Did An Anti-Malaria Drug Make Sgt. Bales Snap?

By Walter Armstrong 03/26/12

A soldier's bloody rampage in Afghanistan may be the most bizarre side effect to date induced by this malaria prevention pill.

Sgt. Robert Bales faces 17 murder charges. photo via

Drugs may have played a role in Army staff sergeant Robert Bales' recent massacre of 16 Afghan civilians—but not alcohol or opiates or any of the other substances we might reasonably suspect. Whether the anti-malaria drug mefloquine (Larium) may have served as the trigger is the possibility pondered by a former high-ranking Army psychiatrist, writing in a blog on Time’s Battleland.

Mefloquine has a long history of triggering abrupt, gruesome and otherwise-inexplicable psychotic episodes, including an infamous case in the summer of 2002 when four Army officers at Fort Bragg murdered their wives after returning home from the war in Afghanistan. VA officials have also raised questions about the drug's potential implication in the escalating high rate of veterans' suicides. By 2004 the Pentagon had grown so alarmed by reports of the drug’s neuropsychiatric risks that it banned its use. Later that year, the VA alerted veterans' doctors to be on the lookout for signs of bizarre mental-health symptoms among vets—side effects that could occur even years after the anti-malaria prevention was last dosed.

Neither the VA nor the Pentagon has confirmed whether Sgt. Bales, who was charged on Friday with 17 counts of murder, received mefloquine. But the odds are very high that the 38-year-old husband and father of two did take the drug because it was routinely prescribed to tens of thousands of soldiers sent to do battle in Iraq where Bales was deployed from 2003 to 2010.

Last Monday, the Defense Department ordered an emergency review of all mefloquine prescribing, seeming to underline concerns about the drug's possible dangers, according to the Huffington Post. Yet if Bales did, as is likely, take mefloquine, the Army may have no record of the fact. A UPI investigation in 2004 found that many soldiers back from Iraq reported having taken the drug, even though their medical records omitted all mention of the treatment.

How this mefloquine angle will play out, if at all, in Sgt. Bales' legal defense remains, for now, a mystery. But it seems at least probable that we have not heard the last of mefloquine or the gap-ridden medical records.

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Walter Armstrong is the Medical Editor at  Saatchi & Saatchi Wellness and the former deputy editor of The Fix. You can find him on Linkedin.