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Oct. 18, 1999, 9:20PM

Test drug may be cause of Gulf War syndrome, scientific survey finds


New York Times


WASHINGTON -- A scientific survey underwritten by the Pentagon has concluded that an experimental drug given to U.S. troops during the Persian Gulf War to protect against a nerve gas may have been responsible for the chronic illnesses afflicting tens of thousands of veterans.

The report, to be released today, is the first commissioned by the Pentagon to identify a possible cause for the illnesses, which have collectively come to be known as Gulf War syndrome. It sharply contradicts two earlier government studies -- by a presidential commission and by the Institute of Medicine -- that ruled out the drug as a cause.

The drug, pyridostigmine bromide, or PB, was distributed to 250,000 to 300,000 of the nearly 700,000 troops sent to the Persian Gulf in 1990 and 1991 as a "pretreatment" for potential Iraqi attacks with the nerve agent soman. While the drug has been used since 1955 to treat a rare neurological disorder, its use as an antidote to soman is still regarded as experimental.

More than 100,000 veterans have reported experiencing symptoms attributed to Gulf War syndrome, including chronic fatigue, muscle pain, memory loss and sleep disorders. But because of the Pentagon's admittedly shoddy record-keeping during the war, it may be impossible to know how many of those took the drug and in what quantities.

The report represented a breakthrough after years in which the Pentagon has systematically discounted possible explanations for the ailments, from stress to exposure to oil-well fires and depleted uranium used in American bombs.

Wary of the reaction of veterans' groups and their supporters in Congress, Pentagon officials on Monday played down the findings of the survey, which was conducted over the last two years by the Rand Corp., a nonprofit research organization funded by the Department of Defense.

"This is not a Eureka," said Dr. Sue Bailey, who is the assistant secretary of defense for health affairs.

Bailey and other officials said they accepted the report's findings but added that more studies were needed before a direct scientific link could be established. They also said the Pentagon would continue to keep PB in its arsenal of vaccinations and antidotes for troops who might face attacks with chemical and biological weapons, even though the survey's conclusions also raises questions about the drug's effectiveness against soman in humans.

The report, written by Dr. Beatrice Alexandra Golomb, is a 385-page review and is based on the findings of scores of medical studies on PB and its effects.

It cites recent studies that have linked the drug to side effects similar to those experienced by some veterans, including one by Hebrew University in Israel that associated PB with neurological disorders in mice and another by the University of Texas and Duke University that concluded that PB, when mixed with other chemicals, can cause nerve damage.

Golomb's report then goes on to suggest that the drug's short-term effects can become chronic as PB causes abnormal levels of a nerve-signaling chemical called acetylcholine. The chemical is involved in many important bodily functions, including sleep, muscular activity, memory and pain, which have all been cited as problems for ill veterans.

The report also says that research has shown that individual reactions to the drug depend on different factors, including stress, physiological differences and exposure to other agents, including pesticides, and even such benign things as nicotine and caffeine. That would explain why only some veterans have reported illnesses.

"One cannot rule out the possibility that long-term effects of PB might occur and might participate in the production of neuropsychological and other deficits reported by some" Gulf War veterans, Golomb concludes.

Scientists and veterans' advocates have long pointed to PB, as well as other experimental drugs given to troops in the Gulf, as one of the possible culprits in the still unexplained illnesses attributed to "Gulf War syndrome."

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