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Statins Appear to Have Favorable Impact on Psychological Conditions: Presented at ACC

By Ed Susman

CHICAGO, IL -- April 2, 2003 -- Elderly patients with coronary disease who take statins over the long term also appear to show improvements in psychological disorders.

Researchers found that, on the basis of the Kellner Symptom Questionnaire, patients who were continually taking statins continued to show improvement in scores reflecting depression, anxiety, and hostility over 7 years of follow-up.

"We can't really explain why this is happening," said Charles Blatt, MD, assistant clinical professor of medicine at Harvard Medical School, Boston, Massachusetts, "but the longer people are on the statins, the more their symptoms of depression, anxiety, and hostility decrease." When people stop taking statins or cannot tolerate the medicine, their depression, anxiety, and hostility return to prestatin levels.

In a press briefing here on April 1^st at the Annual Scientific Session of the American College of Cardiology, Dr. Blatt said that it appeared the improvement in psychological state is an additional effect of statins. "Statins are known to provide a range of beneficial effects beyond coronary artery disease," he said. "They have been found to reduce the risk of stroke, macular degeneration, osteoporosis, and possibly dementia."

The researchers examined the health records of 606 elderly patients with heart disease. One hundred and forty patients had continuous statin use; 219 had intermittent use of the agent and 231 were not on the drugs. About 80% of the patients in the study were men, and their average age at the start of the study was 67.

Dr. Blatt showed that the psychological score began dropping during the first year of therapy and progressively decreased over the course of treatment, while patients not taking the drugs had no change in their psychology.

"This is a very interesting report," said Richard Pasternak, MD, associate professor of medicine at Harvard. We know that statins work to lower cholesterol and prevent heart disease. But, sometimes statins work in ways that are unexpected." Whether statins have psychological impact, however, is still not proven, Dr. Pasternak said. "In this study, there are a host of confounders," he said, including the question of whether the patients feel better because the statins reduce chest pain and hospitalizations -- making the patients less depressed, anxious, and hostile -- or because there is something intrinsic about what statins do.

Dr. Pasternak said that enough studies on statins have been performed over the past 2 decades so that the information about psychological well-being may be already in the records of patients. "These are provocative findings that will lead others to look back at their results," he said.

Dr. Blatt said he did observe that statins that are water soluble failed to show an effect on psychological status, while statins that are fat soluble did show positive effects. Fat-soluble statins may be able to cross the "blood brain barrier" to provide that impact on the brain, he pointed out.


[Study title: Long-Term Statin Use and Psychological Well-Being in the Elderly. Abstract: 1040-82]

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