Statin-associated Cognitive Impairment
Several case reports described cognitive impairment associated with statin use. Medications implicated include simvastatin, atorvastatin, and rosuvastatin. Symptoms reported by patients in these case reports include short- and long-term memory loss, behavioral changes, impaired concentration and attention, paranoia, and anxiety. Symptoms were noted as early as 5 days after initiation of statin therapy; however, in 1 case, symptoms did not occur until after 9 months of therapy. In all cases the offending drugs were discontinued and patients experienced full recovery of cognition, with recovery times varying from a few days to 4 weeks after drug discontinuation.
An analysis of the MedWatch drug surveillance system of the Food and Drug Administration (FDA) over a 5-year period revealed 60 reports of memory loss associated with statins. The majority of reported cases involved simvastatin (36 cases) or atorvastatin (23 cases); 1 case involved pravastatin. Reported symptoms included short-term memory loss, amnesia, or unspecified memory loss. Symptoms developed within 2 months of therapy for approximately half the cases. Thirty-three cases had documented statin discontinuation and, of these, 14 patients had resolution or improvement in memory. Four reports of rechallenge with the same statin were documented, and all 4 resulted in reappearance of memory loss. No formal neuropsychological testing was conducted in any of the reported cases.
Case Reports and Series
Several case reports described cognitive impairment associated with statin use. Medications implicated include simvastatin, atorvastatin, and rosuvastatin. Symptoms reported by patients in these case reports include short- and long-term memory loss, behavioral changes, impaired concentration and attention, paranoia, and anxiety. Symptoms were noted as early as 5 days after initiation of statin therapy; however, in 1 case, symptoms did not occur until after 9 months of therapy. In all cases the offending drugs were discontinued and patients experienced full recovery of cognition, with recovery times varying from a few days to 4 weeks after drug discontinuation.
An analysis of the MedWatch drug surveillance system of the Food and Drug Administration (FDA) over a 5-year period revealed 60 reports of memory loss associated with statins. The majority of reported cases involved simvastatin (36 cases) or atorvastatin (23 cases); 1 case involved pravastatin. Reported symptoms included short-term memory loss, amnesia, or unspecified memory loss. Symptoms developed within 2 months of therapy for approximately half the cases. Thirty-three cases had documented statin discontinuation and, of these, 14 patients had resolution or improvement in memory. Four reports of rechallenge with the same statin were documented, and all 4 resulted in reappearance of memory loss. No formal neuropsychological testing was conducted in any of the reported cases.
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