Skip to comments.Malaria drug links elite soldier suicides
Posted on 09/07/2004 5:20:02 PM PDT by ebersole
By MARK BENJAMIN and DAN OLMSTED WASHINGTON, Sept. 7 (UPI) -- A startling pattern of violence and suicide by America's most elite soldiers has followed their use of a controversial anti-malaria drug, an investigation by United Press International and CNN has found.
The government already warns that the drug, called Lariam, might cause long-term mental problems -- including aggression and suicide.
Six Special Forces soldiers who took their lives are all believed to have taken the drug, according to the UPI-CNN investigation. The cable news network broadcast a segment on the joint investigation Tuesday.
Sen. Dianne Feinstein voiced concern about Lariam and the Special Forces suicides. The California Democrat had previously written key government officials seeking an urgent review of Lariam use.
"I have long been concerned about the use of the drug Lariam for service members and other U.S. government employees deployed abroad," Feinstein told UPI. "Now, there is an indication that Lariam may have contributed to the suicides of some of our nation's elite troops.
"The Department of Defense, and all other government agencies that give this drug to their employees, should immediately reassess their decision to use Lariam and look for alternatives that can protect our troops without causing dangerous side effects."
The Pentagon announced in February that it is investigating whether there is a link between the drug and any soldier suicides. But it defends Lariam, known generically as mefloquine, as both highly effective and safe for soldiers to take. Army medical officials declined requests for an interview but said in a written statement, "We have no data that indicate that Lariam was a factor in any Army suicides in Operation Iraqi Freedom and Operation Enduring Freedom (Afghanistan)."
Instead, the Army said, the deaths were linked to "failed personal relationships, financial crises, legal difficulties and mental problems like depression and psychosis" -- the same factors that trigger suicide in the general public, magnified by ready access to guns.
The psychotic behavior and suicides are particularly jarring because Special Forces soldiers are highly trained and psychologically vetted. An Army study in 2000 showed Special Forces soldiers produce more of a chemical in the brain that helps them cope with and recover from extreme duress.
"It's just antithetical to their whole practice of their craft to suddenly lose control, become depressed, paranoid, hallucinate and become suicidal," said Dr. Paul Ragan, associate professor of psychiatry at Vanderbilt University and a former military psychiatrist. "You have to look for some exogenous factor, some outside factor, something new in the mix that will change how they've otherwise been able to operate."
Those deaths then raise concerns about the tens of thousands of soldiers who have taken Lariam during the war on terrorism -- and about dozens of suicides and a handful of murders among troops while overseas or after returning home.
The pattern also suggests that the Army might have missed the cause of three murder-suicides involving Special Forces soldiers at Fort Bragg, N.C., in the summer of 2002. A report by the Army surgeon general's office blamed marital problems for all the deaths and called Lariam an unlikely factor. But the report did not consider physical or mental problems among the three Special Forces soldiers, described by family and friends, that fit side effects from Lariam.
The UPI/CNN investigation found three more suicides by Special Forces soldiers -- all of them Green Berets believed to have taken Lariam. None appears to have had acute marital problems, combat stress or other personal issues that would help explain their sudden plunge into violence.
- A 43-year-old Special Forces weapons sergeant killed himself in 1997 in Ecuador, where he was helping train Ecuadorian Special Forces. Engaged to be married, he smilingly picked up a gun and shot himself in the head in front of two fellow soldiers.
- A Special Forces sergeant killed himself in July 2003 in the Washington suburb of Alexandria, Va. Happily married and expecting his first child, Tyler Whiffen, 32, went to the woods behind his condominium and shot himself in the head. "He wasn't depressed at all," said Karla Whiffen, his widow and mother of his 6-month-old son. "In fact, I have never known anyone to enjoy life so much. For him to take his life was so out of the blue. Nothing has surfaced that would make this anything but this drug." Whiffen took Lariam in Afghanistan.
- The most recent case involved Special Forces Chief Warrant Officer William Howell, 36, who served in Iraq and killed himself after returning to Fort Carson, Colo. His wife, Laura, also reported no marital problems. He killed himself in March after stalking her around their yard with a gun and pointing it in her face. He shot himself when police arrived.
"I knew my husband, I knew who he was. I know what he was," said Laura Howell. "The only difference was one pill. A little white pill that he took. There was nothing else in his life that was different, in his job, nothing. And there was no accumulative effect of anything in his life that would lead to suicide."
The suicides since Sept. 11, 2001, identified by the UPI-CNN investigation are the only Special Forces suicides during that period, according to the Army. It could provide no data on Special Forces suicides before then or on the number of Special Forces soldiers who have taken the drug.
Lariam has physical and mental side effects. A cluster of physical symptoms also appeared in the pattern of Special Forces soldiers who committed suicide, matching those noted by the Food and Drug Administration, including diarrhea, rash, headaches, trembling and night sweats.
For example, after taking Lariam in Iraq, Bill Howell specifically complained of ringing in the ears, panic attacks, headaches, diarrhea, vomiting, skin rash and tingling and numbness in his hands and feet. All are listed under adverse reactions on Lariam's official product label.
The Department of Veterans Affairs recently alerted every doctor in the VA healthcare system to be on the lookout for soldiers suffering mental or physical problems from taking Lariam, even if the service members had not taken the drug for a long time.
This summer, a Navy doctor at a Pentagon treatment facility in San Diego has begun to diagnose service members with permanent brain-stem damage and fingered Lariam as the apparent culprit. One Special Forces soldier diagnosed with that permanent damage said Lariam has given him homicidal and suicidal urges.
"I can tell you from my own personal experience that it goes from zero to 100 very quickly," said this active-duty soldier, who asked not to be identified for fear of retribution. "You're ready to take that plunge into hurting someone or hurting and killing yourself, and it comes on unbelievably quickly. It's just a sudden thought it's the right thing to do. You'll get a mental picture, and it's in full color."
He said that after taking the drug he attacked his wife and considered suicide for the first time.
The 1997 apparent suicide of a Special Forces soldier uncovered in the UPI-CNN investigation involved a Green Beret weapons sergeant who was in a room with two other soldiers at a base near Quito, Ecuador.
"He had picked up the team sergeant's weapon. He looked at the team sergeant and asked if it was loaded. Then he looked at my other friend, smiled, and pulled the trigger," said Justin Schuman, a former Army staff sergeant who retired in June. Schuman was not in the room during the shooting but was present when the medical helicopter arrived. He said the two soldiers who were in the room at the time immediately described what happened.
"We were at a loss. We really had no idea what possessed him to do that," Schuman said. "We knew there were some stressors in his life. He was about to get remarried, but there was nothing in particular. Nobody mentioned Lariam."
Schuman said he and the two soldiers who were present decided to portray the incident as an accident.
"We told Army investigators that it was an accidental discharge because (we feared) they would have denied his family all his benefits. Because he never said anything about suicide, we just played it off as if he was playing suicide."
But it could not have been an accident, he said. "There really is no more trained person in the world than a trained (Special Forces) weapons sergeant. I can't tell you that it was the Lariam, but he was on Lariam at the time and he committed suicide right in front of us in a very bizarre way."
Last year, the FDA ordered that all patients given Lariam be told in writing about rare reports of suicide, along with psychiatric side effects that have been reported to last "long after" someone stops taking it. The FDA says it does not know if Lariam caused any of the reported suicides.
While malaria can be deadly, there are other drugs that prevent it. A recent study showed that 29 percent of people taking Lariam had some kind of mental problem -- twice the rate of a similar malaria drug.
The violent behavior that accompanied all but one of the Special Forces suicides raises troubling issues because experts say that a drug that could trigger homicide should not be prescribed to anyone. Karla Whiffen said her husband shoved her on two separate occasions -- once knocking her to the ground -- after returning from Afghanistan, something he had never done before.
Laura Howell said her husband punched her "four or five times in the head" before he went to get the gun he ultimately used to kill himself. He had struck her once before, when he was taking steroids to bulk up. "He was very sensitive to chemicals. Anything that had a side effect to it, he would get it," she said.
At Fort Bragg, none of the three Special Forces soldiers involved in the murder-suicides in 2002 had any known history of domestic violence, according to family, friends and police. Experts said it is rare for a domestic homicide not to be preceded by an escalating pattern of violent abuse.
Lariam's manufacturer, Swiss pharmaceutical giant Hoffmann-La Roche, said in a statement by spokesman Terence Hurley that there is "no credible scientific evidence" linking Lariam to suicide, suicidal thinking or violent criminal conduct. The rate of serious mental and neurological side effects is "very low," he said, adding that "data from well-designed studies show Lariam to be safe and well-tolerated."
Hurley added: "The label has advised for many years that Lariam should be used with caution in patients with psychiatric disturbances and has disclosed, clearly, that depression and other neuropsychiatric events have been reported among patients who have used Lariam."
He also noted the Army developed the drug and said, "The Army has its own extensive knowledge base and experience with Lariam. As with all decisions regarding prescription medications, the decision about whether Lariam is appropriate for any individual patient -- whether soldier or civilian -- is a matter for the independent medical judgment of the prescribing physician."
Based on a three-month investigation, UPI reported in May 2002 that mounting evidence suggests Lariam has caused such severe mental problems that in a number of cases it has led to suicide
I remember when this was controversial what? two/three years ago.
They didn't listen then, and if I remember correctly, at least one man took a courts-martial rather than the shot. Some even took an early out or retirement.
Same thing only different.
Shoulda just sprayed the areas with DDT first and then sent in troops. Wouldn't need the anti-malaria drugs then.
But I guess junk science is more important the human lives.
Took the stuff for a year... ruins the mind..... takes a full 2 years to get it back.
I am not sure there is a link...
When my husband fought in the 1973 Yom Kippur war, he was sent on the other side of the Suez canal into Egypt and had to take Lariam for 6 weeks...
When I consulted in Equatorial Africa I took it for a few weeks...
No effect either...
Psychotic behavior? Chris Mathews???
Also, Mefloquine has also been used throughout the conventional military extensively, every time they are in a malarial zone, which in this war means since the first deployment to Afghanistan. And SF, active and Guard, have been taking it for years -- malaria is endemic in the third world hell holes we go to, and trust me on this, malaria would wrack up a lot more guys and kill a lot more guys than Lariam could, even if it was a hundred times as bad as this writer suggests.
Now, on the other hand, we had a guy in our unit (then A Co. 1/11th SF, USAR) leave the unit and some years later he killed himself. However, when he was in the unit its area of interest was Arctic Europe -- Norway and the northern USSR. SO Malaria was not a concern and no one ever took Lariam in those days. In his case, he wound up losing his job with the State Police because he ran afoul of Massachusetts's politically connected Bulger crime family. He got depressed and wouldn't welcome his old friends again. Finally, one day, he ended it -- a sad business and those criminals Whitey and Billy Bulger are to blame more than Bill is for his death.
But my point is, yes, even elite SF guys do occasionally suffer sufficient life reverses that they kill themselves. Guys even did it in Vietnam. A guy I know did it in Lebanon. And yes, we reported them as accidental deaths because the Army would screw their families out of insurance and benefits.
I wonder if this post is a preemptive strike on Special Forces men by the mainstream media, because SF veterans have been in the forefront of many of the most damaging attacks on Kerry. Either that, or they want to harm SF because it is effectively prosecuting the war on terrorism.
Criminal Number 18F
Er, make that a guy I knew. Among all the typos in my post, that one is painfully glaring.
Criminal Number 18F
Pfizer and Merk say so.
And they will sue anybody who says different, and ruin any physician who says different.
None of us had any ill effect, to my knowledge.
So what's the problem with Chloroquin?
None of the 9 SF soldiers had significant life reverses unless coming home is considered life reverses.
Thanks. I have been on that stuff many times, mostly in Central America and Asia but never connected to the military. I trust those in charge to know their business.
Doesn't work against the new strains of Malaria...
This is why you need mefloquin...
18F I can guarantee you with a 100% that no one in this story is targeting SF, and the writer is about as apolitical as a reporter can get. In fact, he has worked extensively with the Gulf Veterans Center to make sure information is brought forward to the military so that those soldiers (however few they may be) receive the appropriate disability benefits. Those of use who have been around SF for a very long time know how your bodies break down at a fast rate and how notoriously the military does not acknowledge the damage. I agree that there are a significant number of soldiers who have no problems with the drug, and that malaria is a disease no one wants. However, I would hope that SF command would not follow the regular military down a blind path. Iraq and Afghanistan are not resistent areas for chloroquine, there were only a few cases of malaria in these regions according to the CDC. The CDC does not recommend Lariam for any region of the world(resistent or not). There are safer alternatives that are just as effective in preventing malaria. Since I know the SF soldier to be quite intelligent, my hope is that questions are asked and answered by the command.
Wife of former 18a and CW2
"...are all believed to have taken the drug..."
UPIs solid research and reporting is C-R-A-P!!!!!!
Get the damned facts before you write it, asswipes!
Dammit, dammit, dammit!
I took Larium for four months in Somalia. It gave me red spots, some vivid dreams but no long lasting effects. That was in 93.
Compaired to Malaria, I'm sure I got the better deal.
The only folks I want to see die these days is terrorists.
Which soldier(s) specifically mentioned in the article did not take Lariam?
I'm glad that largest side effect was the dreams. There can also be subtle signs of lariam toxicity such as indigestion, skin rash, tingling in the hands and feet, ringing in the ears, diarrhea and joint pain. Thank you to your sons and their sacrifices. Cheers
Stay safe !
Grasping corpo-rats are as vile as any vermin in the world. I hope the coverup on this fails and the human filth involved gets successfully prosecuted. Using warriors as guinea pigs. Despicable.
However, many substances have a specific side effect only a small segment of the population -- like peanut allergies. Could be that's the case with Lariam, especially since it is well known to have mental/neurological effects. Another possibility is that the combination of Lariam with something else that is now being given to these servicepeople triggers the effect in a certain subset of them -- new vaccines, a certain type of amphetamine prescribed to keep Special Forces guys going through long rigorous missions, or something else along those lines.
Those boys were already diagnosed as mentally disturbed before they started taking the drugs -- that's why they were taking them. Big difference from these Special Forces guys who are put through some of the most rigorous psychological screening on earth before getting into those units.
The military alternative to mefloquine is doxycycline, which has its own can of worms, most seriously that it is given daily vice weekly.
It is interesting that aviators must take doxy; even before this controversy they would be grounded for taking Lariam. The docs considered putting those of us who must retain FAA medicals on doxy, and decided after consulting FAA aeromedical that it would not have an impact on our physicals, as long as we were off the stuff before resuming flying. (My advice to anyone is do not tell your AME you have been on it).
If the guy is not targeting SF then why doesn't he acknowledge that a million Joes and Janes have been on mefloquine for months and years, and apart from the known side effects (particularly the nightmares), most have no problem, and suicide rates are in the normal range?
As far as Vet Centers are concerned... I dunno what yours is like there, but around here they are wall to wall wannabees and phonies, encouraged by lefty shrinks full of Lifton's tendentious drivel. There's one a few miles from my house -- it treats a bunch of bums with war stories they got from the TV in a homeless shelter somewhere. I wouldn't **** on it if it was on fire!
Anyway, the basic reason that the troops on the ground take Lariam is that it is easy to administer. My personal observation in Afghanistan was that in the low country, malaria was widespread among the locals and a common cause of child mortality. Of course they had everything else too: worms, meningitis, TB, bizarre suppurating abscesses; you name it. Other teams encountered cholera and typhus, presumably vectored by returning refugees; we did not. But I would place no stock in CDC statistics from Afghanistan, which has not had any kind of functioning public health system for 25 years, or Iraq, which was isolated for ten.
It's my impression that chloroquine-resistant malaria is becoming the dominant strain. It's not isolated in black Africa any more. (For instance, Indonesia has had cases on Java).
Criminal Number 18F
The Wonderlic is an IQ test, full stop: it weeds out the dummies, nothing more. (It is a backup for the GT score (IQ) minumum standard). The MMPI is a personality test that produces several scales indicating where in a range of several personality traits a person finds himself. It is uncannily valid, and can catch people trying to fake the test. So it weeds out some of the quitters, glory seekers and personality disorders (pity they didn't have it when 'Jack' Idema joined up). The TABE just tests basic knowledge: it weeds out the ignorant, the very poorly educated, and those that have learning problems.
When I joined up they didn't have all these tests; instead you had to get a "crazy statement" from the crazy doctor that you were not a nutball. (This is still required for certain types of advanced training today, about which the less said the better). My "crazy doctor" was an AF Pshrink who was absolutely appalled to find himself in the presence of someone who would want to go, in his words, "running off killing snakes and eating people." When I explained that it was eating snakes and killing people, he reluctantly signed the statement for me.
Now, today's regime is certainly more comprehensive than that, and it's more than what other parts of the military do to people who are, mostly, already in the service with good records; but it's far from infallible.
Plus, any psychological test or review is a snapshot of a moment in time. I think most of us can, from our own experience as friends, supervisors, etc., attest to the power of (for instance) a love affair, especially in the throes of starting or ending, to screw up even an orderly and disciplined life.
Right now, malaria prophylaxis is saving American lives. (All the main theaters of the GWOT are in malaria season this very minute). That doesn't mean we can't learn from study, but I want to remind everybody that the decision when the best scientific evidence is in may well be, to take the hits we take from mefloquine psychosis (the literature online says 1 in 15,000 or 20,000 users, which is a VERY high level of such a serious side effect), rather than risk the hits that malaria will give us.
Criminal Number 18F
One of them, whom I won't name here, found somebody's Size 14 Air Jordans under his marriage bed -- figuratively speaking. Normally an SF guy can dissociate in a situation like that and reason it out to the point that he knows he's going to be laughing with his buddies about it in a year. But not everyone can, all the time.
Criminal Number 18F
I guess I ought to read up more on malaria and its severity. I had it twice before age 5 (living in Rwanda) and don't seem to have suffered any ill effects, so I don't think of it as a big killer -- though I hear it is, at least among the native populations of 3rd World countries who don't have access to high quality medical care.
The weird thing is how the suicides and homicides seem to be heavily concentrated among Special Forces, when 1) lots of other servicepeople are taking this drug (along with other drugs, vaccines, etc.) and 2) they are psychologically screened to a higher level than most other military units. Sure they've got more stressful missions, but that's always been the case, and I don't recall hearing about rashes of suicides or homicides among them in the past.
Was the guy in Lebanon an officer who accidentally shot himself "while cleaning his .45?"
Nope...that was a soldier out of Bragg during the summer of 2002 who accidentally killed himself.
Brandon or Bill?
About 200 million people will sicken with malaria in 2004 and about 2 million of them will die. Most of these victims are young people and children in Africa, but there are a few Americans on the list every year.
Criminal Number 18F
I'm dating myself, back to 83.
Junior NCO, and it was Browning HP. Nobody had any idea why. What a tragedy, he wasn't even 25, I think.
Criminal Number 18F
"If the guy is not targeting SF then why doesn't he acknowledge that a million Joes and Janes have been on mefloquine for months and years"
Mark has acknowledged this in many of his previous pieces on the military and Lariam. He also acknowledged this on the CNN segment. If you watched the segment, Paula Zahn wanted to go down the "cover-up" path, but he did not give her what she was looking for. The current suicide rate in Iraq is currently at its lowest point ever and whether or not that is due to the stoppage of mefloquin or implementation of a mental health program, who knows at this point. I'm just damn glad the rate has dropped.
"As far as Vet Centers are concerned"
I should've been more clear in the terminology. The Gulf War Resource Center headed by Steve Robinson has done a significant amount of work on behalf of the veterans in getting many "unexplained" illnesses and the associated problems in front of Congress in order to receive benefits for the soldiers and their families. Lariam toxicity is the latest illness to be recognized by the VA and has awarded the first claim (80%) several weeks ago. This is no small feat considering how long it took the Army to acknowledge the problems associated with the first Gulf War as well as with Vietnam.
Unfortunately, I only know information moving forward from 97...
They don't give a rip if it causes instant death, they will cover up, defend, obfuscate, or whatever it takes to keep from having to answer for the deleterious effects of their drigs.
drigs = drugs. (sheeesh!)
The guy with the marital problems was not either of the ones you mention (or should I say all three? As there are two Bills) but actually came home early to try to straighten out the marital difficulties. He took the wrong approach. Although I believe that one of the names you listed also maps to long-time marital stress.
Now, there is another case that gets tossed in with these and definitely shouldn't be. There was a 10th Group soldier that capped himself after returning from Iraq -- shortly after being arrested for trying to set up a tryst with a 13 year old. In that case, suicide was probably the best thing for that sick soul. That man was not either of the ones you have named (and I don't believe he was an SF soldier, rather a support guy... who are no better than the average run of support guys and occasionally you get a bummer. In 10th in 1979 we had two guys murder one of 'em's wife and we had "Green Beret Killer" headlines for three years... they were a cook and a truck driver, IIRC).
If you really want to know who had an Air Jordans problem, freepmail me. This stuff is tragic enough without washing it out in public.
And finally: to anyone who reads this --- if it's that bad, divorce her (or him!). You'll be able to laugh about it soon enough. Suicide is pleasing only to Allah, I mean Satan (I'm always getting those two confused. Must be the mefloquine!)
Criminal Number 18F
Whoa, that's pretty whacked.
What were the effects, if you don't mind my asking? It sounds like Malaria is preferable...
Paranoia without realizing you are paranoid... and you can sense the moods and vibes within a city due to the hypersensitivity (without realizing it)... it is like feeling by the tips of your hair.... also freaky dreams
"I have to say, I have my doubts about this. Thousands of us took Mefloquine (Lariam), once a week, for months on end, and while there were some side effects -- most of the guys had extremely vivid nightmares -- "
Vivid nightmares are an indication that a drug IS having an effect on the brain, mild though it may be. From what I understand, those guys who had the severe reactions to Larium subsequently had tests that showed brain stem damage. Specifically, they had SPECT scans and, I believe, evoked nystagmus tests. You only flunk both those tests if you have something bad going on in your brain. You certainly don't exhibit nystagmus, especially persistent upbeating nystagmus, or have an abnormal SPECT from garden variety psychological issues. It's organic in nature. And the psych problems are secondary to the organic problem, not the other way around. Also, there's no way to predict who'll get those particular side effects from Larium. In other words, the guys who are a little 'off' aren't necessarily the ones who'll have problems. It seems to be completely random. I'm sure Larium helps zillions more than it hurts, but woe to the one in a thousand. I, for one, am glad that the potential side effects are getting publicized, however rare they may be. Forewarned is forearmed.
It was the "are all believed..." part that I have a problem with.
All of the specific soldiers mentioned in the article were confirmed to have taken Lariam. I don't believe he meant all of the US soldiers in theatre in Iraq and Afghanistan, but then again if he did mean all soldiers in the middle east, then he is wrong.
Most boys are diagnosed by the public schools as something or other these days - that way they can drug 'em and forget 'em.