The most important thing is to have a high index of suspicion that somebody may have been exposed to mefloquine and then to ask the person if they had been on an anti-malarial, was it a daily dose, Malarone or doxycycline, or a weekly medication. Soldiers and other service members know that if it's weekly, it's mefloquine. And then as a result of that, there is an overlap in symptoms but some we think are unique to mefloquine. Those are the effects of damage to the vestibular part of the brain, that's the brain stem, so that's a dizziness, nystagmus, your eyes fluctuate back and forth, and then looking at all the other symptoms as well.
We are now beginning a study at the veterans administration where we are trying to categorize the symptoms, and we're hoping to find what's called pathognomonic symptoms and others that are unique to mefloquine. We're not there yet, but we think that we may find a combination of neurological and psychological problems. Of course, they're not mutually exclusive, and that's part of the challenge. You've served in Somalia, you've served in Afghanistan, you've been exposed to the blast of combat, so you may have TBI and PTSD.
It can be a tremendous relief to the service member to be asked about their exposure. Often they're concerned about it; they feel nobody takes it seriously. Simply to hear that story and say, yes, we think mefloquine could have been related—
Very quickly, the problem is we don't know how to treat it yet, and that's an area of research we need to have. If you have these symptoms, what is the best treatment?