The lariam legacy.

As well as all the usual means to prevent malaria, Mefloquine, trade name Lariam, is an anti-malarial which only needs to be taken once a week. However, it has significant psychotropic and sometimes psychiatric side-effects including hallucinations, bad dreams and depression. Most tourists will have a choice of anti-malarial medicine as there is a well-tolerated alternative with one downside that it has to be taken daily. However, in the Armed Forces the decision over which medicine to prescribe is taken by higher powers. Armed Forces in other countries have phased out Lariam's usage. Andrew Marriott, a retired army officer, in 2003 took lariam when he was based in Sierra Leone. He experienced a range of unpleasant side-effects. Johnny Asbit performed the same job as Marriott and reported the same problems he as well as his men experienced. Dr Remington Nevin from the US has been instrumental in advising the US Army to stop using lariam in some situations. Dr Ashley Croft, an expert in tropical medicine, is frustrated that the risks are not being taken seriously. There are psychological disincentives to reporting the side-effects of lariam. Unfortunately, there are cases of suicide and enduring problems of nightmare-orders. MHRA collates the yellow cards which indicate side-effects of drugs; Mike Foy explains how the scheme works. There is a fear that there has been significant - and possibly deliberate - under-reporting of side-effects. A spate of military murders have been linked with Lariam.