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Veterans Suffering with Chronic Psychiatric Symptoms Should Seek Screening for Mefloquine Exposure

Originally developed by scientists working in affiliation with the Walter Reed Army Institute of Research (WRAIR), mefloquine was licensed by the FDA in 1989 and was sold as the branded medication Lariam from 1989 to 2011. Mefloquine is an antimalarial drug associated with the risk of chronic neuropsychiatric adverse effects (AEs).

For the treatment of uncomplicated malaria and for the prevention of malaria, as a convenient weekly dose, mefloquine had become the U.S. military’s drug of choice by the early 1990s. In 1992, starting with operations in Somalia and over the next 20 years, mefloquine was widely prescribed to military service personnel who were deployed to malaria-endemic areas, such as Afghanistan and Iraq.

Mefloquine has been available in several generic forms as well from 2003 to present, but all approved versions appear as a white/slightly-off-white, smaller than dime-sized round tablet, containing 250 mg of mefloquine hydrochloride.

Veterans who have a consistent history of having taken mefloquine weekly as a preventative medication against malaria should be considered as having been exposed, as the drug was often given without documentation and informally in military settings. This exposure could entitle veterans to disability claims for additional service-connected benefits.

Even if the veteran recalls taking an anti-malaria medication weekly, the tablet may not have been the appropriate color, shape, and size. If that is indeed the case, the medication was likely chloroquine, which is not associated with the risk of chronic neuropsychiatric adverse effects (AEs) at this time.

Mefloquine exposure is also not likely if the veteran recalls taking an anti-malaria medication daily. These medications were likely to be atovaquone/proguanil, marketed as Malarone, or doxycycline, neither of which are associated with the risk of chronic neuropsychiatric AEs.

A warning label was added by the FDA to mefloquine in 2013 cautioning that neuropsychiatric AEs from the drug could last years after use or even become permanent. Since then, WRAIR researchers have stated that chronic neuropsychiatric AEs attributable to mefloquine, including nightmares, insomnia, anxiety, irritability, and cognitive dysfunction, may confound the diagnosis of post-traumatic stress disorder (PTSD). The Department of Veterans Affairs (VA) has awarded at least one veterans disability benefit claim for service-connected psychiatric conditions attributable to mefloquine exposure. It is likely these types of claims will increase in the coming years.

The Injured Veterans legal team at Gordon & Partners is here for military veterans and their families. Please contact us immediately, if you are having difficulty with your claim or you are not receiving the disability benefits to which you are entitled. Call us at 1-888-231-9144 or fill out the form on this website.

Read the full story here: https://www.mdedge.com/fedprac/article/132560/mental-health/screening-symptomatic-mefloquine-exposure-among-veterans