http://www.denverpost.com/Stories/0,1413,36%257E53%257E2205792,00.html
The Denver Post
medical problems
Soldiers blame ills on drug
Two Fort Carson GIs say they took an anti-malaria drug in Iraq and now
are suffering
By Eileen Kelley
Special to The Denver Post
Friday, June 11, 2004 -
Fort Carson - Spec. Heather Stanbro finds herself standing in rooms
with no idea how she got there. She shakes uncontrollably and has
trouble walking without staggering. She recently bit and punched her
husband in what she calls a psychotic episode.
The 25-year-old soldier blames her medical problems on the
anti-malaria drug Lariam that she was forced to take weekly last year
while serving as a medic in Iraq.
Stanbro said a military medical specialist recently told her that she
is suffering from brain-stem damage, with Lariam being the probable
cause for at least her balance problems.
The medical expert, Dr. Michael Hoffer, on Thursday confirmed the
conversation and added that he suspects Lariam is also to blame for
the physical problems Fort Carson soldier Georg Pogany suffers. Pogany
became the first soldier since the Vietnam War to be charged with
cowardice after his panicked reaction to seeing a dead Iraqi in a body
bag. His career is in limbo, and, like Stanbro, he has balance
problems and other troubles.
"I've had the ringing in my ears pretty much since I have been back,"
Pogany said. "I hear sounds when there is none. It can drive you
crazy."
The two Fort Carson soldiers will be part of a new U.S. Navy study
into the drugs and chemical exposures of several hundred servicemen
and women who have complained of balance and vision problems, another
Navy doctor told The Denver Post on Thursday.
Both soldiers were treated and evaluated by Hoffer, the director of
the Department of Defense Spatial Orientation Center at Naval Medical
Center, San Diego. The two Fort Carson soldiers are among 11 service
members he has seen for balance problems in the past eight weeks.
Hoffer has treated hundreds of service members for balance problems,
but something stands out in 10 of the 11 recent cases, he said
Thursday.
"The common thread is Lariam in what we have seen so far," Hoffer
said.
The new Navy study, prompted by the 11 recent Iraq and Afghanistan
returnees with balance problems, will take another look at several
hundred service members earlier seen for similar problems.
An epidemiologist and captain for the Navy, Dr. Dean Bailey will be
leading the new investigation to see if Lariam has caused the
problems.
"There are quite a few things which can do this and, be honest, we are
looking at all of them," Bailey said. "... There are several hundred
patients, and we are trying to find out what the common factors and
exposures are."
Another study was announced in March by the Department of Defense to
investigate the effects of Lariam and other anti-malaria drugs.
The drug mefloquine was created by the military and is now
manufactured under the brand name Lariam by Roche Pharmaceuticals.
According to its warning label, Lariam can cause psychiatric symptoms
ranging from anxiety, paranoia and depression to hallucinations and
psychotic behavior.
"On occasions, these symptoms have been reported to continue long
after mefloquine has been stopped," the warning on Roche's website
says.
Department of Defense records indicate that between Oct. 1, 2002, and
Sept. 30, 2003, the department bought 4,153,000 doses of mefloquine
and issued 49,206 mefloquine prescriptions to 44,634 individuals.
But the department has decided that Iraq's mosquito problem is not so
severe that the widespread distribution of the drug is needed.
"Based on the revised risk assessment, anti-malarial medications are
not expected to be required next mosquito seasons in most parts of
Iraq," the department said Thursday in a written answer to a question
from The Post.
The two Fort Carson soldiers are angry that they took a drug they
apparently did not need and now are suffering.
Stanbro said she probably took 32 pills before she was medically
evacuated from Iraq after being injured in a mortar attack July 3.
Her condition at home continued to worsen. A March incident was the
clearest sign that something was wrong.
"I had a psychotic episode; I cannot think of another way to word it
nicely," she said.
After having two or three glasses of wine at a friend's house, she
vaguely recalls lashing out at her husband, Jason, believing that he
was trying to kill her and that someone's combat boot was crushing her
throat.
"I was talking gibberish and started crying and screaming bloody
murder at the top of my lungs, and he went to hug me and I beat him
away," she said. "He grabbed my wrist to calm me down, and I bit his
hand. I guess I felt like I had to escape."
The next morning, after a night in the emergency room, she was covered
in bruises along her right side.
Pogany, the 33-year-old interrogator with the 10th Special Force Group
at Fort Carson, has been battling the Army since his panic attack in
late September. Pogany made national headlines when he was charged
with cowardice - a crime potentially punishable by death.
Pogany and his attorney have maintained that he had a normal combat
stress reaction that was exacerbated by the use of Lariam. On that
September day, he was given the third of what would be four doses of
the anti-malaria drug.
Charges against Pogany were dropped, but he remains in a legal limbo.
He is still without his security clearance and without written word
from commanders that charges have been dropped.
When asked if he felt vindicated after learning of the brain-stem
damage believed to be caused by the Lariam, Pogany responded: "Redeem
myself from what? Redeem myself from having an adverse reaction to a
medication they gave me?"
Last week, Sen. Dianne Feinstein, D-Calif., released letters to
Defense Secretary Donald Rumsfeld and Veterans Affairs Secretary
Anthony Principi urging the Pentagon to come up with a plan that would
allow service members to report side effects of the drug without
retribution.
Pogany says that didn't happen after he asked for help while in Iraq.
"I had to beg them for a post-deployment health assessment because
when I asked them for one I was told that I was not entitled to one,"
Pogany said.
"They ignored the facts or failed to research the side affects of
Lariam," said Pogany's lawyer, Richard Travis. "Georg is the poster
child for the effects."
Doctors in California say they are concerned about the well-being of
Pogany, Stanbro and the other service members. They say they intend to
help them to overcome their physical problems.
"We think, based on our extensive experience, that we can get these
folks better," Hoffer said.
Pogany's career with the Army Special Forces is effectively over.
Stanbro, too, appears to be on her way out of the service.
"The Army finds me unfit for duty with PTSD (post traumatic stress
disorder), so how many jobs are going to (find) me fit, especially
with the Lariam damage?" Stanbro said this week.
She says the Army has offered her a discharge and $20,000 severance
for her injuries, but no monthly disability pay.
"I got screwed. ... Everything is all jumbled up. There are so many
things that have happened in not even a year," she said. "It's
frustrating. I am 25 years old and I'm happily married, and then I go
off to war to fight for the freedom of another nation, and this is the
thanks I get."
Eileen Kelley of the Denver Post can be reached at 719-667-0162 or
coloradokell65@aol.com
/sidebar data
Lariam, the brand name for mefloquine hydrochloride, is a widely used
malaria preventive. Developed by the Walter Reed Army Institute of
Research and licensed to Swiss pharmaceutical giant Hoffman-La Roche,
the drug received FDA approval May 2, 1989. The Centers for Disease
Control declared the medication its "drug of choice" for the Peace
Corps, the State Department and the U.S. Army in March 1990, and by
fall of that year it recommended the individual dose be doubled from
once every two weeks to once a week. Nearly 400,000 Americans who
travel abroad are prescribed Lariam each year.
Soldiers serving in Somalia in the early 1990s reported problems to an
outside advocacy group: outbursts of rage, anxiety, paranoia,
depression and suicidal urges. The military medical officers in charge
of giving Lariam to more than 20,000 U.S. troops there in 1992 and
1993 said they saw no evidence of a problem.
A 1994 internal Hoffman-La Roche safety report says Lariam can cause
depression, which can lead to suicide, and that "therefore a causal
link to Lariam can in theory not be ruled out." It also says that
reports of suicide attempts linked to Lariam are rare and fall within
the incidence of suicides among the general population. In 2002, after
several murder-suicides among Fort Bragg soldiers and their families,
the Army concluded that Lariam toxicity was an "unlikely" explanation
for such a cluster of domestic-violence incidents.
Sources: Salon.com, June 9, 2004; United Press International, Sept. 8,
2003; United Press International, May 21, 2002; PR Newswire, May 5,
1989; Consumer Reports, March 2002; United Press International, April
12, 2004
ANNE FEILER
DENVER POST LIBRARY
/end
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