Author Topic: Mefloquine (a.k.a Lariam) anti-malarial in CF use (merged)  (Read 40174 times)

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Offline Pieman

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Re: Malaria drug for Canadian troops called dangerous
« Reply #50 on: April 11, 2012, 19:28:53 »
I'm not seeing any numbers with regards to how many people they think are effected long term. Then this quote: "Long-term neuropsychological effects and reports of suicide ideation or suicide have not be confirmed, the agency says."

So....is it really a problem or bogus reporting?
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Offline MCG

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Re: Malaria drug for Canadian troops called dangerous
« Reply #51 on: April 11, 2012, 19:34:31 »
http://www.cbc.ca/news/canada/story/2012/04/10/malaria-drug-mefloquine.html

Someone please remind me, there was a weekly malaria pill and a daily pill for 2009 tours.  What were they called?

Which is the drug they are talking about here?

I am worried this could have implications for veterans who are being treated.
The option to use the other drug has been around at least since the end on 2005.  If troops started to experience symptoms, they could be switched from one drug to the other.

Offline Rider Pride

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Re: Malaria drug for Canadian troops called dangerous
« Reply #52 on: April 11, 2012, 20:15:53 »
If you have received a weekly medication to prevent Malaria from the CF since about 1992ish, it was most likely Melfloquine, otherwise known as Larium.

Most recently the dosage was 250mg starting 3 weeks prior to departure, until 4 weeks after return.

The dosing for this weekly medication has, over the last 20 yrs has decreased as it has been shown higher does are no more effective than lower doses to prevent malaria, while having a significant adverse effect rates.

It was seen at 1000mg (Somalia doses) that vivid dreams, nightmares, nausea, and occasionally seizures were an issue. Latest Kandahar dose of 250 mg per week still have a 1 in 10 occurrence of vivid dreams on the night of the dose, but that effect is mitigated by taking the medications earlier in the day.

BTW, the Mefloquine patient information card specifically states anyone who has suffered from depression, anxiety or  schizophrenia should avoid the medications as the vivid dreams can aggravate the underlying condition. Anyone who claims that the medication "caused" them to have a mental illness after taking it, should be very careful to not have any mental health issues prior to taking the drug.

I have an electronic version of the patient info cards for Mefloquine and Malarone on my computer. If people want to see them, I can attach them.

BTW; 3 tours of Afghanistan, seen lots of blood and badness. Took Mefloquine all three times. Had dreams. Had nausea. All went away once drug was discontinued after I was home....every time.

My position: every medication has its role, and adverse effects. As a medical professional, we constantly balance the drugs affects with its effects. Mefloquine remains the most reliable drug for long term use in a hot, sunny climate. The US Army tended to dose their soldiers higher than the CF, which may explain some of the issues. In the last year, the US forces have switched to Doxycycline (an antibiotic) as their primary malaria prophylaxis medication. My take is they did it because of the cost. Malarone is a very expensive drug, at about $4 per tab vs 50 cents for Doxy.
« Last Edit: April 11, 2012, 21:20:34 by Rider Pride »
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Offline Pieman

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Re: Malaria drug for Canadian troops called dangerous
« Reply #53 on: April 11, 2012, 20:56:34 »
Thanks for the info Rider. 

I am curious to know what percentage of people are effected long term as sited in the media report? It has to be low considering how long the drug has been around. 
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Offline E.R. Campbell

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Re: Malaria drug for Canadian troops called dangerous
« Reply #54 on: April 11, 2012, 21:00:30 »

Ditto, although I'm not sure what the drug was, three times, for periods ranging from a few weeks to about nine months, between 1975 and 1990ish. We heard all kinds of horror stories but I never saw nor heard, first hand, any real evidence about ill effects.


Sorry, I should have said "any real evidence about long term ill effects." There were, indeed, some (many?) cases of headaches, sleep troubles and so on while members were taking the drug.
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Re: Malaria drug for Canadian troops called dangerous
« Reply #55 on: April 11, 2012, 21:12:48 »
I had trouble with it and switched to Doxy for the rest of the tour. Once I was off the mefloquine I was fine (at least I think so, others aren't sure)
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Offline Snaketnk

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Re: Malaria drug for Canadian troops called dangerous
« Reply #56 on: April 11, 2012, 21:30:22 »
Unfortuantely, it's hard to track things like that over the long term.... Nobody's ever asked me about psychological effects since my tour (except for that 5 minute social worker interview shortly after returning), and I definitely didn't get a follow up asking me about how my regimen of Mefloquin went.

Even I don't know what the symptoms were; so many things were going on, I could attribute psychological symptoms/irregularities to any number of things.
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Re: Malaria drug for Canadian troops called dangerous
« Reply #57 on: April 11, 2012, 21:39:14 »
Definitely going to try another anti-malarial if I have to try again. I didn't dream in colour with Mefloquine, it was Bluray high-def. That, combined with the nausea for 3 days after made me thankful I only had to take it for a few months as I got a winter tour. All the stuff seemed to go away a few weeks after completing the meds though.

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Re: Malaria drug for Canadian troops called dangerous
« Reply #58 on: April 11, 2012, 21:54:12 »
I was on Mefloquine in 94, 06 and 08. No ill effects noted, either acutely or long term. There were millions of doses prescribed to civilians prior to the CF taking it on board.
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Offline medicineman

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Re: Malaria drug for Canadian troops called dangerous
« Reply #59 on: April 11, 2012, 21:55:44 »
I'm with RP on this with one small exception - chloroquine is also a once weekly med that people still get to take in certain areas.  I took Lariam for my mini tour in 03 - the one night I actually had a cool dream, someone interrupted it and woke me up.  To be honest, I think that side effect is a little over exaggerated at the dose it's given at - like the vast majority of folks, I had more gut rot issues with it than anything.

Like it or lump it, in the dose it's given now, I'd say that you're unlikely (I didn't say not ever, though one does have to wonder about placebo here sometimes  :)) to have any issues with the stuff...and if you notice things, you can just go in and ask to be switched to the alternate. 

Pieman, given that they didn't cite any stats, they're having problems finding them (and so are we for that matter) but are trying to infer that there are many.  Just like the drug was "declared dangerous" - by one physician.  The PHAC or any other regulatory agency in this country haven't come out saying so, and we've been using it for a number of years now.  If someone were to decide that mefloquine was dangerous, PHAC and Health and Welfare Canada would have to acknowledge that...and to be honest, if it were to get pulled, they'd better start pulling some considerably more dangerous medications and other products off the shelves shortly afterwards.

To paraphrase Paracelsus - ALL substances are poisons...the difference between a remedy and a toxin is the dose.

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Offline Rider Pride

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Re: Malaria drug for Canadian troops called dangerous
« Reply #60 on: April 11, 2012, 22:05:07 »
Alcohol is a dangerous substance whose byproducts include formaldehyde. Most people have no problem over dosing on it.


On a completely different thought:
Ask anyone who has had malaria....they'd rather have some bad dreams, instead of living in one for 10-14days.
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Offline Pieman

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Re: Malaria drug for Canadian troops called dangerous
« Reply #61 on: April 11, 2012, 22:08:15 »
Quote
Pieman, given that they didn't cite any stats, they're having problems finding them (and so are we for that matter) but are trying to infer that there are many.  Just like the drug was "declared dangerous" - by one physician.  The PHAC or any other regulatory agency in this country haven't come out saying so, and we've been using it for a number of years now.  If someone were to decide that mefloquine was dangerous, PHAC and Health and Welfare Canada would have to acknowledge that...and to be honest, if it were to get pulled, they'd better start pulling some considerably more dangerous medications and other products off the shelves shortly afterwards.

Seems like some pretty terrible reporting by the CBC, once again......I know that must come as a shock to many of you. ha! I'm not sold this is a real issue unless they come up with some stats showing long term effects one way or the other.
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Offline medicineman

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Re: Malaria drug for Canadian troops called dangerous
« Reply #62 on: April 11, 2012, 22:08:51 »
Alcohol is a dangerous substance whose byproducts include formaldehyde. Most people have no problem over dosing on it.


On a completely different thought:
Ask anyone who has had malaria....they'd rather have some bad dreams, instead of living in one for 10-14days...or longer

There - FTFY.  Saw my first malaria attack when I was 9 - my grandfather started cycling on a plane ride back from the UK with me.  He contracted it in SE Asia during the Second World War and never got rid of it.

Edit for spelling.

MM
« Last Edit: April 12, 2012, 08:49:40 by medicineman »
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Offline mark-space

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Re: Malaria drug for Canadian troops called dangerous
« Reply #63 on: April 11, 2012, 23:56:20 »
Mefloquin turned me into a newt!

Wacky Wednesdays on ROTO 0 in Kandahar...my nightmares were more entertaining than anything else in that dust pit.....

Offline Beadwindow 7

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Re: Malaria drug for Canadian troops called dangerous
« Reply #64 on: April 12, 2012, 08:47:33 »
In 2007, I took Malarone, one of the daily pill because I didn't have enough workup time before deploying to get on mefloquin. Didn't like it because 1. I always forgot to take it, and 2. it seemed to mess with my appetite.

In 2009, I wanted mefloquin, particularly to see what the "vivid dreams" would bring me. First Mefloquin monday, nothing at all...and the same followed for the following 10 months. What a rip.

We did however have a guy who did get the terrors, pretty bad ones too. Easy enough, go to the medics, "Hey, mefloquin f**** me up", and prescription promptly changed.
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Offline Hatchet Man

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Re: Malaria drug for Canadian troops called dangerous
« Reply #65 on: April 12, 2012, 08:48:37 »
I took mefloquine, and got the crazy dreams (don't know about nightmares, but I would definately wake up, with a sense of well that was f'ed up).  I still get the dreams though, and I have been back for over a year.

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Re: Malaria drug for Canadian troops called dangerous
« Reply #66 on: April 12, 2012, 08:51:49 »
I had trouble with it and switched to Doxy for the rest of the tour. Once I was off the mefloquine I was fine (at least I think so, others aren't sure)

You are correct in your assessment sir and I heartily concur!!

A few  troops from the Airborne told me they had "meflomares". All anecdotal though and no real evidence.
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Re: Malaria drug for Canadian troops called dangerous
« Reply #67 on: April 12, 2012, 10:21:29 »
You are correct in your assessment sir and I heartily concur!!

A few  troops from the Airborne told me they had "meflomares". All anecdotal though and no real evidence.

I have no numbers, but many shipmates (myself included) described suffering from nightmares after we deployed to Somalia on HMCS Preserver.  Some of them continued long after we stopped taking the medication.  Again, no numbers, and nobody official has ever solicited my input as part of a study to find out how prevalent the problem was.

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Re: Malaria drug for Canadian troops called dangerous
« Reply #68 on: April 12, 2012, 10:49:27 »
Problem is, I don't think there is a study on how the drug affects patients who are taking it coupled with a highly-stressful environment like deployed operations in a war zone. There may be a majority who have no ill-effects, but we can't call BS on the members who are having issues without scientific backing.

Offline 2 Cdo

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Re: Malaria drug for Canadian troops called dangerous
« Reply #69 on: April 12, 2012, 10:51:10 »
Vivid technocolour dreams on the day I took it, but fine the other six days of the week with no lingering issues.
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Offline Pieman

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Re: Malaria drug for Canadian troops called dangerous
« Reply #70 on: April 12, 2012, 12:35:35 »
Quote
There may be a majority who have no ill-effects, but we can't call BS on the members who are having issues without scientific backing.
I totally agree there. The numbers could super low, but does not mean it does not happen to people.
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Offline Jarnhamar

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Re: Malaria drug for Canadian troops called dangerous
« Reply #71 on: April 12, 2012, 13:20:31 »
Not a single bad dream.

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Offline Gronk

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Re: Malaria drug for Canadian troops called dangerous
« Reply #72 on: April 12, 2012, 19:20:00 »
Took the pills on 02 tour, gave me vivid gory violent dreams. stopped taking it after I started hallucinating. Still have the dreams- couldn't say whether pills are partly to blame or not.

Offline Rider Pride

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Re: Malaria drug for Canadian troops called dangerous
« Reply #73 on: April 12, 2012, 22:50:11 »
Here is the Health Canada site giving drug warnings about Larium...AKA Mefloquine:

http://www.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/public/_2005/lariam_pa-ap-eng.php

Two key points I will highlight, as does Health Canada:

1. Do not take 'Lariam' to prevent malaria if you

    have or had depression
    have had recent mental illness or problems, including anxiety disorder, schizophrenia (a severe type of mental illness), or psychosis (losing touch with reality)
    have or had seizures (epilepsy or convulsions)
    are allergic to quinine or quinidine (medicines related to 'Lariam')


2. If you use 'Lariam' to prevent malaria and you develop a sudden onset of unexplained anxiety, depression, restlessness or irritability, or confusion (possible signs of more serious mental problems), or you develop other serious side effects, including a persistently abnormal heart beat or palpitations, contact a doctor or health care provider. It may be necessary to stop taking 'Lariam' and use another malaria prevention medicine instead.


This was known in 2005.

If you were not completely honest on your questionnaire (which I know was done in 2005) before you got the meds, or did not report adverse symptoms while on the meds, then you should not be surprised how the government lawyers will present the case against you.

« Last Edit: April 12, 2012, 22:54:26 by Rider Pride »
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Offline AJFitzpatrick

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Re: Malaria drug for Canadian troops called dangerous
« Reply #74 on: April 12, 2012, 22:57:10 »
Anecdotal:

 Myself and friend going to Honduras: same malaria medication and dosage.

Me : no effect
Friend:  strange dreams

I'll stick to Gin and Tonics or better Rum and Tonics