Thursday, June 20, 2013

A Smoking Pillbox: Evidence that Sgt. Bales May Have Been on Lariam By Elspeth Cameron Ritchie

New evidence has surfaced that Army Staff Sergeant Robert Bales may have been on mefloquine during his March, 2012, rampage that killed 16 Afghan civilians.
I first wondered if Bales had been on the anti-malarial agent, also known by its trade name, Lariam, on March 20, 2012, a week after the massacre. I noted that “this medication has been increasingly associated with neuropsychiatric side effects, including depression, psychosis, and suicidal ideation.” A number of other media outlets picked up the story.
But that was just a working hypothesis, absent evidence on Bales’ use of the drug. Strangely, the government never confirmed — or denied — that he had been given Lariam.
My colleague and co-author of a paper on the subject of mefloquine and forensic psychiatry, Dr. Remington Nevin, recently obtained a so-called “adverse event report.” That’s a document describing a negative side-effect to a medication. This particular document details a “medically confirmed” event of homicide by a Soldier taking mefloquine.
Nevin got the report from Action Lariam for Irish Soldiers (reach them at, for the Irish network RTÉ. The broadcaster prepared a report on the possible links between Lariam and suicides among Irish peace-keeping soldiers.
We have been unable to determine who wrote the initial report, but generally they’re turned in by physicians or others involved in the case. The document suggests that on March 29, 2012, Roche, Lariam’s maker, received a report that someone involved in the homicide of 17 civilians had been taking mefloquine.
On April 11, Roche forwarded the document on to the FDA, as it is required to do.
Here is the key passage from the much longer document, which has the relevant parts highlighted:
Homicide [REDACTED] A patient of unknown demographics started on mefloquine (therapy details unspecified) for an unknown indication. After an unspecified duration, the patient who was a soldier experienced homicidal behaviour which led to homicidal killing of 17 [REDACTED]. It was reported that the patient was suffering from traumatic brain injury (TBI) and was administered mefloquine against military rule (mefloquine is directly contraindicated in patients with TBI as per [REDACTED] rule).

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