Statins can impair brain functioning

This paper was published in the Journal of Korean Medical Science 2012 Apr;27(4):458-9

 

Study title and authors:

Reversible dysphasia and statins.

Davies GR.

Department of Psychiatry, University of Wollongong, New South Wales, Australia. alienist@ihug.com.au

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22468114

Dysphasia is a partial or complete impairment of the ability to communicate resulting from brain injury.

This paper, authored by Dr Gordon Davies, presents a case of reversible dysphasia occurring in a patient prescribed atorvastatin.

(i) A 58-year-old woman was presented for medicolegal examination with regard to a compensation claim involving allegations of harassment at work producing anxiety and depression. At the time of her initial presentation for treatment her general practitioner had noted that her blood pressure was higher than usual and had prescribed the statin Lipitor (atorvastatin) 10 mg per day together with indapamide 2.5 mg per day.
(ii) A few days later the patient reported that she had developed problems in "word finding" in that her speech would be interrupted because she would be unable to find a word to describe an object.
(iii) The patient ceased the Lipitor and said that her symptoms had resolved quite quickly.
(iv) The patient then commenced on Crestor (rosuvastatin) 5 mg daily while continuing on indapamide and four weeks later at her medico-legal assessment she was noted to have clear but intermittent difficulty in word finding. She was also tense and tearful at times.
(v) She was reviewed two weeks later. At this point she had stopped the rosuvastatin and her speech was fluent and clear. She was continuing to take indapamide 2.5 mg per day.

This case highlights the possibility that statins can impair brain functioning. Dr Davies concludes: "The immediate inference from the above observations is that the patient had developed dysphasia as a direct side effect of the use of simvastatin. That this is likely to have been a generic statin effect is supported by the recurrence of milder symptoms on rosuvastatin and their remission on its cessation. Using the method of attribution recommended by Naranjo and colleagues, see here, it would rate at 9 (definite adverse reaction)".

Clinicians should be aware of possible adverse cognitive reactions during statin therapy

This paper was published in Pharmacotherapy 2006 Aug;26(8):1190-2

 

Study title and authors:

Short-term memory loss associated with rosuvastatin.

Galatti L, Polimeni G, Salvo F, Romani M, Sessa A, Spina E.

Department of Clinical and Experimental Medicine and Pharmacology, Section of Pharmacology, University of Messina, Messina, Italy. lgalatti@unime.it

 

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16863497

This paper reports the case of rosuvastatin-related short-term memory loss.

(i) A 53-year-old man experienced memory loss after being treated with rosuvastatin at 10 mg per day.
(ii) After discontinuation of rosuvastatin, the neuropsychiatric adverse reaction resolved gradually, suggesting a probable drug association.
(iii) During the following year, the patient remained free from neuropsychiatric disturbances.

The lead researcher of the paper, Dr Laura Galatti, concludes that clinicians should be aware of possible adverse cognitive reactions during statin therapy.

Statins induce a decline in cognition

This paper was published in the Annals of Pharmacotherapy 2006 Oct;40(10):1880-3

Study title and authors:
Simvastatin-induced decline in cognition.

Padala KP, Padala PR, Potter JF.
Geriatrics Section, Department of Internal Medicine, 981320 Nebraska Medical Center, Omaha, NE 68198-1320, USA. kpadala@unmc.edu

This paper can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/16940411

This paper describes a case of new-onset cognitive difficulties in an older patient after initiation of simvastatin therapy.

(i) A 64-year-old man developed cognitive difficulties (short-term memory loss, long-term memory loss, and item misplacement) within one week after starting simvastatin 40 mg/day.
(ii) Simvastatin was discontinued, and the patient's cognition improved to normal within six weeks.
(iii) He again tried simvastatin, this time at half the original dose and his cognition deteriorated over a two week period.
(iv) Simvastatin was stopped, and his normal cognition returned within four weeks.

This case shows that statins can induce a decline in cognition.

Statins may adversely affect cognition in patients with dementia

This study was published in the American Journal of Geriatric Pharmacotherapy 2012 Aug 22

Study title and authors:
The Effect of HMG: CoA Reductase Inhibitors on Cognition in Patients With Alzheimer's Dementia: A Prospective Withdrawal and Rechallenge Pilot Study.

Padala KP, Padala PR, McNeilly DP, Geske JA, Sullivan DH, Potter JF.
Geriatric Research Education and Clinical Center, Central Arkansas Veterans Health Administration System, Little Rock, Arkansas; Reynolds Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22921881

The aim of this study was to evaluate the impact statins have on cognition. The study included 18 older subjects with Alzheimer's dementia who were on statin therapy who underwent a 6-week withdrawal phase of statins followed by a 6-week rechallenge with the drug. The primary outcome measure was cognition, measured by the Mini-Mental State Examination (MMSE).

The mini–mental state examination (MMSE) or Folstein test is a brief 30-point questionnaire test that is used to screen for cognitive impairment. It is commonly used in medicine to screen for dementia. Any score greater than or equal to 25 points (out of 30) indicates a normal cognition. Below this, scores can indicate severe (less than 9 points), moderate (10-20 points) or mild (21-24 points) cognitive impairment.

The study found:
(a) The subjects had an improvement in MMSE scores with discontinuation of statins and a decrease in MMSE scores after rechallenge.
(b) Cholesterol levels increased with statin discontinuation and decreased with rechallenge.

The head investigator of the study, Dr Kalpana P. Padala from the University of Arkansas, concluded that: "The study found an improvement in cognition with discontinuation of statins and worsening with rechallenge. Statins may adversely affect cognition in patients with dementia".