A trail of human wreckage The record of problems relating to mefloquine is a long one. In December 2002, Naval Lt. Cmdr. Bill Manofsky was given Lariam, the Roche version, during his deployment to Kuwait. There was no prescription and no warning about side effects, as far as Manofsky can recall. Three days before the Iraq War began, in March 2003, Manofsky experienced uncontrolled vomiting and vertigo while operating in the Kuwaiti desert. Two months later, back home in China Lake, Calif., he had a panic attack on the way to a local restaurant. He tried to jump out of the truck his wife was driving and, when they arrived at the restaurant, threatened to kill himself, ending the evening at an emergency clinic. Today, Manofsky is a veterans' advocate who questions the quality of medical care given to active-duty soldiers and veterans. "There is a tremendous amount of dysfunctionality in Army medical, to the point that the Army surgeon general can put a directive out and it can be ignored," Manofsky says, referring to the Schoomaker advisory. "I would never go into the Army the way it is now. I am telling them, 'People, don't send your kids to the Army until the medical stuff gets fixed.' " About the same time Manofsky first experienced problems, four soldiers at Fort Bragg, N.C., killed their wives before three of them took their own lives. Three of the four had been taking Lariam before the shootings. As evidence of problems associated with mefloquine mounted, the Army seemed slow to recognize the pattern. In February 2004, the Army surgeon general at the time, James Peake, testified before a House Armed Services subcommittee that an Army investigation had found no link between Lariam and soldier suicides. A month later, U.S. Chief Warrant Officer Bill Howell, who had taken Lariam while deployed with Special Forces in Iraq, shot and killed himself in the front yard of his Colorado home. His wife suspected Lariam had a role in his death. A study released that same month by doctors at the Walter Reed Army Institute of Research bolstered her claim, finding that a quarter of the individuals taking Lariam to prevent disease and nearly three-quarters of those taking it as a treatment experienced damage to their central nervous systems. That report cited psychological disorders such as hallucination and insomnia, and neurological disorders like seizures and dizziness. On July, 11, 2004, 25-year-old Army reservist John Torres killed himself with an M-16 while stationed at Bagram, where Adam Kuligowski would later die. A report that mentioned the presence of Lariam in Torres' system, together with a bit of strange phrasing in Roche's medication guide on the drug, were among Michael Kuligowski's first clues that mefloquine may have played a role in his son's death. Roche's guide said: "Some people who take Lariam think about suicide. Some people who were taking Lariam committed suicide. It is not known whether Lariam was responsible for those suicides."