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Malaria Drug Raising Concerns

Sep 7, 2004 | CNN ZAHN: A grim marker today for U.S. troops in Iraq. The number of military personnel who have died in Iraq has surpassed 1,000. It now stands at 1,002. Defense Secretary Donald Rumsfeld acknowledged that today noting that war quote "has its cost."

Another cost for U.S. troops is the exposure to potentially deadly diseases. And tonight, there is new concern about a drug that is supposed to prevent malaria that's been given to thousands of soldiers in Iraq and Afghanistan. A CNN investigation with UPI reporters Mark Benjamin and Dan Olmsted has uncovered a series of suicides among a group of elite soldiers who took that drug.

Here is Mark Benjamin.

MARK BENJAMIN, UPI REPORTER: Army special forces soldiers are carefully selected and trained for mental stability. Bill Howell had excelled in difficult assignments around the globe for 10 years. But three weeks after his return from Iraq, his wife, Laura, says he snapped. In an uncontrollable rage, he beat her with his fists. Then he got his gun.

LAURA HOWELL, WIFE OF SOLDIER: I'm screaming at him to put the gun down. He still has a hold of me by the shoulder, by the collar of my shirt. And he's screaming, you're going to watch this, you're going to watch this. And he takes a couple of steps back. And I think that was the first time that he heard the police officers, because they're screaming at him, put it down, it's not worth it. Put the gun down. Put the gun down. And he kind of just oh noticed and took a step back and shot himself. BENJAMIN: We found six special forces soldiers, including Bill Howell, who friends and family say had sudden deadly psychotic breaks. Among these are the only five special forces suicides since the U.S. entered Afghanistan and Iraq.

According to those who knew them, each of these soldiers had taken the anti-malaria medication called Lariam. The Food and Drug Administration warns Lariam, also called mefloquine, might cause mental problems, including rare instances of psychosis, aggression and suicide. The drug's manufacturer, Roche Pharmaceuticals, said there is no reliable scientific evidence linking Lariam and violent criminal behavior.

L. HOWELL: I knew my husband. I knew who he was. I knew what he was. The only difference was one pill, was a little white pill that he took.

BENJAMIN: An Army study in 2000 showed special forces soldiers actually produce more of a brain chemical that manages stress.

Dr. Paul Ragan, a former military psychiatrist, said special forces soldiers rarely snap.

PAUL RAGAN, VANDERBILT UNIVERSITY: It's just antithetical to their whole practice of their craft to suddenly lose control, become depressed, paranoid, hallucinate and become suicidal. You have to look for some exogenous, some outside factor, something new in the mix that would change how they have otherwise been able to operate.

BENJAMIN: Invented by the Army to prevent malaria, Lariam is in a class of drugs called quinolones. It can actually cross what is called the blood-brain barrier and dissolve into the brain. For most people, this is harmless. But there's mounting evidence that, for some, Lariam may kill.

This summer, the Department of Veterans Affairs notified all of its doctors to be on the alert for mental and physical disorders among soldiers who had taken Lariam, even if they hadn't taken the pills in a long time. More than a year ago, the Food and Drug Administration ordered that anyone given Lariam should get a written warning about reports of suicide. The same month the FDA warning was issued, Special Forges Sergeant Timothy Tyler (ph) Whiffen walked into these woods behind his Northern Virginia condo and put his gun in his mouth. He had taken Lariam during his six months in Afghanistan.

At the time of his suicide, Whiffen's wife, Karla, was four months pregnant. She said that before he began taking Lariam, Tyler was happy.

KARLA WHIFFEN, WIFE OF SOLDIER: No, he wasn't depressed at all. And in fact, I have never known anyone to enjoy life so much in all my life. He truly defined living.

BENJAMIN: The possible side-effects of Lariam listed by its manufacturer are physical as well as psychological. After he returned home, Bill Howell's wife said he had a rash, diarrhea and panic attacks. In addition to diarrhea and headaches, Tyler Whiffen's wife said he endured night sweats, insomnia, aggressiveness, paranoia, and delusions.

WHIFFEN: There was nothing in his life that would have pointed to this. This was not him. For him to take his life, it was so out of the blue and out in left field. And sometimes you have a 20/20 vision, and nothing, nothing, nothing has surfaced that would make this anything but this drug.

BENJAMIN: There are alternatives to Lariam to prevent malaria. A recent scientific study showed that 29 percent of people taking Lariam experienced some kind of mental problem, twice the rate of a similar malaria drug. In testimony before Congress this year, the now retired Army surgeon general dismissed concern about Lariam as Internet mystique.

Despite repeated requests from CNN and UPI over a span of weeks, the Army would go no further than issuing a statement, saying they have no data that indicate that Lariam was a factor in any Army suicides in Iraq or Afghanistan.

However, a Navy doctor at a Pentagon treatment facility in San Diego has diagnosed Lariam as the likely cause of permanent damage to this special forces soldier's brain stem. The soldier, whose identity we've hidden because he's still on active duty, said the drug can induce a sudden urge to do the unthinkable.

UNIDENTIFIED MALE: You're on the brink. You're ready to take that plunge into hurting someone or hurting or killing yourself. And it comes on unbelievably quickly. There is no thinking about it. There is no logic to it. It's just a sudden thought. It's the right thing to do. And you'll get a mental picture.

BENJAMIN: These deaths, which include three murder/suicides at Fort Bragg in 2002, raise concerns about the tens of thousands of soldiers who have taken mefloquine.

The Army announced late last year it would stop using Lariam in Iraq because the risk of malaria is so low. In February, the Pentagon ordered a new study on the link between Lariam and suicide.

WHIFFEN: Knowing my husband and knowing how strong mentally and physically he was, I think that is a very powerful drug. I think that if it can take him, it can take anyone.

BENJAMIN: Mark Benjamin

ZAHN: And with me now is the man you've just been hearing talking over the last several minutes. Mark Benjamin of UPI, welcome.

BENJAMIN: Thank you.

ZAHN: Is there any way with where the science is today you can make this direct link between Lariam and this extreme behavior that you're talking about?

BENJAMIN: Science does not prove a direct link between taking the pill and committing suicide.

However, when you have these high-level individuals who are OK; they take the drug; then they have a series of physical and mental problems after taking the drug; and it results in suicide, it's a very compelling case.

ZAHN: You talk very pointedly about the FDA's warnings about these drugs. The soldiers you talked to, how many of them had been warned about the social side effects of taking it?

BENJAMIN: I have talked with dozens and dozens of soldiers at eight bases in the United States and Europe. I have not met a soldier yet who's been warned about the possible side effects of this drug, despite FDA requirements to do so.

ZAHN: Why is that, Mark?

BENJAMIN: I don't know why the Army is not doing its job in warning these soldiers. But I do know there are a lot of soldiers who wish they had been warned.

ZAHN: Is there a suggestion of some kind of cover-up there? You also pointed out in this report that our government is responsible, actually, for manufacturing originally, I should say, creating this drug.

BENJAMIN: The Army did invent this drug in the 1970s to prevent malaria. I don't have any evidence that this is a cover-up. However, it is an extremely disturbing series of events. No question about it.

ZAHN: Well, there's another thing that caught my eye that I thought was disturbing. And that is the fact by law, the military is required to put into the medical records of soldiers when Lariam has been administered. That hasn't happened.

BENJAMIN: That's right.

ZAHN: Why?

BENJAMIN: Well, we don't know for sure. After the first Gulf War, Congress moved swiftly to make sure that if we may have caused some of Gulf War illness with anthrax shots or some other medicines, that doesn't happen again in terms of trying to figure out what happened.

In other words, Congress said, "Army, record everything in these medical records so we can go back and find out if we've done any damage to our soldiers."

The Army didn't do it. And once again, we're in a situation where we have, really, an unknown number of soldiers out there with potentially very serious health problems.

ZAHN: And how many of them may potentially be at risk?

BENJAMIN: We don't know for sure. We know that the latest prescription data from the Pentagon shows that at the end of October 2003, 45,000 service members had been given prescriptions for this drug up to that in that year ending in October 2003.

ZAHN: Just want to jump back to that other question of why this stuff wasn't recorded in medical records. Would someone be motivated to do that out of the desire to cover up something? Or is there just sloppiness at work?

BENJAMIN: I have no evidence that it was nefarious conduct by the Army. But I wish they'd done better.

ZAHN: Mark Benjamin, thank you for bringing that report to us this evening.

And this note: we asked the Army for a response; got none.

Coming up next, a soldier tells us why she thinks Lariam led her to commit an unthinkable act of violence.

ZAHN: We are talking about questions surrounding an anti-malaria drug given to thousands of American military personnel and whether the drug is connected to suicides and other acts of violence by some troops.

Joining us now is one former member of the Army who says she took Lariam for months while serving in Afghanistan and then tried to shoot her lieutenant. She has asked us not to reveal her last name or location, so we will call her just by her first name, Destiny.

Thanks so much for joining us, Destiny.


ZAHN: First of all, how many months did you take Lariam for?

DESTINY: Six months: August '02 to January '03.

ZAHN: And you took it orally about once a week?

DESTINY: Every Monday, yes, ma'am.

ZAHN: And how long was it before you felt you were having reaction to any of the medication you were taking?

DESTINY: Like the stomach cramps, diarrhea, nausea happened the first week or two. And after that, it just steadily got worse: the nightmares, the panic attacks, being dizzy, being scared, not knowing what you're scared of.

ZAHN: Did you take any of these effects of this medicine to your doctors or to your superiors?

DESTINY: Well, we all took it, but no one ever told me to think that's what it was. They didn't us that anything could happen. They said, you know, that when you take it, be prepared to have to, you know, maybe throw up, you know, have cramps. That was all they ever told us about it.

ZAHN: So no one ever told you what the FDA is telling doctors today, that there can be psychotic episodes associated with Lariam? No one ever said that to you?

DESTINY: No, ma'am, not even the doctors when I saw combat stress. They never even mentioned that that's what it could have been. You know, it.

ZAHN: You never witnessed combat personally, right? You served in Afghanistan, but were never on the front line?

DESTINY: No, ma'am.

ZAHN: So describe to us the rage you felt when you attempted to attack your lieutenant.

DESTINY: I can't even explain it, just being so angry for nothing. I mean, just being so just livid and so irate that you have no control over anything: your thoughts, your actions, nothing.

ZAHN: And Destiny, when you look back on it, do you think at that point of your downward spiral...

DESTINY: That wasn't me.

ZAHN: Yes. Would you have been capable of killing him?

DESTINY: At the time?

ZAHN: Yes.


ZAHN: And,today, you can make a complete disconnect between where you are emotionally and where you were then?

DESTINY: I hope I'm better than I was then. Sometimes I see a difference, and sometimes I don't. I see, I see me getting upset. I see me screaming at my parents to the point that my parents are scared of my sometimes.

My little brother and sister can be completely terrified of me, because I get just so angry so quickly.

ZAHN: And I understand to help smooth out all of this, you've been given some anti-depressants; you've been given some Valium.

What do doctors tell you about this potential link between Lariam and what you're describing tonight? DESTINY: Most of the time, I know more about it than they do. V.A. all the doctors I've seen so far, they're just I had to bring them their own document. They didn't even know it existed.

ZAHN: Do you feel like.

DESTINY: They're learning.

ZAHN: Sorry, Destiny, there's a little bit of a delay in the signal. Do you think many of them write you off as having cracked up along the way, and not take this seriously?

DESTINY: The military doctors did. Now that I've gotten to V.A. finally, they seem to be, like, looking reading into it. And they listen to me; they think about it. And they read through the documents and my medical records.

And just over the last year of doctors and civilian and military doctors. They think that everything points toward that. But they don't know they don't know enough about it to flat out tell me anything.

ZAHN: Well, Destiny

DESTINY: They can't find anything else.

ZAHN: We know this has been a very tough journey for you and your family. We appreciate you sharing your story with us.

And just a reminder, that what Destiny is describing tonight is pretty similar to some other stories he's heard from family members who have taken this drug while on duty in Iraq or Afghanistan.

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