Our Troops Are Still Suffering from This Anti-Malaria Drug

It’s been three weeks since Nichole Yost involuntarily committed her husband, Matthew Leddon, to Avera Behavioral Health in Sioux Falls, South Dakota, for attempted suicide.

Leddon, a former U.S. Army reservist, had been meticulously planning his death for quite some time, unbeknownst to her. He had given away many of his belongings — even researched how he might preserve his brain in death so that it could be donated for mefloquine neurotoxicity research once he was gone.

It’s the mefloquine, after all, the anti-malaria drug that he was forced to take every Monday while in Afghanistan 13 years ago, that got him here in the first place.

“We have way too many veterans who are committing suicide from this,” Yost told LifeZette. “Avera has been amazing and probably the only reason he’s still alive right now. At this time, he is doing fairly well and I have more hope than I’ve had in many years.”

Mefloquine was developed by Army researchers toward the end of the Vietnam War. It’s been used for decades to prevent malaria among our troops who are serving overseas. Malaria is a serious disease caused by a parasite that commonly infects mosquitoes, which then bite humans. While uncommon in the United States, it is a major cause of death worldwide.

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Despite years of concerns voiced about the psychiatric and physical side effects of the drug, the Department of Defense only started to officially recognize the risk and scale back its use in 2003.

But it wasn’t until 2013, due in large part to the research of Dr. Remington Nevin, an epidemiologist with Johns Hopkins University and an Army major, that the U.S. Food and Drug Administration issued a “black box warning” for mefloquine. Specifically, the FDA noted, Lariam (the brand name) should not be taken by anyone suffering from depression. Neurological and psychiatric side effects of the drug, the organization stated, included seizures, depression, hallucinations, violent behavior, feeling that others want to harm you, thoughts of hurting or killing yourself, and many others.

“Neurologic side effects can occur at any time and last for months to years after the drug is stopped or can be permanent,” said the FDA of mefloquine.

The FDA, at the time, also admitted that neurologic side effects can occur at any time during drug use, “and can last for months to years after the drug is stopped or can be permanent. Patients, caregivers, and health care professionals should watch for these side effects.”

As a result, the drug is now formally considered a “drug of last resort,” Nevin said. The most recent statistics show mefloquine comprises fewer than 1 percent of new antimalarial prescriptions.

“I first became interested in this topic during a deployment to Afghanistan in 2007, where I served as a public health physician and adviser to U.S. forces,” said Nevin. “At first, my concerns with mefloquine were limited to what I had recognized was the U.S. military’s inappropriate use of mefloquine among troops with pre-existing mental or neurological disorders. According to our own military policies, and the guidance of the drug’s manufacturer, these troops should not have been prescribed the drug.”

[lz_bulleted_list title=”Symptoms of Mefloquine Neurotoxicity” source=”http://www.fda.gov”]Dizziness|Loss of balance|Ringing in the ears|Anxiety|Distrust|Depression|Hallucinations|Inability to sleep|Convulsions or seizures|Confusion[/lz_bulleted_list]

“However, work I had undertaken while in Afghanistan uncovered that it was fairly common for such troops to be erroneously prescribed the drug,” he said. “As many as one in seven of our deployed troops who should have been contraindicated the drug nonetheless received a prescription for it. Although this was my initial interest, over time, I became equally concerned about the drug’s use even among healthy troops [among whom the drug had been previously thought to be safe] and also its use among civilian travelers, and also in its use for the treatment of malaria.”

All of this begs the question why — years later in 2016 — do families still not know about it? Why do the health concerns and claims of those like Leddon continue to be ignored throughout the Veterans Administration system or be otherwise treated and recognized only as post-traumatic stress disorder? Leddon never let up.

On July 21, 2016, he became one of the first in the nation to be awarded 100 percent disability with unemployability due to mefloquine neurotoxicity, according to Yost.

“One of the reasons his claim was approved was that he never stopped seeking help,” said Yost. “In 12 to 13 years, he never stopped going to a VA no matter where we lived or where we were, and saying, ‘I know something has happened to my brain and it started with mefloquine.'”

Yost believes so many soldiers are committing suicide each day because they’ve not had their concerns or claimed validated. It’s not just PTSD.

“That’s probably what I hear in mefloquine support groups more than anything from other people who are experiencing this. If you’re suffering from something for 13 to 20-plus years and no one will validate it, you do feel crazy and out of your mind. But you can’t give up. You have to be persistent; otherwise you’re never going to win this battle,” Yost said.

Yost and Leddon still have a long way to go in their own fight for survival and a healthier future. Leddon remains hospitalized at a VA inpatient facility in Sioux Falls while a new, comprehensive team both inside and outside the VA work to finally get him the help, resources, and treatment he needs.

Whatever happens to him, Leddon told Yost his only goal in sharing his story is for others to know they’re not alone, and they’re not crazy. He hopes others investigate mefloquine neurotoxicity if they’ve had their own issues since taking the drug. And that they don’t let up.

“The U.S. military developed mefloquine — and so certainly ought to have known of its dangers,” Nevin said. “What is interesting is that the dangers of this particular class of antimalarial drugs — the quinolines — was known to military researchers since the WWII era. In my researching the history of this class of drug, the biggest question I have is precisely how it came to be that the U.S. appears to have simply overlooked decades of research on these dangers.”