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.

“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

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.

“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.

“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.

“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.]

More Information on Malaria, Treatment, and Side Effects