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Losing Your Mind? It's not the Statins
There does not seem to be a day that I don't wake up in the morning and see some negative press regarding statins. Well yesterday was no exception when on Good Morning America, I once again heard that some "expert" said that statins make women lose their memory. It really is getting ridiculous. It would be nice to hear that statins have changed the face of Cardiovascular disease by reducing morbidity and mortality dramatically. Despite this, we still have a long way to go to eradicate Cardiovascular disease which still remains the number 1 killer of men and women in the United States.
I was planning to write on this topic next week, as I have been really busy seeing patients, but thought I needed to take the time to address the new comments. Like I have said before, the Statin Safety Task Force of the National Lipid Association also formed a Neurology Panel to look at the evidence based literature to assess the effects of statins on the Nervous System.
First of all, there is no evidence that statins are a common or significant cause of peripheral neuropathy. This is supported by the large randomized clinical trials including the Heart Protection Study (HPS) and the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). The HPS was the largest statin trial to date and included 20,536 participants who were followed over a 5 year period. It is always possible that a rare case of peripheral neuropathy could occur but this would most likely represent an idiosyncratic reaction which I talked about in a previous posting.
In regard to the question whether statins impair memory or cognition in some patients, the answer is that there is no evidence of a causal relation between impaired memory and/or cognitive dysfunction. Besides the HPS and PROSPER, two additional studies have specifically evaluated the effect of statin therapy on patients with Alzheimer's disease, a population group at risk for cognitive decline. In one of the trials, there was a statistically significant reduction in the rate of cognitive decline compared with placebo, suggesting a benefit for Atorvastatin in Alzheimer's disease. This is the exact opposite of what I heard this morning.
I think the best way to approach a patient with peripheral neuropathy or impaired cognition while on statins is to first undergo a thorough neurologic exam by a neurologist in an attempt to find a cause. If this is not possible, it is certainly appropriate to stop the statin to see what happens.
Due to the length of time it can take to resolve reversible peripheral neuropathy, the patient should remain off the statin for 6 months. For patients with impaired cognition they should wait about 3 months. If symptoms improve then it is certainly possible that a presumptive diagnosis of being caused by statins can be made.
One might want to consider a different statin, as the benefits of statins in reducing Cardiovascular Morbidity and Mortality have been proven. If the neurologic symptoms do not improve, the problem may be categorized as unrelated to the statin and therapy may want to be restarted based on a risk-benefit analysis.
One must remember that many other causes of impaired cognition and/or peripheral neuropathy in patients taking statins may exist. These include Vascular disease, Diabetes Mellitus, and advancing age. I feel confident in saying that statins do not make women lose their memory.
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Technorati Tags: statins, cognitive impairment, heart disease
I was planning to write on this topic next week, as I have been really busy seeing patients, but thought I needed to take the time to address the new comments. Like I have said before, the Statin Safety Task Force of the National Lipid Association also formed a Neurology Panel to look at the evidence based literature to assess the effects of statins on the Nervous System.
First of all, there is no evidence that statins are a common or significant cause of peripheral neuropathy. This is supported by the large randomized clinical trials including the Heart Protection Study (HPS) and the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER). The HPS was the largest statin trial to date and included 20,536 participants who were followed over a 5 year period. It is always possible that a rare case of peripheral neuropathy could occur but this would most likely represent an idiosyncratic reaction which I talked about in a previous posting.
In regard to the question whether statins impair memory or cognition in some patients, the answer is that there is no evidence of a causal relation between impaired memory and/or cognitive dysfunction. Besides the HPS and PROSPER, two additional studies have specifically evaluated the effect of statin therapy on patients with Alzheimer's disease, a population group at risk for cognitive decline. In one of the trials, there was a statistically significant reduction in the rate of cognitive decline compared with placebo, suggesting a benefit for Atorvastatin in Alzheimer's disease. This is the exact opposite of what I heard this morning.
I think the best way to approach a patient with peripheral neuropathy or impaired cognition while on statins is to first undergo a thorough neurologic exam by a neurologist in an attempt to find a cause. If this is not possible, it is certainly appropriate to stop the statin to see what happens.
Due to the length of time it can take to resolve reversible peripheral neuropathy, the patient should remain off the statin for 6 months. For patients with impaired cognition they should wait about 3 months. If symptoms improve then it is certainly possible that a presumptive diagnosis of being caused by statins can be made.
One might want to consider a different statin, as the benefits of statins in reducing Cardiovascular Morbidity and Mortality have been proven. If the neurologic symptoms do not improve, the problem may be categorized as unrelated to the statin and therapy may want to be restarted based on a risk-benefit analysis.
One must remember that many other causes of impaired cognition and/or peripheral neuropathy in patients taking statins may exist. These include Vascular disease, Diabetes Mellitus, and advancing age. I feel confident in saying that statins do not make women lose their memory.
Related Topics:
Technorati Tags: statins, cognitive impairment, heart disease
20 Comments:
I have diabetes T2 and SO MANY folks are trying to convince me that statins are bad, but I've decided not to listen to them, because cholesterol is deadly to our system and that's a proven thing.
There may be some folks who react to statins, but until the medical researchers prefect the genetic testing for folks to KNOW how a certain person will respond to their medication regiment, taking statins or not, will be an individual decision, hopefully made WITH their doctor's input.
i know that diabetes now can treat so dont worry.
Although statins are well tolerated by most people, they do have side effects, some of which may go away as your body adjusts to the medication.
Well...I was put on Lipitor 10mg back in 2004 and that's when my problems began with leg and feet pain. Add some joint aches and concentration annoyances to that mix, too. I was switched to Zocor 20mg a year ago, since my insurance would no longer cover the price of the Lipitor. To make a long story short, after 4 years on a statin, I decided to follow my intuition. I discontinued my statin in February. It is now March 21,2008 and my pain is almost completely gone. I still have some residue from the damage that was done to my legs and feet. I'm hoping, in the months to come, I'll have no need for the pain meds either. Had I known that statins had this side effect, I would never have begun taking them. Needless to say, my faith in doctors has been near destroyed. Patient beware.
As someone who has experienced memory loss while on a statin, I find it disheartening that my own doctor did not believe it was happening to me. My wife noticed the differences in me, and my ability to perform my day to day tasks was impaired.
Approximatley 2 -3 months after quitting my statin, my ability to function returned to its pre-statin level. It is disappointing to me that this side effect seems to be so casually dismissed.
Even the drug makers themselves say there are serious side effects to statins, and although they say they are rare, in my experience, I don't find them rare at all! My doctor tried to put me on statins twice--trying several different kinds when my liver enzymes went up. He made me quit when they didn't go back down, and then a couple of years later tried again. This time I was on lipitor for only four months. My liver enzymes were elevated 10 to 15 times higher than what they had been when I started, and suddenly I had no muscle strength in my arms and legs. I couldn't climb into my car or pick up my grandchildren. I was only 57! I have been off of these statins for almost a year now, have taken vitamin supplements, exercised and walked almost every day, but cannot seem to get my muscles back! Are they gone for good?? What did these statins do to them that I can't get them back. I have always been a very active, strong person. I am really angry that I was given this drug. You can never convince me that statins don't have serious side effects. Every time I see someone shuffleing their feet when walking, walking with a cane, complaining that they have no strength in their legs, I ask them if they are on statins, and every one of them is! Don't tell me that the side effects are rare! I think sooner or later everyone that takes statins is going to have side effects. I only wish I could convince them to stop before they end up like me!
I witnessed two pwople lose their memory on statins. My father and a close friend. The dry weight of the cerebral cortex is 50% cholesterol. The human brain relies on about 20% of the body's cholesterol to function properly. Trans Global Amnesia is a recorded side effect in some individuals taking statins. The biological explaination is clear. The medical case history exist. I would suggest Dr. Richman dust off his high school biology books and begin reading.
"There is no evidence of statins inducing neuropathy?" Dr. Richman, that statement is 100% false. I would suggest you research it in the national library of medicine (PubMed) and study publications from neurology journals. The evidence is overwhelming with many confirmed case history reports. Young man, If you worked for me, I would have to let you go.
In 2002 I was taking 10 mg Lipitor with no side effects but no real reduction in cholesterol numbers. Doctor upped dose to 20 mg, soon started to get some aches and pains in lower back, buttocks and thighs. I stopped the Lipitor. About 9 months later doctor said lets try Crestor which had just been cleared for marketing in Canada. Like an idiot I agreed. After 5 weeks enormous sciatic type pain, 2 crutches need to move for 3 weeks, then walking stick for 4 months. 5 years later I still have a slightly numb left foot and a dropped arch. No physical reason for sciatica. Nerve sheathing, myelin, impacted, neurology in other words.
I disagree with Dr. Richman's statement that there is "no evidence of statins causing memory problems"
There is significant eveidence of statin induced cognitive impairment along with a history of lipitor inducing TGA ( amnesia) The complaint of memory problems with statin usage is rampant.
For those of you interested in hearing from a physician who suffered amnesia from lipitor, go to spacedoc.net
I am a new patient that was put on Crestor.
After only 5 weeks my doctor abruptly took me off the medication after blood work and told me that it had "given me gallstones". He says he did not take a baseline of my liver function and that my liver is now not working correctly.
He has now sent me to a GI doctor.
Please advise....can Crestor cause such serious side effects in such a short time?
Is this common?
I am a 71 year old male with some high BP and cholesterol a little high...My doc put me on Lipitor which changed my personality, than switched to Zocor 20mg about two months ago. I am very active, a strong walker and an outdoors kind of person. Suddenly I can hardly walk with both legs just giving up. Not enough strength to get around without wobbling, hobbling, and holding on. The doc says my muscle enzymes are elevated. I quit taking zocor two weeks ago and still suffer with no muscle strength in my legs and sore lower back. I am blaming the zocor.
I'm border line diabetic, with high cholesterol, not because of diet or lack of excercise. I'm 62, I've been taking Lipitor for maybe 4 years. My feet are killing me, I've gone to a podiatrist and had cortizone shots in both which eleviated the shooting pains. Now they just hurt, I have a appointment with my Dr. and I stopped taking the lipitor today. I can't believe that a drug that is suppose to help is the cause so much pain. I'm going to go the natural root to reduce my cholesterol. Also I take previcid for acid reflux my next research will be on that drug to see if it is also causing the foot pain and increased flatulence.
I am a 67 yr old female. I walk everyday. Started Lipitor for 3 mo and started feeling bad with muscle aches and went off of it. 1 year ago started 40 mg Zocor. My vision started getting blurry after about a year. I have been to (2) eye doctors and they find my regular perscription fine. My body aches like flu symptons. 3 weeks ago I went off Zocor and am wondering how long it will be before I notice a change. ANYONE OUT THERE KNOW?????? Please Advise
I'm a 59 yo physician treated with Lipitor for several years. I had increased muscle spasms in my feet but continued taking the medication. I later developed numbness in the toes of both feet. After researching this I stopped the Lipitor and had substantial but incomplete improvement within 1 month. 8 months later the neuropathy is continuing to slowly improve but is not gone. No diabetes, no vascular problems, B12 OK, TSH OK. No other systemic meds.
No evidience that Lipitor can cause Neuropathy? Then my doctor must not know what she's doing. I started Lipitor in January 2009. Within few months I began to experience increasing pain in my feet and legs, with accompanying nightly insomnia. My doctor stopped the Lipitor, and viola the pain has all but gone. My doctor has informed me that Lipitor can cause Neurapathy as a side effect.
The title "Losing Your Mind, It's not the Statins" is an awful, condescending title. I have firsthand experience with drug side effects being disregarded by doctors who think they have learned all they need to know in medical school. Doctors have learned about drug dispensing from drug companies. Having worked for drug companies, I must say there are, of course, many great studies being done by them, and many honorable individuals who work hard to make sure that data is accurate. However, the general thrust behind any drug company endeavor is to SELL the drug. So they are very happy when a drug makes it to market. BUT, there is absolutely no way that it is possible to know how safe a drug is until the mass market starts taking it. Post-marketing studies are the most important ones. Any knowledgeable drug marketer will tell you this, and any ethical FDA regulator will tell you this as well. The FDA takes heed when consumers file adverse events, and doctors should be encouraging their patients to be concerned about adverse events. For this doctor to actually advise patients to be unconcerned about side effects that are possibly related to a very strong drug, is unethical. Condescending, unethical, and suspicious. Maybe he works for a drug company. Or needs their advertising dollars. Crestor is a very new drug...be careful.
As a professional woman in her 50s and I was put on a statin and within months my short term memory became so poor I could barely hold a conversation as I had increasing trouble remembering what words I wanted to say. I thought I was getting alzheimers. A doctor I work with asked if I was taking a statin and advised me of the side effect which I confirmed from many web sites. I've been off the statin for only two months and the difference is enormous. I still occasionally can't remember a word but am able to do my job effectively once again. There is definitely a correlation to statin and short term memory loss.
Interesting posts. I was not aware that statins could be directly related to peripheral neuropathy symptoms. I am a 55 yr old male who has been taking generic Zocor for several years as prescribed by my MD to control cholesterol levels. I have had a progressive feeling of numbness, tingling and burning pain in both feet that started with the toes. It's now progressed to the balls and into the arches and the top past the toes. I have also had cramping in the arches and the calf muscles. I never associated this with my satin drug, but I will try a short withdrawal experiment to see what happens.
I have gone through all the neurological tests at a specialist for nerve conduction, damage, etc, and no problems could be found. I am not diabetic and blood sugar counts are within range.
I'm a 57 y/o female who was prescribed a statin for high cholesterol. After several months, I could not remember common nouns. I was very concerned that I might be having Alztheimer's symptoms. I then began to think about what medications had changed recently. My cholesterol medicine! I Googled Statin and found that one of the side-effects was memory loss.
I reported this to my doctor on my next visit and we agreed to discontinue it, especially when I told him I couldn't remember the name of that thing around his neck (stethoscope). Best decision we ever made. I have now gone vegetarian and take Niacin for my cholesterol. AND, my memory has returned.
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