The time has come for Parliament to immediately direct the Minister of Veterans Affairs to establish a national registry for veterans who believe they may be suffering chronic health effects from exposure to the neurotoxic antimalarial mefloquine (Lariam), a drug developed by the U.S. military over four decades ago.

Evidence suggests that a syndrome of lasting neurological and psychiatric effects occurs among a significant percentage of veterans who have been ordered to take this drug as chemoprophylaxis for malaria since the  original issue of this drug by Health Canada (unlicensed at the time) in November 1992.

Contrary to FDA guidance, many of these veterans were ordered to take mefloquine without receiving critical warnings or effective monitoring. Prodromal symptoms such as:

• insomnia, 

• vivid dreams,

• dissociation, 

• homicidal ideation,

• suicidal ideation,

• cognitive impairment,

• anxiety, 

• depression, 

• restlessness, and/or 

• confusion.

These symptoms should have prompted them to immediately discontinue the drug. They did not and could not.

In July 2013 the FDA directed a black box warning appear on the mefloquine product insert clarifying that neurological side effects from the drug could be permanent and that psychiatric side effects could persist “for months or years after mefloquine has been stopped.â€? Many of these side effects mimic those of traumatic brain injury and posttraumatic stress disorder, yet affect veterans who lack the history of traumatic exposures that would better explain these diagnoses. These veterans risk suffering in confused silence. 

VAC must initiate a nationwide campaign to identify all veterans who took mefloquine and may be suffering from its chronic health effects, so as to better guide their future medical treatment and to determine how best to compensate those suffering permanent disability from the drug’s neurotoxicity. The United States is already underway with such a program. Why not Canada?

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