Monday Aug 11, 2014(foodconsumer.org) -- In a new report published in CNS Drugs, scientists at Tuscan Regional Centre of Pharmacovigilance, Florence, Italy remind the public that statins can cause many adverse effects including neuropsychiatric adverse effects.

Statins, or 3-hydroxy-3-methyl-glutaryl coenzyme A reductase inhibitors include atorvastatin, fluvastatin, lovastatin, pravastatin, pitavastatin,  rosuvastatin and simvastatin.  They are often used as cholesterol-lowering drugs in clinical practice to prevent coronary artery disease because high cholesterol is associated with high risk of heart disease. 

According to the report, these drugs are generally well tolerated and rarely cause severe adverse effects.   However, over the years, case reports registered to national registries of spontaneous adverse drug reaction reports have shown that statin treatment is associated with the occurrence of neuropsychiatric reactions.

The neuropsychiatric adverse effects associated with statin use include "behavioral alterations (severe irritability, homicidal impulses, threats to others, road rage, depression and violence, paranoia, alienation, antisocial behavior); cognitive and memory impairments; sleep disturbance (frequent awakenings, shorter sleep duration, early morning awakenings, nightmares, sleepwalking, night terrors); and sexual dysfunction (impotence and decreased libido)," the report claims.

It remains largely unknown how statins could induce such neuropsychiatric adverse events in sensitive patients.  But a few mechanisms explain that statins trigger the occurrence of neuropsychiatric events by inhibiting cholesterol biosynthesis, which is actually important for the central nervous system.

The report suggests a few things that can be done to prevent and manage such adverse effects including discontinuation of statin use, and induction of  dietary restriction, close monitoring, switching to another statin, dose reduction, and supplementation of omega-3 fatty acids and treatment with psychotropic drugs.

Studies have suggested that statins which are effective in lowering cholesterol are not cost-effective in preventing heart disease in individuals who have had no prior heart condition.

A person's diet can affect his serum level of cholesterol.  A vegan diet or plant-based diet is associated with lower risk of heart disease regardless of the cholesterol status.  (David Liu)

Tuccori M, Montagnani S, Mantarro S, Capogrosso-Sansone A, Ruggiero E, Saporiti A, Antonioli L, Fornai M, Blandizzi C., Neuropsychiatric adverse events associated with statins: epidemiology, pathophysiology, prevention and management.  CNS Drugs. 2014 Mar;28(3):249-72.