![Major Stuart McCarthy is calling for a public inquiry into the ADF's use of antimalarial drug mefloquine. Photo: Brendon Thorne Major Stuart McCarthy is calling for a public inquiry into the ADF's use of antimalarial drug mefloquine. Photo: Brendon Thorne](/images/transform/v1/crop/frm/silverstone-feed-data/506753a5-c516-4ca4-a39e-c39d3c1e60ec.jpg/r0_0_729_409_w1200_h678_fmax.jpg)
Australian soldiers and veterans are calling for an immediate inquiry into the use of an antimalarial drug they believe scarred them with permanent psychological damage, anxiety attacks, vertigo, nightmares, suicidal thoughts and hallucinations.
Subscribe now for unlimited access.
$0/
(min cost $0)
or signup to continue reading
The group, which includes commandos and officers who have served in Iraq and Afghanistan, believe they have been incorrectly diagnosed with post-traumatic stress disorder or depression and were ignored by the military after raising concerns about the drug.
The Inspector-General of the Australian Defence Force has launched an internal inquiry into the use of the drug mefloquine, or Lariam, which has been used on up to 2000 personnel since a controversial drug trial in East Timor in 2001-02.
But documents obtained by Fairfax Media reveal Chief of Army Lieutenant-General Angus Campbell does not support a campaign against the drug because it would deny deployment opportunities, despite acknowledging the side effects.
The internal review is the result of formal complaints by Major Stuart McCarthy, who has broken ranks to condemn "a culture of denial, deceit and impunity" at the top of the Defence Force.
"I have been an army officer 27 years and I have no trust in the Australian Defence Force's handling of this matter," he said.
One veteran said the drug made his tour "like living in a heavily armed lunatic asylum" with instances of deep depression, vivid nightmares, anxiety attacks and debilitating paranoia.
Defence insists the use of mefloquine is ethical as those who experience confusion, restlessness, depression or anxiety are urged to contact their medical officer immediately.
"In these cases mefloquine is ceased and an alternative antimalarial prescribed," a spokesman said.
Mefloquine was developed by the US armed forces in the 1970s and remains the third-choice drug for ADF members unable to take safer antimalarials such as doxycycline.
The drug was first used on Australian soldiers during a double-blind trial in 2001-2002 after 64 Australian soldiers contracted malaria during the first five months of an international peacekeeping mission in East Timor.
Australia's Therapeutic Goods Administration warns that patients with a history of depression, anxiety disorders or other psychiatric illness should not be prescribed the drug.
About 580 ADF members were prescribed mefloquine between 2000 and 2005. Another 1319 were prescribed as part of studies by the Army Malaria Institute in 2001 and 2002. About 25 ADF personnel are now treated with mefloquine each year.
The trial also prescribed soldiers with the antimalarial tafenoquine despite it not being approved for use in Australia. The drug remains banned to this day.
Luke Grogan, who served with fourth battalion commandos in East Timor, said he became anxious and suffered vertigo after taking the drug during the trial period. He had trouble sleeping, would wake up screaming and punching the wall, and suffered blackouts.
Mr Grogan was medically discharged from the army in 2011 but said a public inquiry would provide certainty his post-traumatic stress disorder was not exacerbated by the drug.
Bill Harris, who served as an infantryman during the trial, said the drug had an immediate impact on him and many soldiers have remained silent about the side effects.
"I had nightmares that night and I woke up with a feeling of dread and anxiety," he said. "I had never felt like that before. For some time I kept my mouth shut about it because you were not allowed to serve in East Timor without an antimalarial."
Scott McCormick, who also served with the fourth battalion, said the group were told only one in 10,000 people would develop side effects and many favoured the drug as it was taken only weekly.
"Mood swings and unusual behaviour were the norm on this deployment," he said.
"At various times it was like living in a heavily armed lunatic asylum. I myself developed sleep paralysis and generalised anxiety after the second or third dose, which then manifested into clinical depression."
Major McCarthy was not a participant in the East Timor trial but was prescribed mefloquine while serving in Ethiopia and Eritrea in 2001, where he believes he first experienced side effects.
"I took it for three months and experienced depression during the operation with a period of mild suicide ideation," he said. "I stopped taking it and was told the side effects would stop.
"When I got back home I was diagnosed with depression and have had a series of depression incidents since then. I have vertigo, hearing problems, cognitive impairment and problems with working memory and difficulty with concentration."
In late September, Major McCarthy's father, Brian, wrote to Vice-Admiral Ray Griggs to allege his son was "threatened and intimidated and ordered not to speak to the media" about his experiences.
A review of the 2001-02 trials, published in the Medical Journal of Australia, reported nine serious adverse effects with three men withdrawn due to psychiatric symptoms "possibly associated with mefloquine use".
"The first soldier had auditory hallucinations, which, on psychological assessment, were consistent with his undisclosed history of auditory hallucinations preceding mefloquine use and the episode in East Timor," the report said.
Another soldier experienced illness on patrol with symptoms of nausea, dizziness and abdominal pain before have a generalised seizure. He was later found to have an undisclosed history of epilepsy and returned to Australia.
"The third soldier experienced depression, episodic anxiety, mild paranoia, short-term memory loss and suicidal ideation. Although he was taken off mefloquine and placed on doxycycline, his mental state continued to deteriorate," the report said.
"He was psychologically evaluated and returned to Australia."
Despite these side effects, the report found mefloquine was well tolerated and accepted by soldiers with requests for wider use of the drug from military units deployed to East Timor.
The majority of soldiers and veterans who spoke to Fairfax Media are not seeking compensation, but instead seek explanations for their own enduring traumas and support for other veterans.
"I am certain this drug is a major part of my problems because the symptoms and experiences I have had are consistent with research on the toxicity of this drug," Major McCarthy said.
The Inspector-General's internal inquiry comes as British veterans prepare to share their own stories of depression, nightmares and suicide attempts before a House of Commons defence select committee hearing.
Mefloquine remains the first choice for British personnel deployed to malaria-prone regions, despite the drug being banned from prescription to US special forces in 2013.
The international focus on mefloquine has encouraged many Australian veterans to continue seeking explanations for their injuries.
"Our claims about mefloquine were put in the fruitcake category for about a decade, so we feel somewhat vindicated by the latest science," Mr McCormick said.
The Department of Defence has insisted the use of mefloquine by the British military is "substantially different" although has promised to monitor the inquiry and consider if its findings are relevant to Australia.
Documents obtained by Fairfax Media reveal the Chief of Army is opposed to any campaign against the drug as it would be "contrary to the advice and approval of the appropriate Australia regulatory authority".
"I would be acting to the disadvantage of those members for whom mefloquine is the most suitable malaria prophylaxis," he said. "This would deny them the ability to achieve a deployable status, and potentially deny them the ability to pursue military careers of their choice."
According to the Department of Defence, Lieutenant-General Campbell is not responsible for the military's policy on mefloquine, which falls under the responsibility of the Surgeon-General of Australian Defence Force.
The department has acknowledged some soldiers continue to face psychological illness after taking the drug more than a decade ago, and insisted the wellbeing of veterans was being taken seriously with comprehensive care offered.
"Whilst in the majority of cases these side effects disappear after ceasing the medication, Defence accepts that some people do continue to experience ongoing issues linked to mefloquine use," a spokesman said.
A spokesman for drug company Roche, which produces mefloquine under the brand name Lariam, said more than 39 million patients had received the drug worldwide since its first approval in 1984.
"We closely monitor the safety profile of all our medicines and take any reports of side effects from doctors, patients and researchers very seriously," a spokeswoman said.
Dr Jane Quinn, a senior lecturer at Charles Sturt University, said the side effects of mefloquine including sleep disturbances and vivid dreams could be lasting or permanent.
"We can take reports of these very seriously," she said. "It is well documented in the medical literature that these occur, both from individual case reports and broader epidemiological studies of larger patient groups, including military personnel."
Dr Quinn is the widow of British soldier Cameron Quinn who took his own life in 2006 after attributing nightmares and depression to his use of mefloquine while serving in the army.
A public inquiry similar to the British hearing would be beneficial given the drug can confound the diagnosis of post-traumatic stress disorder among veterans, she said.
"Certainly a review would seem an obvious place to start given the current international scrutiny surrounding use of mefloquine in military settings," she said.
"The long-term effects of taking mefloquine and tafenoquine on the personnel who were involved in these trials has not been established, but should be from a duty-of-care perspective."