 percent of study participants reported more than one adverse side effect, such as nightmares and hallucinations, and 6 percent needed medical treatment after taking the drug.

Yet mefloquine remains on the market while Walter Reed Army Institute of Research conducts research on medications in the same family as mefloquine, including tafenoquine, hoping to find a malarial preventive that is less toxic but as effective.

Mefloquine was developed under the Army’s malaria drug discovery program and approved for use as a malaria prophylactic in 1989. Shortly after commercial production began, stories surfaced about side effects, including hallucinations, delirium and psychoses.”

Military scientists have researched a new set of drugs for malaria that have been approved by the FDA.

Military Times stated in August, 2018,

The new Tafenoquine drugs are:

  • Krintafel, a single dose treatment for the cure of the Plasmodium vivax form of malaria, approved July 20. The current drug must be taken for 14 days to be effective.   
  • Arakoda is a preventive malaria drug taken for the three days before travel, then weekly, during time in areas known to have mosquitoes infected with the malaria parasite. It was approved Aug. 8. It protects against all malaria, including Plasmodium falciparum, which is a serious, deadly form of malaria. 

Malaria is deadly and is a serious threat to our warriors. But we are losing at least 20 service members every single day to suicide. If part of that is induced by drugs then it needs to stop immediately. Some of our best and brightest both young and old have died at their own hand…was part of it because of a drug and not just “PTSD?”

We hope that with the changes in these anti-malarial drugs, there won’t be anymore cases of Mefloquine-induced brain damage. The FDA can approve these drugs, but keep in mind they also approved Mefloquine.

We have to do better. Lives depend on it.

Featured photo: Cpl. Timothy Dobson takes doxycycline once per day to prevent the spread of malaria while deployed to Africa. (Lance Cpl. Timothy L. Solano/Marine Corps)