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Mefloquine information

The Department of Veterans' Affairs (DVA) offers a range of support for current and former Australian Defence Force (ADF) personnel who took mefloquine (trade name Lariam) and are concerned about possible side effects.

DVA recognises mefloquine as being associated with several health conditions under the Statements of Principles (SoPs) system that applies to treatment and compensation claims.

Defence and DVA encourage general practitioners (GP) to review Defence Joint Health Command's Clinical Guidelines for providing appropriate care to ADF members concerned about having been prescribed mefloquine. While there is no specific way to diagnose the long-term effects of mefloquine and no specific treatment, other than to treat presenting symptoms, these guidelines outline a commonsense approach to the management of individuals who are concerned their current problems may be caused by mefloquine use in the ADF.

For a summary on mefloquine and the resources/ support available (including relevant web links, phone numbers and email addresses), see the:

Visit Defence Health for more information about malaria, mefloquine and the ADF.

Support available

Medicare-rebated health assessment

All former serving personnel can access a comprehensive health assessment from their GP. Ex-service personnel can access this one-off health assessment at any stage after leaving the ADF, as there are no time restrictions.

A key objective of this comprehensive health assessment is to help the GP identify and diagnose the early onset of any physical or mental health conditions. GPs will then be able to treat or refer their patients to other services, as necessary.

A Medicare rebate is available for this assessment.

Mental health treatment

DVA can pay for treatment for any mental health condition without the need for the conditions to be accepted as related to service. This is known as non-liability health care and it is available to anyone with one day of continuous full-time service in the ADF.

The Veterans and Veterans Families Counselling Service (VVCS) also provides free, confidential, nationwide counselling and support for eligible current and former ADF members and their families. VVCS can be contacted 24/7 on 1800 011 046.

Free online tools

Mental health information and resources for veterans and their families are available through At Ease — DVA's portal to online mental health information.

At Ease provides self-help tools and information to support mental health and wellbeing and is a gateway to websites and mobile apps about stress, PTSD, alcohol management, resilience and suicide awareness and prevention. The apps include High Res, which helps build resilience and manage stress, Operation Life for those managing suicidal thoughts and On Track with The Right Mix, which helps people track and manage their drinking.

For a summary of DVA's online resources, download a copy of the handout:

At Ease also provides links to a wide range of mental health resources for health professionals and GPs for effective evidence-based treatment of veterans.

Claiming

Current and former members of the ADF who have a diagnosed health condition that they believe relates to mefloquine can lodge a claim with DVA.

To lodge a claim, contact DVA, or visit DVA's online Entitlement Self-Assessment tool.

For assistance with mefloquine-related claims, call DVA on 1800 555 254 and ask to be put in touch with the dedicated mefloquine support team.

When a claim is accepted, current and former ADF members can access treatment and rehabilitation support.

Access to mental health treatment is available immediately, when required, and is separate to DVA's compensation process.

DVA assesses compensation claims under three pieces of legislation, two of which use SoPs. SoPs are legislative instruments that state factors that must exist to establish a connection between a health condition and military service.

An independent statutory authority, the Repatriation Medical Authority (RMA), determines the SoPs.

Together, mefloquine and tafenoquine are included as a potential causal factor in SoPs for 15 conditions. Of these, mefloquine is covered by 14 SoPs and tafenoquine is covered by six SoPs.

Condition Anti-malarial medication
1. Anxiety disorder Mefloquine
2. Bipolar disorder Mefloquine
3. Depressive disorder Mefloquine
4. Heart block Mefloquine
5. Myasthenia gravis Mefloquine
6. Peripheral neuropathy Mefloquine
7. Schizophrenia Mefloquine
8. Suicide and attempted suicide Mefloquine
9. Trigeminal neuropathy Mefloquine
10. Epileptic seizure Mefloquine and Tafenoquine
11. Acquired cataract Mefloquine and Tafenoquine
12. Sensorineural hearing loss Mefloquine and Tafenoquine
13. Tinnitus Mefloquine and Tafenoquine
14. Psoriasis Mefloquine and Tafenoquine
15. Methaemoglobinaemia Tafenoquine

Claims that do not use the SoPs are determined based on specialist medical opinion.

RMA investigations

The RMA investigated mefloquine as a cause of panic disorder. It found that panic attacks resulting from medications belong under a diagnosis of 'medication-induced anxiety disorder' and are covered by a new factor in the anxiety disorder SoP. As such, there is no new factor relating to mefloquine in the panic disorder SoP.

The RMA investigated whether SoPs may be determined in respect of 'chemically-acquired brain injury caused by mefloquine, tafenoquine and primaquine'. The RMA found that there is insufficient sound medical-scientific evidence that exposure to these pharmaceuticals causes chronic brain injury and, therefore, will not make SoPs in relation to this. The report is available via the RMA.

Mefloquine Outreach

Townsville Outreach Program

Following the Government's election commitments to support veterans concerned about mefloquine, the DVA-Defence Links Steering Committee recommended the establishment of an outreach program in Townsville to provide information to those with concerns. DVA, in collaboration with the Repatriation Medical Authority and VVCS, ran an outreach program in Townsville on 13–15 December 2016. The purpose of the program was to provide current and former ADF personnel, their families, carers and friends, with easy access to information and face-to-face assistance.

For the presentations and handouts from the information sessions see the following:

Further brochures available via the VVCS.

State and Territory Ex-Service Organisation (ESO) Consultative Forums

The DVA-Defence Links Steering Committee recommended formal community consultation through the DVA Deputy Commissioners' State and Territory ESO consultative forums.

The Deputy Commissioners provided ESO representatives with an update on mefloquine and discussed the information and support that is available to those concerned about its use in the ADF. The Mefloquine Information Paper was distributed to the ESO representatives, as follows:

GP engagement

DVA's Principal Medical Adviser, Dr Ian Gardner, has written to General Practitioners (GPs) to bring their attention to information that may assist in managing patients who have taken mefloquine.

Ahead of the outreach program, Townsville-based GPs and psychologists were invited to an information session on 29 November 2016. They were provided with information about mefloquine and the outreach program and their assistance was sought in raising awareness of the outreach program in Townsville.

For the presentations given at the information session see the following:

The following GPs attended the briefing and are able to assist individuals who may present with symptoms or conditions which they attribute to being prescribed mefloquine or tafenoquine while in the ADF (Note: that DVA does not recommend or endorse any individual GPs):

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