February 25, 2016

mefloquine and mental health in the armed forces

Mefloquine (also known by the trade name Lariam) is an anti-malarial drug that has been in use for over thirty years and is on the World Health Organisation’s List of Essential Medicines. It is the primary anti-malarial drug prescribed to members of the armed forces in the UK, but recent controversy about psychiatric side effects have led some to call for it to be replaced with a different anti-malarial treatment.

While potential psychiatric side effects from mefloquine use have been documented for many years, the extent to which psychiatric issues in the armed forces may be due to the drugs is complicated and unclear due to the elevated risk of certain psychiatric conditions within this group.

The Ministry of Defence has opened into an inquiry into the use of mefloquine in the armed forces, and is currently hearing evidence from various experts and individuals. Journalists came to the SMC to hear three scientists discuss the evidence and issues around mefloquine use and mental health in the armed forces, and answer questions such as:

• What is mefloquine, how does it work and how does it differ from other anti-malarial drugs?
• What is the evidence for both its effectiveness as an anti-malarial and the risk of side effects? Is there evidence that these side effects may lead to longer term issues?
• Are certain populations using mefloquine, such as the armed forces, more at risk of experiencing side effects than others?
• Is there any evidence for a link between mefloquine use and increased risk of developing psychiatric conditions in the armed forces?
• More broadly, are members of the armed forces at greater risk of developing psychiatric conditions in general?
• Is it possible to untangle the evidence for the risk of psychiatric side effects and the risk of psychiatric conditions?
• Based on the evidence, should mefloquine continue to be prescribed as the primary anti-malarial drug for the armed forces?
• What can be done to better tackle psychiatric issues in the armed forces?

Speakers:

Dr Ron Behrens, Senior Lecturer in Tropical and Travel Medicine at the London School of Hygiene & Tropical Medicine, & Consultant in Tropical and Travel Medicine, Hospital for Tropical Diseases, University College NHS Foundation Trust

Prof Neil Greenberg, Professor of Defence Mental Health, Academic Centre for Defence Mental Health, King’s College London