Army's Top Doc Says Lariam Not Related to OIF Suicides

Army Surgeon General Lt. Gen. James B. Peake testifies to Congress. On the left is Sergeant Major of the Army Kenneth Preston.

Story and photo by Sgt. 1st Class Marcia Triggs
Army News Service

The Army surgeon general told Congress that there is no correlation between the anti-malaria drug Lariam and a recent spike in suicides in combat zones.

There have been 24 confirmed suicides in the Iraq theater, but only four of the Soldiers were in units that were taking Lariam, and only one had traces of the drug in his system, Lt. Gen. James B. Peake told members of the House Armed Services Total Force Subcommittee Feb. 25.

"We do know the documented side effects of this medicine, but the key causes of the suicides were failed intimate relationships, legal and financial problems," Peake said. "The same kind of issues that you see back home related to suicides seem to be the predominant triggers in theater as well."

A 12-person mental health advisory team went to Kuwait and Iraq from August to October to assess mental health issues and behavioral health care for Soldiers serving in Operation Iraqi Freedom after an annual rate of 17.3 suicides per 100,000 Soldiers per year was reported.

This is an increase from the 9.1 to 14.8 annual Army-wide rates between 1995 and 2002.

Suicide, depression and paranoia are some of the reported side effects of Lariam. But Peake said that if a Soldier has a history of depression, then an alternate anti-malaria drug is given.

Chloroquine is a daily anti-malaria drug, but the weekly dose of Lariam is preferred, Peake added.

This summer chloroquine may be given to Soldiers in Iraq, or there may not be a need for any anti-malarial medicine in Iraq, said officials from the surgeon general's office. The Central Command surgeon will make the decision after mosquitoes are tested for malaria, officials said.

Two task forces are studying the perception troops have of Lariam and to see if it causes adverse outcomes, Dr. William Winkenwerder, assistant secretary of defense for health affairs, said during testimony.

The scientific study may take several months to two years to complete, Winkenwerder said. The study on perception is ongoing to see how service members feel about the drug, and how they came to their conclusions, he added.

Cpl. Victor Thibeault, from the 10th Mountain Division, said he stopped taking Lariam because he started having nightmares and it made him physically ill.

He testified that everyone he knew who was taking the drug also had similar complaints.

The Food and Drug Administration has approved Lariam, and it is used to protect Soldiers from a deadly form of malaria, Peake said. There have been Soldiers and Marines who have died from malaria, Peake added.

Winkenwerder said Thibeault's feelings toward the drug worry him, and he's hoping that the ongoing studies can dispel myths about Lariam and give Soldiers confidence in the drug.

The 12-member advisory team that went to Iraq to study the behavioral health of Soldiers places more emphasis on adapting current garrison-based Army suicide prevention initiatives in the deployed regions.

"We're seeking to elevate suicide awareness beyond the medical field," said Winkenwerder. "We want everyone to know about the impact of stress and anxiety and how it can lead to depression and suicide."

Source: Mercury, an Army Medical Department publication, April 2004 - Army's Top Doc Says Lariam Not Related to OIF Suicides