Science Segment on Lariam
Voice of America, News Now
(4:00) MAY 17, 2001
INTRO: U.S. health officials say the anti-malaria drug mefloquine - trade name "Lariam" -- has saved many lives, especially in areas where malaria is resistant to some other drugs. It's used in many places around the world both to prevent and treat malaria. But some travelers taking the drug as a preventative have suffered severe side effects - and say they should have been better informed about the risks. VOA's Carolyn Weaver reports:
TEXT: Kristi Anderson was a federal criminal investigator when she traveled to South Africa on vacation in 1991. To protect her against malaria - a potentially fatal disease carried by mosquitoes - Ms. Anderson's doctor prescribed the drug mefloquine, sold in the United States under the brand name Lariam. After the third pill, she began having constant dizziness, nausea, and panic attacks.
TAPE: CUT ONE - KRISTI ANDERSON
"I would sweat, I would have chills, I'd shake. Almost always there was
nausea, but sometimes it was a wave of dizziness or vertigo, and then I
would start having this feeling of impending doom, I wanted to get out
of where I was, I just wanted to get back home or someplace where I felt
safe."
TEXT: After months of illness, Kristi Anderson quit her job and moved back home with her parents, until she was well enough to work again. But in 1996, she returned to South Africa - and again took Lariam - and again became violently ill. A neurologist confirmed her suspicion that Lariam was the cause.
TAPE: CUT TWO - KRISTI ANDERSON
"He said the damage was in my brain stem."
TEXT: Neurological tests at Stanford University's California Ear Institute in 1998 found damage to a part of her brain, the vestibular system, that controls balance.
TAPE: CUT THREE - KRISTI ANDERSON
"He told me from the Lariam patients he had seen and what his tests
showed, he believed that Lariam was the cause of my vestibular problems
and he thought it was the cause of my earlier problems as well."
TEXT: A spokesman for the Roche pharmaceutical company, which makes Lariam, declined VOA's requests for an interview, saying the company saw no advantage to participating. In the 12 years Lariam has been approved for use in the United States, Roche has twice added new warnings of possible adverse effects in the package insert given to doctors and pharmacists. It's a long list, including among other things, nausea, anxiety, and dizziness - and rarely, convulsions, hallucinations, and psychotic reactions. But patients aren't routinely given the package insert. And many travel doctors, like former State Department consultant Martin Wolfe, say side effects are usually mild and rare:
TAPE: CUT FOUR -- Martin Wolfe
"We do prescribe it very frequently because it only has to be taken
once a week, and we believe the compliance is better with a drug taken
once a week than one taken daily. And since we are protecting against a
potentially life threatening disease, we want to do the very best we can
to encourage people to take their medication."
TEXT: Colonel Wilbur Milhous was among the military scientists who first developed Lariam, or mefloquine, at the Walter Reed Army Institute for Medical Research outside Washington, D.C. The drug promised to protect American troops abroad - as well as Peace Corps volunteers and ordinary travelers. Colonel Milhous says the Army's 12 years of experience with the drug has been good. But as reports of severe reactions to Lariam emerged -- and as lawsuits were filed over serious illness allegedly linked to the drug - Colonel Milhous says the government feared that Roche would pull the drug off the market.
TAPE: CUT FIVE - COL. WILBUR MILHOUS
"There was clearly an unmet medical need which the drug fulfilled. We
were frightened from a U.S. perspective, in terms of national
contingencies, what would happen if it were withdrawn?"
TEXT: To avert that, Colonel Milhous says health officials promised Roche they would continue to back the use of Lariam, despite the reports of adverse effects. More than two-thousand such reports have been filed by doctors with the Food and Drug Administration.
[For VOA News Now, this is Carolyn Weaver.]