If fuzzy thinking or misplaced car keys slipped into your life along with a statin, there are ways to determine whether this useful heart drug or some other factor is to blame.
Who is at Risk?
There are hints that women may be more likely to develop memory problems from statins than men, but there is little scientific evidence to confirm it. Among the statins, the fat-soluble types -- simvastatin, lovastatin, atorvastatin, and fluvastatin -- may be slightly more likely to cause thinking problems than the water-soluble drugs -- pravastatin and rosuvastatin.
How Often Do Statins Cause Memory Loss?
A review of doctors' case reports to the FDA turned up only 60 patients with memory problems from 1997 to 2002, a time when statins were widely used. "So many people have used these drugs and they've been so heavily investigated in the early 1980s and 1990s, that if there is a problem, it's probably very rare," said Alan Daugherty, PhD, director of cardiovascular research at the University of Kentucky.
But looking only at case reports to the FDA could miss some problems. Doctors may chalk up a patient's forgetfulness to advancing age, instead of their new cholesterol medicine, so they don't send an "adverse event" report back to the drug-monitoring agency. A closer evaluation of how statins affect memory and mood is underway at the University of California at San Diego and may soon provide a better picture or scope of the problem.
Symptoms and Solutions
It's hard to measure mild cognitive impairment and discuss it clearly with a doctor, but a few warning signs to look for include:
- Difficulty finding the right words
- Trouble following conversation
- Trouble carrying out complex tasks like cooking
If these problems have increased for you or a loved one since starting a statin, bring it up with the doctor who will try to rule out other possible causes.
Changes in sleep cycles, other illnesses, menopause and beta-blockers are common reasons for memory lapses. "Memory loss and feeling bad are two different things," notes Joseph Miller, MD, clinical director of heart health at Piedmont Hospital in Atlanta. "It's very important to be specific. We're just now learning more about how genes affect your response to drugs."
Your doctor may suggest that you stop taking the drug for a while to see if your memory and attention improve. "It takes 1 to 2 weeks to wash [the drugs] out of the system, then 2 weeks to notice a difference in symptoms," explained Miller. If symptoms return when you go back on the drug -- called a re-challenge -- it may be time to switch to a different statin.
The six statins each work a little differently, and patients may have quirky, idiosyncratic reactions to just one drug in the class. Some patients have told Miller they felt awful on one brand, but do fine once he switches them to another.
Statin Risks and Benefits
Some individuals do develop troublesome side effects from statins, but overall statins are very safe, according to Miller, and their benefits far outweigh their risks. They can prevent heart attacks, strokes and help people with heart disease live longer.
New clues about a possible statin-brain benefit come from study results published in the July 2008 issue of Neurology. Researchers found that taking statins cut the risk of developing dementia in half among people at high risk for the condition.
Considering the proven and emerging health benefits of statins, people who suspect that their prescription is causing memory loss should not simply quit taking the medication on a hunch. Work with your doctor to find the true cause of any memory problems and keep both your heart and your mind healthy.
Cramer, C., M.N. Haan . "Use of Statins and Incidence of Dementia and Cognitive Impairment Without Dementia in a Cohort Study." Neurology 71:5(2008):344-50. <http://www.ncbi.nlm.nih.gov/pubmed/18663180>.
Daugherty, Alan, PhD. Personal interview. 20 Oct. 2008.
Miller, Joseph I., MD. Personal Interview. 22 Oct. 2008.
Rosenson, Robert S. "Lipid Lowering With Statins." uptodate.com. May 2008. UptoDate, Inc. 4 Nov. 2008. <http://www.uptodate.com/online/content/topic.do?topicKey=lipiddis/7436> (subscription).