Editorial Note: We have run previous posts on mefloquine (Lariam) – the The Strange History of Lariam and Lariam Hell and quinoline anti-microbial, as well as on a different group of anti-microbials – the fluoroquinolones – but a lot of their problems overlap. More to the point, those with Mefloquine problems have faced difficulties from Roche that so many others taking fluoroquinolones and other compounds have faced from other companies. The creation of a Foundation to collate expertise and handle the problems of specific drug groups may be a way forward for other groups seeking to move problems forward. Remington Nevin the driving force behind this initiative has been working on these problems for years – as have a large number of others who have had family members affected.
The Quinism Foundation has announced its official incorporation as a domestic non-profit corporation in the village of White River Junction, Vermont.
The Quinism Foundation promotes and supports education and research on the potentially life-threatening medical conditions caused by poisoning by quinoline drugs including the antimalarial drugs mefloquine (previously marketed as Lariam®) and tafenoquine, an unlicensed drug currently undergoing regulatory review by the U.S. Food and Drug Administration (FDA).
Symptoms of neuropsychiatric quinism, or chronic quinoline encephalopathy, can include terrifying nightmares, severe insomnia, crippling anxiety, and debilitating cognitive dysfunction and can contribute to an increased risk of suicide. Particularly among military veterans, many of whom were issued quinoline antimalarials during combat deployments, the lasting symptoms of neuropsychiatric quinism are regularly mistaken for those of Posttraumatic Stress Disorder (PTSD).
“Quinism affects veterans and civilians alike, but veterans suffering from chronic quinoline encephalopathy are frequently misdiagnosed with PTSD,” said Remington Nevin, MD, MPH, DrPH, executive director of The Quinism Foundation. “We are delighted to join the VA’s National Center for PTSD in making White River Junction, Vermont, our home. Our location helps position the village as an emerging center for research and education on these two neuropsychiatric conditions, which often mimic each other.”
In 2013, the FDA warned that mefloquine can cause long-lasting and even permanent adverse effects. More recent research confirms that nightmares and other abnormal dreams affect nearly 1 in 7 of those exposed to mefloquine , and that more than 1 in 5 of those who complain of nightmares report this symptom continuing over 3 years after exposure . Other symptoms of neuropsychiatric quinism, due to central nervous system toxicity, can include lasting tinnitus, dizziness, vertigo, paresthesias, and visual disorders.
Authors at the U.S. military’s Walter Reed Army Institute of Research (WRAIR) , where several quinoline antimalarials including mefloquine and tafenoquine were developed, have noted that mefloquine toxicity “can persist for several years after exposure has been discontinued, with little to no abatement in symptoms over time,” and that given “the overlapping symptoms of post-traumatic stress disorder and mefloquine toxicity, it can be challenging to distinguish between the two diagnoses.” The U.S. Department of Veterans Affairs (VA) has recently awarded several disability claims to veterans for permanent neuropsychiatric conditions, including anxiety and insomnia, that it has concluded were due to exposure to mefloquine while serving in the military . Independent research concludes that “mefloquine has been proven to be highly neurotoxic,” and that tafenoquine is even more neurotoxic than mefloquine .
About The Quinism Foundation
The Quinism Foundation promotes and supports education and research on quinism. Founded in January 2018, The Quinism Foundation is supported by private donations and is advised by an international committee chaired by Mr. Andrew Bryce, of Dublin, Ireland. The Foundation’s board of directors includes retired Navy Commander William Manofsky and retired Army Lieutenant Colonel Gregory Alderete.
Dr. Nevin, executive director, is a board-certified preventive medicine physician and former U.S. Army medical officer and epidemiologist. He is author of more than 30 scientific publications on malaria and the quinoline antimalarials, including “Mefloquine and Posttraumatic Stress Disorder,” published in the U.S. Army’s Textbook of Military Medicine series (see: http://www.cs.amedd.army.mil/FileDownloadpublic.aspx?docid=59eea54e-292d-4a35-9117-d9be6c40dac3).
Tickell-Painter M, Maayan N, Saunders R, et al. Mefloquine for preventing malaria during travel to endemic areas. The Cochrane Database of Systematic Reviews. 2017;10(10):CD006491.
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