Statins and Mental Health

Dr. Weeks Comment: Here we have an article published yesterday with a very perilous conclusion. This article describes an association between statins and improved mental health.  But they don’t say WHY that association exists.  So let’s unpack this (I hate the phrase) – rather, let’s examine this study.  Do statins help people with mental health issues?  YES.  But the reason they do has NOTHING to do with lowering cholesterol.  They help people with mental health challenges for one reason:  statins are weak anti-inflammatory agents.  That is a good thing.

As my reader know, all mental illnesses are made worse by inflammation.

But what the article does NOT reveal are two important things:

1) the negative effects of statin drugs is far greater than its anti-inflammatory benefits, (including dementia,   muscle pain   fatigue  etc.

and  2) there are many more powerful anti-inflammatory agents which have NO negative side-effects.

Therefore:  don’t give toxic statins to mental health patients because the negative are far greater than the positives and there are many more beneficial anti-inflammatory agents available aside from statins.

 

Association of Hydroxylmethyl Glutaryl Coenzyme A Reductase Inhibitors, L-Type Calcium Channel Antagonists, and Biguanides With Rates of Psychiatric Hospitalization and Self-Harm in Individuals With Serious Mental Illness

JAMA Psychiatry. Published online January 9, 2019. doi:10.1001/jamapsychiatry.2018.3907

Question  Are drugs in common use for physical health problems (hydroxylmethyl glutaryl coenzyme A reductase inhibitors, L-type calcium channel antagonists, and biguanides) associated with reduced rates of psychiatric hospitalization and self-harm in individuals with serious mental illness?

Findings  In this series of within-individual cohort studies of 142 691 patients with bipolar disorder, schizophrenia, or nonaffective psychosis, exposure to any of the study drugs was associated with reduced rates of psychiatric hospitalizaiton compared with unexposed periods. Self-harm was reduced in patients with bipolar disorder and schizophrenia during exposure to all study drugs and in patients with nonaffective psychosis taking L-type calcium channel antagonists.

Meaning  Hydroxylmethyl glutaryl coenzyme A reductase inhibitors, L-type calcium channel antagonists, and biguanides hold potential as repurposed agents in serious mental illness, and the central nervous system mechanism of action of these drugs requires further investigation.

Abstract

Importance  Drug repurposing is potentially cost-effective, low risk, and necessary in psychiatric drug development. The availability of large, routine data sets provides the opportunity to evaluate the potential for currently used medication to benefit people with serious mental illness (SMI).

Objective  To determine whether hydroxylmethyl glutaryl coenzyme A reductase inhibitors (HMG-CoA RIs), L-type calcium channel (LTCC) antagonists, and biguanides are associated with reduced psychiatric hospitalization and self-harm in individuals with SMI.

Design, Setting, and Participants  These within-individual cohort studies of patients with SMI compared rates of psychiatric hospitalization and self-harm during periods of exposure and nonexposure to the study drugs, with adjusting for a number of time-varying covariates. Participants included 142 691 individuals from the entire population of Sweden with a diagnosis of bipolar disorder (BPD), schizophrenia, or nonaffective psychosis (NAP) who were 15 years or older and who were treated with psychiatric medication from October 1, 2005, through December 31, 2016. Data were analyzed from April 1 through August 31, 2018.

Interventions  Treatment with HMG-CoA RIs, LTCC antagonists, or biguanides.

Main Outcomes and Measures  Psychiatric hospitalizations and self-harm admissions.

Conclusions and Relevance  This study provides additional evidence that exposure to HMG-CoA RIs, LTCC antagonists, and biguanides might lead to improved outcomes for individuals with SMI. Given the well-known adverse event profiles of these agents, they should be further investigated as repurposed agents for psychiatric symptoms.

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Dr. Weeks Comment: Here we have an article published yesterday with a very perilous conclusion. This article describes an association between statins and improved mental health.  But they don’t say WHY that association exists.  So let’s unpack this (I hate the phrase) – rather, let’s examine this study.  Do statins help people with mental health…
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