British armed forces set to ban most prescriptions of controversial anti-malarial drug Lariam

A long awaited parliamentary report into Britain’s armed forces being given a highly controversial anti-malarial medication, Lariam, is due to recommend that it is banned except in very restricted cases, according to campaigners against the use of the drug and senior Whitehall sources.

Campaigners had hoped for a complete end to the prescribing of the drug. Nevertheless, the findings of the Defence Select Committee, out on Tuesday, are seen as likely to be enough for hundreds of legal cases being taken against the Ministry of Defence by service men and women who say they have suffered terribly from taking Lariam.

A number of senior officers say that recognition of the dangerous side-effects that the use of Lariam is long overdue. General Lord Richards, the former head of the British military, told The Independent that measures should be taken to implement the recommendations in the report, due out on Tuesday, without delay.

It is understood that as Chief of Defence Staff, General Richards had raised the issue of concern over the drug within the Ministry of Defence. He said today “If the use of Lariam is banned, or even restricted, it would not be before time. There has been worry for a very long time over the use of Lariam, I know personally from when we were serving in Sierra Leone in 2000. We know people who have been affected by this drug. I certainly hope that appropriate steps are taken as soon as possible.”

Lady Caroline Richards, the General’s wife, had also taken a keen interest in matter for a long time. She added “Wives and partners of people who had been affected by the use of Lariam approached me and described what had happened. There were some terrible, sad stories of trauma, of relationships ending, psychological problems. We heard about other forces which have stopped using Lariam, so this is obviously something which needed looking into.”

Gen Richards led British troops in Sierra Leone when the civilian population of the country was under attack from armed militias. He was also the head of international forces in Afghanistan. British troops serving in both countries were prescribed Lariam by the MoD.

Lariam is the brand name of the medication Mefloquine which was developed by the US Army in the 1970s. In 2012 it was alleged, but not proven, that a US soldier, Staff Sergeant Robert Bales who massacred 16 villagers in southern Afghanistan, was on Lariam. In 2013 the US Food and Drug Administration added a warning to the packages of the drug regarding potential neuropsychiatric side effects which may persist even after its use is ended. The same year US special forces stopped prescribing Lariam to its members.

The British military no longer gives Lariam to its divers or pilots, but continues to do so with soldiers. The law firm, Hilary Meredith Solicitors, say they have already been contacted by 470 former military personnel prescribed Lariam who have suffered from a range of side effects including hallucinations, severe depression, sleep deprivation and anxiety. Another firm, Irwin Mitchell, say they have received more than 30 approaches from people affected by taking the medication.

The Legal firms representing the former personnel hold that prospect of successful litigation will be strengthened as the Defence Committee report shows that the MoD had failed to find the correct balance between providing protection against malaria and the side effects of Lariam.

Philippa Tuckman, a partner at Hilary Meredith Solicitors, said because of the risks associated with Lariam “the Medicines and Healthcare Regulatory Authority (MHRA) as long ago as 1996 took the extremely rare step of saying that any doctor who is going to prescribe Lariam needs to make sure not only that the patient is completely aware of the possibility of psychiatric and other problems, but also that they know they must get to a doctor, before the next dose, if they experience any of these problems.

“Above all, the MHRA made it crystal clear that absolutely no one with any history whatever of neuropsychiatric disorders - and that would include problems that are common in the military, such as PTSD and anger management or alcohol issues - should be given the drug. It is negligent to administer Lariam without following the MHRA’s guidance. I have personally heard so many service personnel tell me that they were not asked about their history, that they were not told about the potentially catastrophic side effects of the drug.”

Lieutenant Colonel Andrew Marriott, of the Royal Regiment of Fusiliers, was prescribed Lariam before going to Sierra Leone to train the country’s troops in 2003. He was told that there may be side effects, but that these would be temporary. Instead he has suffered severe long-term problems. “The MoD has accepted my condition was caused by Lariam”, said Lt Col Marriott. “I have not had one night’s undisturbed sleep since 2002. I have nightmares which I do not want to tell anyone about.”

Lt Col Marriott, who left the Army in 2008, said: “This problem has been known about for a very long time. It is quite disgraceful that it has taken so long for something to be done. There needs to be a detailed examination of some of the officials on this matter.

“We are told that Lariam only adversely affects a small number of people. But why on earth would anyone want to risk that with people using weapons in a hostile situation? I have been in the Army for 30 years and served all over the world. Hasty decisions are sometimes made in the heat of battle which are mistakes and which are then rectified. But the decisions on Lariam were made by people sitting in relative safety back home; and they refuse to rectify their mistakes.”

An MOD spokesperson said: “All anti-malarial treatments have associated side effects but we must protect our personnel from this potentially fatal disease. We need to be able to use the most appropriate drug to ensure resistance and base our advice on Public Health England guidelines. While Mefloquine [Lariam} is used throughout the world, it’s not prescribed widely in the UK military, and only after an individual risk assessment.”