Thursday, November 17, 2016

Mefloquine and PTSD

The issue of "Mefloquine" - medication used to prevent or treat malaria - with its side effects that include possibly long-term mental health problems, anxiety and other serious effects such as abnormal and violent behavior surfaced during the Commission of Inquiry into the Deployment of Canadian Forces to Somalia.  In its 1997 Report titled "Dishonoured Legacy: Report of the Commission of Inquiry into the Deployment of Canadian Forces to Somalia" the Commission of Inquiry noted that
"It is clear that mefloquine caused some minor problems in Somalia, as might be expected from a review of the medical literature. We learned of several incidents of gastro-intestinal upset, vivid dreams, nightmares referred to by soldiers as 'meflomares', inability to sleep following the use of the drug.. . . However, we are not able to reach a final conclusion on this issue [and we can] offer only general observations about the decision to prescribe mefloquine to personnel deployed to Somalia."
However, the Commission was not able to 'explore fully the possible impact of the mefloquine" because it ran out of time after the government of the day decided to truncate the mandate of the inquiry.

However the issue has not gone away primarily because the Canadian military has continued to use mefloquine during the deployment of soldiers to Afghanistan.

1.   For instance, in April 2012, the Canadian Broadcasting Corporation (CBC) reported on the experiences of several Afghanistan veterans. Chronicling the use of mefloquine in Canada and the US military,  the CBC is critical of the continued use of this drug by Canadian Armed Forces. See:  "Canada's military apparently unconcerned over anti-malarial drug effects"

2.  In a series of articles published this November by the Globe and Mail newspaper, the mefloquine issue has resurfaced with renewed vigor.  On Monday, November 14, 2016 the Globe and Mail examined "The Malaria Drug's psychotic effect on Troops' and reported  that Canadian veterans say that the anti-malarial drug prescribed in Somalia has ruined lives. The following day, the daily revealed that Defence Minister Harjit Sajjan is defending the military's continued use of the drug noting that troops can make their own informed decisions about whether to take it or not. [As an aside, I doubt very much that a soldier is given such an option.] Yesterday, the Globe and Mail reported that the "Canadian Military to reassess the use of controversial anti-malaria drug". On Thursday, November 17, 2015 the Globe and Mail quotes the Honorable Gilles Létourneau, the former chair of the Somalia Inquiry who agrees that it would be worthwhile to now take a hard look at the dangers posed by the drug, which is still being offered to Canadian Forces members.
"Surely, run a survey of existing use of mefloquine with the Armed Forces and see whether the problems that were raised 20 years ago are still there." 
Most obviously the Mefloquine issue will not go away particularly following the troublesome commentary made by a Dr. Passey, a medical expert, published in this morning's edition of the Globe and Mail:
"One of the worse problems with mefloquine toxicity is that its symptoms mimic those of PTSD, and that can make it difficult to diagnose. . . there's a whole veteran population out there that may not have been identified properly as far as what's causing their condition. " [My emphasis]

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