Molecular formula: C17-H16-F6-N2-O
Molecula structure:

Lariam - Molecule of the Month - October 2017 (HTML version)

Excerpt from article on Sara Thompson, a Peace Corps Whistleblower:

… Shortly after arriving in Burkina Faso, Thompson was given an anti-malaria medication called mefloquine (also known as Lariam, the brand name). Thompson received a concentrated dose for the first three days, contrary to CDC recommendations. The Peace Corps mandated that all Peace Corps trainees and PCVs take antimalarial prophylaxis. If Thompson refused to take the mefloquine, she would have been terminated from her post. Mefloquine is in pill form, and within the first twenty-four hours of being in-country, Thompson was given a medical kit containing the anti-malaria drug. Thompson was given a fact sheet regarding mefloquine and had to sign a sheet stating she would be fired if she did not take it.

Mefloquine is an antimalarial medicine sold as a generic medicine and can be prescribed for malaria treatment or prevention. The potential side effects of mefloquine are dizziness, difficulty sleeping, anxiety, vivid dreams, and visual disturbances. It can also cause stomach pain, nausea, diarrhea, and vomiting. It is recommended that people concerned about side effects should start taking the medicine three or more weeks before traveling. Thompson was not offered the drug or information about the medication before departing the United States. She was told she would be terminated if she did not take medicine after arriving in Africa. But most importantly, she was never advised of any chronic, long-term side effects of the drug.

However, a February 2, 2009 memorandum from the Office of the Surgeon General, a department of the U.S. Army, revealed: “It is critically important that all Army healthcare providers be familiar with the proper use, contraindications, warnings, and precautions for prescribing mefloquine, especially concerning neurobehavioral effects.” Warnings from the Surgeon General included the symptoms that Thompson experienced.

In April 2007, an article in the Journal of the Royal Society of Medicine noted that mefloquine had been causally associated with 19 deaths in users, including three suicides. It was reported that 60% of all mefloquine occurrences cited neuropsychiatric disturbances. The Food and Drug Administration in the United States took the unprecedented step of insisting that a patient medication guide be given to all recipients of mefloquine, warning patients about the incidence of neuropsychiatric adverse effects of mefloquine.

Thompson, who did not receive any warnings before arriving in Africa, began to experience “several health issues related to impaired cognitive functioning.” Previously very organized in the United States, Thompson began to find herself misplacing everyday items at her Peace Corps post. She started sleeping sixteen hours a day and became paranoid about other people taking things. Thompson began to see things that were not present in her environment. She complained to her Peace Corps Medical Officer (PCMO), to no avail. At no time did anyone talk to Thompson about any possible adverse effects that she experienced could stem from mefloquine ingestion. Thompson initially dismissed the strange occurrences as being in a new environment. Cognitively and physically, Thompson experienced constant fevers, parasites, diarrhea, and chronic staph infections in the form of boils. She suffered from severe dizziness and vertigo, and in one instance, experienced vertigo so intense that she vomited excessively.

During conversations with other volunteers, Thompson discovered that mefloquine caused them to suffer symptoms. Still, the volunteers kept pushing through or discontinuing the drug without notifying their PCMO. During her two years of service, none of Thompson’s symptoms dissipated, and in fact, appeared to intensify. At no time did any PCMO tell Thompson that her symptoms could stem from mefloquine ingestion. At one point, a PCMO advised Thompson that she was suffering from an ear infection.

In August of 2012, Thompson finished her Peace Corps Service. From that date until now, she continually suffers from intense bouts of dizziness, vertigo, and disequilibrium. The turning point for Thompson after she got back from the Peace Corps was when she went out for a run “and could not even get to the end of the block.” In May of 2013, Thompson spoke to another PCV, who informed her that she should “look at mefloquine toxicity.” Thompson studied mefloquine and found out that mefloquine toxicity affects the brain and causes permanent damage. Thompson found other volunteers who suffered problems with mefloquine toxicity and discovered Dr. Remington Nevin, formerly a Major in the U.S. Army Medical Corps, who helped her understand mefloquine toxicity. Nevin relayed to Thompson that mefloquine was “The Agent Orange of today’s generation.”

Once back in the United States, Thompson underwent a series of medical tests. She went to Ear, Nose, and Throat specialists and a primary physician in Washington, D.C. Medical tests revealed no abnormalities. However, Thompson was still experiencing dizziness, vertigo, and disequilibrium, which continued with more frequency and intensity. Thompson discovered that the U.S. military discontinued mefloquine as the first drug of choice in 2009. The drug company, F. Hoffman-La Roche, stopped producing mefloquine. Despite the U.S. military moving away from mefloquine and the drug company halting the manufacturing of the drug, the Peace Corps continues to distribute the drug and uses the drug on Peace Corps volunteers.

When Thompson returned from Africa, she started working at the World Bank and coordinated a $2 million research grant on African elephant poaching. She had minimal health care, was scared, had limited resources, and was fearful of being disabled.

On August 12, 2014, Thompson filed a claim with the Peace Corps for damage and injury, which was rejected. Medical care for Peace Corps volunteers has been a subject of tort litigation in federal court. In 2016, Thompson filed a lawsuit against the Peace Corps for the damages she sustained due to the agency’s negligent prescription of the antimalarial drug mefloquine. Thompson brought the claim under the Federal Tort Claims Act (FTCA). Thompson’s case was then dismissed without reaching the merits of her case because of an FTCA provision known as the “Foreign Country Exception.” The Exception bars any claim brought under the FTCA “arising in a foreign country.” Relying on a bright-line rule adopted by the Supreme Court in 2004, the court determined that Thompson was not eligible for any judgment because the injury occurred in a foreign country. The court also ruled that the government did not waive its sovereign immunity under the FTCA and that the Peace Corps Act does not provide an independent cause of action. 

Thompson next filed a whistleblower complaint with the Office of Special Counsel. It was rejected because Peace Corps volunteers are not considered federal employees. Speaking out against the Peace Corps is not a popular pastime, as it is likened to “punching a puppy,” Thompson said.

… Still suffering from the effects of mefloquine toxicity and looking at a future that may hold no change, Thompson is weary from the fight, which so far has been a losing one. She comments, “My soul is black, my soul is just a black entity that holds nothing but cynicism.” “Through over five years of lobbying on the Hill to push for change without seeing any substantial improvement, it has been an incredibly frustrating experience, and especially having worked in the federal government as well, it was just a soul-sucking experience,” Thompson said….

*Original article online at