Veterans Affairs committee  Thank you, Mr. Chair, and thank you, members of the committee, for inviting me here today. I'm Dr. Remington Nevin, and I'm the executive director of the Quinism Foundation, which is a Vermont-based non-profit organization. Our mission is to support and promote education and re

Veterans Affairs committee  Yes, I'd be happy to follow up my testimony with an additional brief. Could you clarify precisely what the question is that I am being asked?

Veterans Affairs committee  To distinguish the military, the Department of National Defence, from VAC.... I have long stated that we will make the most progress on this issue with a simple acknowledgement in the United States, either by DOD or VA, that mefloquine is the cause of some degree of chronic disab

Veterans Affairs committee  Our group was formed largely to advocate for and to support and promote education and research on this medical condition, which we have termed “quinism”. We chose this language very deliberately. We believe that quinism is a disease, that chronic quinoline encephalopathy is a med

Veterans Affairs committee  Thank you. So we know that mefloquine and the related quinolines are neurotoxic and we know that this neurotoxicity is demonstrated in animal models. It affects very specific areas of the brain stem and limbic system. As Dr. Ritchie was alluding to, on animal model studies, thes

Veterans Affairs committee  Thank you. The product monographs for any drug are routinely updated on the basis of new safety signals and the need to warn the public of drug safety risks. I am more familiar with the history of the U.S. label, but I believe the Canadian label language closely mirrors that of

Veterans Affairs committee  I believe, today, we have mostly addressed the problem of improper use of mefloquine. I would suggest that there are individuals out there who have taken mefloquine many times and, for whatever reason, they are simply not susceptible to the adverse effects of this drug. We don't

Veterans Affairs committee  I am surprised. That number seems a little high. Five per cent is much higher than the rate of use in other countries. For example, in the United States military—the United States developed mefloquine—we use mefloquine so rarely now that it accounts for, I believe, less than one

Veterans Affairs committee  Let me turn the question around. Health Canada and the product manufacturer very clearly state you must discontinue this drug at the onset of any psychiatric or neurological symptoms. This means that Health Canada is telling us if you develop anxiety, depression, restlessness, co

Veterans Affairs committee  Some common manifestations of what we believe is the brain stem dysfunction caused by mefloquine neurotoxicity are such things as central vestibulopathy and central visual disorders: chronic dizziness, chronic vertigo, chronic disequilibrium, visual impairment caused by the neuro

Veterans Affairs committee  Yes, I'd be happy to submit that.

Veterans Affairs committee  The term “quinism” was coined to describe the disease caused by poisoning by quinoline drugs. These are mefloquine, chloroquine, tafenoquine, we believe, and primaquine, the synthetic drugs used in World War II. This disease is a consequence of what we believe is the inherent tox

Veterans Affairs committee  Interestingly, mefloquine and related quinoline anti-malarials have recently begun to be explored as treatments for certain types of central nervous system cancers. This makes sense, because these drugs readily penetrate the blood-brain barrier. They readily concentrate—sometimes

Veterans Affairs committee  The simple answer is that it makes no sense. Health Canada, one portion of your government, is very clearly stating that in some cases this drug is acting as a poison; it's causing permanent central nervous system dysfunction. It's very obvious from the product monograph and th

Veterans Affairs committee  It's an excellent question. The fact is there are individuals who, for whatever reason, and we don't understand why—are fortunate to have escaped the horrific adverse effects that other veterans and service members have experienced from this drug. Good for them. Thank goodness t