LORENGAU – The Australian Immigration Department is moving to offer asylum seekers on Manus Island alternatives to a controversial anti-malarial drug known to cause or exacerbate mental health issues in some patients.

Medical staff who once worked on Manus Island say the drug, also known as Lariam, started being prescribed to an unknown number of asylum seekers in late 2012 and early 2013.

The drug is known to cause agitation, mood swings, panic attacks, confusion, hallucinations, aggression, psychosis and suicidal thoughts in a small number of patients.

People who have, or have had, any mental health condition are advised not to take the medication.

One advantage of mefloquine is that it only needs to be taken once a week, rather than daily.

In late 2012, when Labor was in power, asylum seekers were given another anti-malaria medication, malarone, which has far fewer side effects.

The ABC has been told health providers on Manus Island switched from malarone because only 30 per cent of asylum seekers were taking it every day as required.

Fearing an outbreak of malaria, a decision was made to change to mefloquine.

One health professional, who worked on Manus Island at the time but asked not to be named, said potential side effects were weighed up against the risk of contracting malaria, a life-threatening disease.

He described the decision as akin to “Sophie’s Choice”.

The ABC also spoke to Australian malaria expert James Beeson who said mefloquine should only be prescribed after careful consideration from doctors.

“You have to assess each person individually and understand their risks and their other medical conditions and their current environment,” he said.

“So I think if you made an assessment that people were at risk of psychological illness or of high levels of stress or anxiety, that would certainly influence your decision as to whether to give mefloquine to those people.

“When we use anti-malarial drugs we’re balancing the benefits of protection against malaria, which is a serious disease, a life-threatening disease, against the risks of taking these medications.”

In a statement provided to the ABC, a spokesperson for the Immigration Department said asylum seekers were advised of the side-effects of mefloquine.

The spokesperson said the department was taking steps to offer alternatives to mefloquine.

“Mefloquine is one of three TGA medications available for use in malaria prevention,” the spokesperson added.

“Following advice from The International Health and Medical Services, and the Department’s Chief Medical Officer that all three medications should be available, the Department is considering how best to implement this. Transferees and refugees can then make a personal decision as to which agent to use.”

Meanwhile hundreds of former Australian soldiers say they are battling a range of mental illnesses after taking mefloquine.

There have been calls for a review into why the Defence Force prescribed the drug to up to 2000 personnel.

Stuart McCarthy, an army veteran who was given mefloquine during a 2001 deployment to Ethiopia and Eritrea, blames the medication for lasting adverse affects including depression, vertigo and tinnitus.

“It’s devastating for me personally, it’s been devastating for my career and also for my family,” he said.

“There are much safer drugs that have been available right through the history of mefloquine.” - ABC