Do Statins Damage Mental Health?

I just read a new report. It turns out that drugs that lower cholesterol, including statins, damage memory.

The article appears in JAMA, the Journal of the American Medical Association. The lead author is Brian Strom.|
http://www.ncbi.nlm.nih.gov/pubmed/26054031

The findings are fairly straightforward: If you take any drug, statins or non-statins, for lowering cholesterol, your memory will suffer. This is significant and alarming. Memory problems worry us old fogies, and even if they don’t mean that we are developing Alzheimer’s, they are very distracting and upsetting. They can trigger depression and anxiety states, depending on how we view the memory lapses.

The article itself is behind a paywall. Here’s how you get a reprint: Brian L. Strom, MD, MPH, Rutgers Biomedical and Health Sciences, Rutgers University, 65 Bergen St, Ste 1535, Newark, NJ 07103 chancellor@rbhs.rutgers.edu

We already know that benzodiazepines will damage memory, and we also know that use of benzos in older people is a risk factor for developing Alzheimer’s. Is it the drug, or is it the underlying anxiety that triggers dementia? I don’t know. I used to know but I forgot. OK, that is a cheap joke.

But The BMJ (formerly, British Medical Journal) published an editorial in 2014 warning of the trend toward Alzheimer’s in patients taking benzodiazepines, especially the long-acting versions. The fact that the type of drug influences how likely Alzheimer’s becomes, makes me think that perhaps it is in fact the drug, and not the underlying anxiety, that drives the dementia. The BMJ is open, no paywalls, so you can read the article from their website.

http://press.psprings.co.uk/bmj/september/benzodiazepineedit.pdf

(Read it yourself and decide.)

So benzos, that do acutely influence / damage memory, also trigger Alzheimer’s. Could statins do the same? Fortunately there are studies suggesting that perhaps statins reduce the risk of dementia. I am somewhat less concerned, although memory problems always do concern me. At least we seem to dodge the dementia bullet if we take statins. Do they

But the statins aren’t out of the woods yet. We also know for sure that statins raise the risk of several other emotional disorders. In 2010, the online version of Psychiatric Times published a review article by Arlene Kaplan. We learn from that statins do raise the risk of both anxiety and depression, and fairly substantially.

Kaplan reports: ““It has long been reported that total serum cholesterol levels are consistently lower in more severely depressed and more aggressive patients,” said James Lake, MD, chair of the APA’s Caucus on Complementary and Integrative Medicine, and visiting assistant professor of medicine at the Center for Integrative Medicine at the University of Arizona School of Medicine in Tucson. “Because of these findings, it has been suggested that total cholesterol might be a clinically useful biological marker for predicting the risk of suicide and that it may be of prognostic value in managing severely depressed patients.” – See more at: http://www.psychiatrictimes.com/mood-disorders/statins-cholesterol-depletion%E2%80%94and-mood-disorders-what%E2%80%99s-link#sthash.gyDMx4xb.dpuf”

http://www.psychiatrictimes.com/mood-disorders/statins-cholesterol-depletion%E2%80%94and-mood-disorders-what%E2%80%99s-link

The surprising implication is that low cholesterol may be a marker for suicidality.

The bottom line is that both depression / irritability and anxiety are raised by statins, likely because the statins interfere with serotonin.

Are we in mental health asking about statins as a factor in irritability, depression, and anxiety? I doubt it. I know I haven’t been, and likely many in the shrink community don’t.

Finally, what if you have high cholesterol and are taking statins? We need always to consult with our MDs, but frankly, many MDs are far too loyal to statins and don’t want to consider the low-hanging lifestyle change fruit. Statins are a huge money maker for the pharmaceutical houses, and there are equally huge budgets for promoting them to the MDs. Consider a second opinion, ideally from someone in a teaching hospital or at a medical school. There is a lot of evidence that statins are not terribly helpful drugs, and likely they do not reduce total all-cause deaths. They can reduce heart attack risk, but they raise risk of other problems, so some MDs consider it a wash.

For example, in a recent meta-analysis, reviewing the researcher up to date, the authors said:

“There is a categorical lack of clinical evidence to support the use of statin therapy in primary prevention. Not only is there a dearth of evidence for primary cardiovascular protection, there is ample evidence to show that statins actually augment cardiovascular risk in women, patients with Diabetes Mellitus and in the young. Furthermore statins are associated with triple the risk of coronary artery and aortic artery calcification. Cardiovascular primary prevention and regeneration programmes, through life style changes and abstaining from tobacco use have enhanced clinical efficacy and quality of life over any pharmaceutical or other conventional intervention.”

http://www.scirp.org/journal/PaperInformation.aspx?PaperID=34065

S. Sultan and N. Hynes, “The Ugly Side of Statins. Systemic Appraisal of the Contemporary Un-Known Unknowns,” Open Journal of Endocrine and Metabolic Diseases, Vol. 3 No. 3, 2013, pp. 179-185. doi:10.4236/ojemd.2013.33025.

When someone who has no history of heart disease is given a statin, it is for prevention, not so much treatment. The truth is that a drug is not an ideal primary prevention strategy. Lifestyle changes are what will work in prevention., as Sultan and Hynes say above. Which?

For instance:
– Quit smoking. There are many excellent pathways to a tobacco free life.
– Step up your exercise. Shoot for 150 minutes a week. Interval training likely does more good.
– Change your diet: Mediterranean / “rainbow” diet will boost the HDL (good cholesterol) and likely lower the bad. Eat only whole grains, high omega-3 foods such as grass-fed beef and wild caught salmon, mackerel, sardines, green leafy vegetables, and the like. There are eggs with high levels of omega-3.
– Especially in terms of diet, eliminate all sugar and simple carbs. Those raise the “bad” LDL. Eat oats. Lower your intake of white rice, potatoes, and bread.
– Junk food contains fats called “transfats” and they are extremely bad for your heart. Stop! No fast foods, convenience foods, packaged foods.
– Get some sun! Vitamin D can help in many ways.
– Sleep at least 7 hours a day.
– Cultivate happiness, optimism, and gratitude. Practice meditation.

Leave your opinion below. If you find this post thought-provoking, please share it. I hope this helps alert us to mental health factors that we might overlook.