• Government
• Profession
• Business
• Opinion
• Health

• Health reform
• H1N1
• P4P
• EMRs
• Medicare
• Liability
• AMA House
• » More

• Book Excerpt
• Business Pitch
• Meetings
• » More

• Contract Language
• Ethics Forum
• In the Courts
• Practice Management
• Technically Speaking
• » More

• Issue dates
• Regions
• Health plans
• Sections
• News briefs
• Columns
• Editorials
• Letters
• Writers
• Other years

• Search tips
• E-mail alert
• Radio
• RSS
• Mobile
• Subscribe
• Institutions
• Staff directory
• Advertising
• Permissions
• Reprints
• News media
• Site guide
• Useful links
• About
• Premium
• Contact

Anti-malaria drugs trigger care challenges

A murder investigation spotlights concern about Lariam's possible dark side.

By Victoria Stagg Elliott, amednews staff. Sept. 23/30, 2002.

• PRINT|
• E-MAIL|
• RESPOND|
• REPRINTS|
• SHARE

A drug prescribed to travelers to prevent and treat malaria has been mentioned by military officials as a possible factor in the separate murders of four Army wives over a six-week period at Fort Bragg, N.C., earlier this year.

Those events, coupled with manufacturer Roche Laboratories adding suicide risk to a list of rare but possible adverse reactions for Lariam (mefloquine hydrochloride), has increased the pressure on doctors to more selectively prescribe the anti-malaria drug.

A company spokesman confirmed the label changes but added that there is no proven link between the drug and violent behavior. "We can't comment on the Fort Bragg situation as we understand that there is an ongoing investigation of these events by the U.S. Army," said Terence Hurley. "It is important to note, however, that there is no reliable scientific evidence that Lariam is associated with violent acts or criminal conduct. Lariam is an important and valuable drug that's effective in fighting a life-threatening disease."

Patients with a history of mental illness are still considered at higher risk for adverse reactions, according to package labeling.

"The risk is relatively small, and when you prescribe selectively, the adverse events are not as much of a problem," said Bradley A. Connor, MD, medical director of the New York Center for Travel and Tropical Medicine. "But you don't want to leave someone unprotected. Malaria is a very serious infection, and whatever you can do to prevent it, you want to."

Lariam is the preferred choice because of cost, dosing and resistance considerations. And, though online travel journals are filled with tales of wild "Lariam dreams," these are more entertaining than debilitating, and most travelers do not experience adverse events. [...]