Debate over side effects of Lariam in miliary sexual assault case

The manufacturer of anti-malaria drug Lariam warned of potential neuropsychiatric side effects in guidance for health professionals, a court martial in McKee Barracks was told yesterday.

An army private, who cannot be named by direction of the judge, Col Michael Campion, is accused of sexually assaulting a woman colleague on a 24-hour tour of duty.

The accused claimed he has no memory of the alleged assault, and said he remembers only standing in his boxer shorts close to the woman’s bed, while she shouted that he had touched her bottom.

The accused told the court martial he had nightmares, depression, and forgetfulness following overseas trips during which the army prescribed him the anti-malaria drugs Lariam and Primaquine.

Yesterday, Dr Ronald H Behrens, a malaria specialist and adviser to the British military, told the court martial Lariam had no long-term effects and would not have been a contributory factor in the alleged assault.

He said taking it with Primaquine did not represent a double dose, and no studies show that drinking lots of alcohol, which the accused did at the time, exacerbate any effect of Lariam.

Dr Behrens told prosecuting counsel Cmdt Fintan McCarthy that, while some people experienced temporary side effects, Lariam had no long-term effects. He said there would be no causal link between taking the drug and the alleged assault in the year following the accused’s last overseas trip.

However counsel for the defence Gareth Humphreys produced guidance from the distributors of Lariam, Roche Products, issued in 2013, which, he said, included the words: “Due to the long half life of mefloquine [the generic name for Lariam] reactions may occur and persist up to several months after discontinuing the drug.”

Quoting from the document, entitled Guidance for Health Professionals, he said it listed potential side effects as including depression, suicidal tendencies, paranoia, unusual behaviour, amnesia and restlessness.

Dr Behrens replied that such advice was probably written by lawyers for lawyers, and it did not prove a causal relationship between the drugs and the symptoms as described.

Dr Behrens also rejected an assertion that he had received “cash and payments in kind” from Roche. He said the assertion from rival specialist Dr Ashley Croft, who appeared for the defence, was incorrect.

Dr Behrens also said an assertion by the British Medical Journal that he had received research funding from Roche was incorrect. He said he was "surprised" to see the claim about funding and assumed "there was an error". He agreed with Mr Humphreys the error had gone uncorrected since 1998.

Dr Behrens told the court martial the scientific community was surprised when the US military dropped the use of Lariam in recent years. He said scientific knowledge had not changed much in the previous decade and he ascribed the US move as a response to concern in the media about Lariam.

He said if someone who was taking Lariam became ill it did not establish that Lariam caused the illness.

The case continues.