U.S. Marine Corps Cpl. Timothy Dobson, a fire team leader with 2nd Platoon, Ground Combat Element, Security Cooperation Task Force Africa Partnership Station 2011 (APS-11), takes doxycycline, an antimalarial drug, in Toubakouta, Senegal. (Photo by Lance Cpl. Timothy L. Solano/Marine Corps) F rom nuclear testing to Agent Orange to burn pits, the American military has a decadeslong history of inadvertently exposing service members to a range of harmful toxicants responsible for myriad long-term health issues. But there are certain exposures—those which have known dangers—that, as a matter of policy or apparent necessity, have been purposefully introduced to military personnel. This is true of the antimalarial drug mefloquine, which was administered to hundreds of thousands of deployed U.S. troops despite the Pentagon’s and health professionals’ awareness of its adverse effects. Mefloquine, a pill taken weekly, was developed in the 1960s and 1970s by the Walter Reed Army Institute of Research after a drug-resistant strain of malaria sickened troops in Vietnam. It was widely prescribed to U.S. service members from 1989, when it was approved by the Food and Drug Administration, until 2009, when the Department of Defense issued directives effectively making it a last-choice drug for troops. DAV | @DAVHQ | DAVHQ | “It was recognized around the time of its U.S. licensing that there were very significant problems with this drug,” said Dr. Remington Nevin, a board-certified physician epidemiologist and former Army preventive medicine officer who has authored more than 30 scientific publications on malaria and antimalarial medication. “It was clearly known that some people became psychotic and some people became very violent, but at the time, it wasn’t appreciated just how serious these neuropsychiatric effects could be in terms of causing lasting disabilities.” Nevin noted that the known dangers of mefloquine (previously marketed in the U.S. as Lariam) were such that its manufacturer, Swiss multinational pharmaceutical company Roche Holding AG (Roche), and the FDA agreed to language in the initial product insert that warned certain symptoms—anxiety, depression, restlessness or confusion—should be considered as early signs of a “more serious event” and the drug must be immediately discontinued by its user. DAVETERANS | DISABLEDVETERANS 19 COMPANY/DAVHQ |