Mefloquine (Lariam) is an antimalarial drug commonly used by the British Armed Forces to prevent and treat malaria. It has been in use since its approval in the United States in 1985 and is recognized by its brand name, Lariam.

From the beginning, this drug has been a subject of controversy, especially within military circles. Some individuals have reported significant side effects, including psychiatric issues and brain damage. There have also been concerns about its efficacy in treating malaria.

In recent years, the use of mefloquine has faced scrutiny, particularly in the British Armed Forces. Similar to the US Army and Marine Corps, the British military has ceased using the drug due to concerns regarding its safety and effectiveness.

This blog will delve into the controversies and challenges surrounding mefloquine, with a specific focus on its utilization within the British Armed Forces.

Understanding Mefloquine

Mefloquine is an oral medication prescribed to prevent and treat malaria, a mosquito-borne infectious disease. It is commonly administered to individuals traveling to areas where malaria is prevalent.

As an antimalarial drug, mefloquine is effective against the most common forms of malaria, specifically Plasmodium falciparum and Plasmodium vivax. It works by impeding the growth and development of malarial parasites within the human body.

Typically taken once a week, mefloquine is initiated one to two weeks prior to entering a malarial area and continued for four weeks after returning. It is advisable to consume the medication with food or milk, as it may cause nausea and dizziness in some individuals.

Mefloquine Side Effects

Mefloquine carries the potential for serious side effects, including neuropsychiatric reactions, itching, rashes, and vision problems. It is crucial to be aware of the associated risks and discuss any concerns with a medical professional before commencing its usage.

Mefloquine’s Application in the British Armed Forces

Historically, mefloquine has been employed by the US Army, Navy, Marines, and Air Force, as well as the British Armed Forces, for specific personnel traveling to malaria-endemic areas. It is typically used as the primary antimalarial option when other medications are contraindicated or unavailable. Its prescription within the armed forces aims to safeguard individuals from contracting malaria and its associated complications.

Within the British military, mefloquine is predominantly prescribed to personnel deployed overseas to regions where malaria is prevalent. While it remains available for individual cases, the preference of the British Armed Forces is to utilize alternative antimalarial medications. Consequently, the British Army no longer prescribes mefloquine to its personnel.

As with any medication, there are potential risks associated with mefloquine’s use. Therefore, it is imperative for armed forces personnel to be fully informed about these risks and engage in discussions with medical professionals to address any concerns.

Controversies and Challenges Related to Mefloquine

The use of mefloquine in the British Armed Forces has given rise to two interlinked controversies: concerns about the drug’s safety and its use for treating PTSD-like symptoms in military personnel.

Safety concerns surrounding mefloquine stem from studies indicating its potential to cause severe side effects, which may lead to long-term neurological damage. These side effects have been associated with psychiatric episodes, memory problems, and instances of suicide. Reports have also highlighted the presence of permanent movement disorders and increased risk of death among Hispanic and white users of mefloquine.

The second controversy revolves around the use of mefloquine as a treatment for PTSD-like symptoms in military personnel. Medical professionals have expressed reservations, citing concerns that the drug’s side effects may outweigh the benefits in treating these symptoms.

Presently, the British Ministry of Defence is reassessing the use of mefloquine in the military.