Battleland

A Smoking Pillbox: Evidence that Sgt. Bales May Have Been on Lariam

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Army photo / Spc. Ryan Hallock

Staff Sergeant Robert Bales

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 mefloquineireland@gmail.com), 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).

The report is a summary — not the original report — so important details, beyond those redacted, may be missing. It also does not name Bales. But it’s unlikely there was another Soldier with a traumatic brain injury in this time frame connected to 17 homicides (that was the original number; further investigation concluded 16 people had died).

The absence of basic demographic information and other medical information is also noteworthy. It suggests that the person doing the reporting is less well-informed on such an apparently significant case than they should be. But many adverse event reports are incomplete. While this report could represent a spontaneous report from someone without first-hand knowledge of Bales’ case, it is reported by Roche as “medically confirmed” — suggesting an authoritative source. It is also possible that this was an initial report, that was later found not to be true.

Bales’ attorney, John Henry Browne, did not return calls seeking comment on the document. On June 5, the 39-year-old married father of two pled guilty, removing the possibility that he will be executed for the crimes. The plea also avoided a full-fledged trial in connection with the case, which remains murky. Bales, who was on his fourth deployment in 10 years, is slated to be sentenced in August to life imprisonment, possibly with a chance for parole.

A year ago, Nevin testified before Congress on mefloquine’s toxic effects that may mimic PTSD and TBI, as well as contributing to suicide and violence. The Senate Appropriations Committee’s subcommittee on defense considered markup language proposed by Senator Dianne Feinstein, D-Calif., to basically bar Lariam’s use by the U.S. military, and to sponsor additional research into its neurotoxicity. But the provision didn’t make it into law.

Earlier this year, the Defense Department quietly reinforced its standing policy making mefloquine the drug of last resort. However it remains available in the military’s pharmacies to be mis-prescribed to soldiers with TBI and other mental-health conditions, with potentially devastating consequences.

This new report should compel the Pentagon to clear the air on whether Bales was on mefloquine when he killed 16 Afghans, and – if so – to what degree mefloquine may have been the real trigger.

12 comments
PhilRichman
PhilRichman

Where is the transparency?  What are the best treatments for those impacted with long term patterns of psychosis?

JeanneLese
JeanneLese

I only hope the FDA  reads this. And responds with ACTION.

Jeanne Lese, Director, Mefloquine (Lariam) Action

jprietsch
jprietsch

Hopefully, Staff Sgt. Bales' family will retain counsel to obtain his medical records and interview others in his platoon to see if he and they had been given Lariam by the unit corpsman. One pill alone is enough to instill uncontrollable rage in those who take it. To this day, when one asks the medical researchers at the Walter Reed Army Research Institute who created Lariam (generic: mefloquine) what it does inside the human brain, their response is: "we have no idea." Those of us who have unwittingly been prescribed this poison know all too well that taking it has resulted in traumatic brain injuries that are permanent.

NateTyler
NateTyler

When I had seen this on the news, my only reaction was that he had to be on Lariam. I even emailed his attorney about this. It's too bad it was never brought up in his court case. An experimental drug administered to way too many troops. It's ironic that the US Govt put a stop to the use of Lariam, not long after this had happened.

dfatula
dfatula

Excellent resource to add to the gamut of information that supports the same pattern of damage caused by this drug. How many more lives need to be lost to help agencies exercise their role of responsibility and safety of all drugs for all people? I hope this resource in conjunction with all the other work and information Dr. Nevin has done is the catalyst that initiates true change. Put this story together with Ft. Bragg and you have a sunami of sources to tell this story. It takes a village to safe a village. Thank you again for your work. -Doreen Fatula

TamarahCohen
TamarahCohen

My little brother was an International Committee of the Red Cross delegate who was prescribed Lariam while on duty in Chad, then Congo, in 2009. In 2010 he was “med evac”-ed to the US, and left there with no guidance for months. No one at ICRC stepped in when he was undergoing tests for an array of mysterious symptoms that included crippling anxiety, memory loss and suicidal behavior — all of which were new to my brother. No one mentioned Lariam or its neuro-psych side effects. My brother killed himself in February, 2010.

bobcat
bobcat

Dr. Ritchie and Dr. Nevin,

From all the civilian and military victims of Lariam(mefloqiune), thank you for keeping this issue at the forefront. Your credentials and expertise add significant credibility to our side of this debate.

Hopefully this latest revelation will motivate DoD to set the record straight.

DavidHaines
DavidHaines

Hmmmm makes you wonder what funny business went on with that Fort Bragg study.

MefloquineIreland
MefloquineIreland

Yet more questions to be asked about Lariam/mefloquine and avoidable deaths.  Well done Dr Ritchie!  The RTE (Irish TV) investigative report referred to uncovered an increased risk of suicide (3-5 times) in those soldiers deployed on Lariam.  I would encourage everyone to click on the link and watch what is an excellent in-depth analysis of meloquine and suicide.

Of course suicide and homicide are only the tip of the iceberg.  Let us not forget the many thousands of Lariam/mefloquine victims left with persistent symptoms years after being prescribed the drug.  Too many lives have been ruined already.  Surely the time has come for governments around the world to provide adequate funding to properly study the severe neurotoxic effects of this drug?

luriajoseph
luriajoseph

Really important information;  good scoop, Cam. Doesn't rule out contributions from multiple deployments, PTS, or TBI, but all together ... a toxic brew waiting to be ignited by mefloquine.

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