Was Sgt. Robert Bales on mefloquine when he is alleged to have killed 17 Afghan civilians?
March 26, 2012, 8:22 pm
There has been increasing speculation that Robert Bales, the Army Staff Sergeant charged with killing 17 Afghan civilians in Kandahar Province on March 11, 2012, may have been suffering from well-known neuropsychiatric effects of the anti-malaria drug mefloquine (Lariam).
Mefloquine had been widely used for malaria prophylaxis since its long half-life — 13-30 days — meant that it only had to be taken once a week. However, the drug has been associated with episodes of bizarre behavior, depression, agitation, and paranoid, as well as several cases of violent behavior — both suicides and homicides. The incidence of neuropsychiatric reactions to mefloquine seems to increase when patients on it take alcohol. There have been suggestions that Bales may have been drinking on the night of the killings. In addition, Bales is known to have suffered head trauma during a previous deployment — a condition that should have ruled-out use of mefloquine.
According to the Army Times, in 2009 the Army discontinued recommending mefloquine as the preferred malaria prophylaxis medication, substituting doxycycline which has to be taken daily. Actually, in Afghanistan, doxycycline has been considered first-choice prophylaxis since 2004, with mefloquine reserved for those who could not take doxycycline. However, a previous study demonstrated that many soldiers stationed in Afghanistan had been dispensed mefloquine even when it was contraindicated.
Was Bales on mefloquine? The Huffington Post reports that to date the Pentagon has not said whether or not that was the case. It may be noteworthy that nine days after the killings, the Assistant Secretary of Defense for Health Affairs issued an urgent order for a “review of mefloquine prescribing practices” be completed immediately. [Update (4/2/12): There have been significant questions raised about the timing and intent of this order. See Jeffrey Kaye's comment below.] If in fact mefloquine was associated with this tragedy, it will surely figure in Bales’ legal defense.