Veterans Affairs committee  I think it would be very, very rare, and I've given a way that if you had to, you would carefully monitor and be able to intervene. We know how prescribing and dispensing can sometimes go. It's “take the pill,” and that's the end of it. In fact, the surgeon general's report docum

Veterans Affairs committee  I think the reality is that it wouldn't work out all that well. I think most primary care physicians would not be very familiar with.... We know that the management of mental health is a problem in our health care system anyway. Problems aren't recognized. This is getting very de

Veterans Affairs committee  Not to my knowledge, although I suspect Professor Quinn may have managed to stimulate this in Australia. She's quite a force.

Veterans Affairs committee  Of course, this goes far beyond PTSD because the neuropsychiatric consequences of mefloquine can involve depression, psychosis and a whole range of different kinds of symptoms. As a clinical pharmacologist, the kind of thing I would do is look for an index of exposure. I would tr

Veterans Affairs committee  Yes. I think that Professor Quinn is nudging up to what you have to do. It's really the assessment of whether the drug has caused a reaction. In this case, we know the natural history that an acute reaction is associated with a probability of a longer term reaction. So you need t

Veterans Affairs committee  The issue here is that large doesn't make good. That's a particular retrospective kind of study that suffers from failure to document, record and have an accurate estimate, and the kind of symptoms that often get reported never show up in medical records, so—

Veterans Affairs committee  The basis of my little clip there that “large doesn't make good” is that it really depends on the source of the data. That kind of study is very typical of retrospective epidemiologic studies. The universal weakness of those studies is that one does not have information about all

Veterans Affairs committee  No. I can hear you.

Veterans Affairs committee  I'll make a few brief comments. I'm a professor emeritus of pharmacology and toxicology, psychiatry and medicine at the University of Toronto. I've been involved in research, teaching, and clinical care, involving psycho-pharmacology—that is drugs that act on the brain—for over