Antimalaria drug unsafe for some military personnel

Close to 10 percent of US military personnel sent to Afghanistan are not suitable candidates for the antimalarial drug mefloquine, also known by the trade name Lariam, according to a report that appears in the BMC publication Malaria Journal.

The study showed that mefloquine may not be safe for approximately 1 in 12 deploying males and 1 in 5 deploying females, senior investigator Captain Remington L. Nevin told Reuters Health.

Captain Nevin of the Armed Forces Medical Surveillance Center, Silver Spring, Maryland, and colleagues studied data on 11,725 active duty personnel to identify psychiatric and neurological reasons for not using this agent.

Among these conditions are major depressive disorder and Parkinson’s disease. The team also examined use of prescription drugs, such as anticonvulsants, that would be also be a reason not to use mefloquine.

The investigators found that 9.6 percent of the military personnel were not good candidates for the drug. Women were more than twice as likely than men to have a reason not to use mefloquine.

The researchers point out that malaria presents a continued threat to US military personnel, and there is evidence in recent years of at least 64 cases attributable to service in Afghanistan. Although the long-term use of mefloquine has been considered safe and well tolerated, they add, appropriate prescribing is required to avoid severe neuropsychiatric adverse events.

“This study,” concluded Captain Nevin, “reinforces the need for very careful screening of service members” who are sent to areas were malaria is common. It also illustrates the need for alternative antimalarial drugs that are suitable for long-term use and that military members are likely to take.

SOURCE: BMC publication Malaria Journal, February 11, 2008.