Statin safe in neuropsychiatric disorders

Statin use is associated with a significant reduction in risk of depressive disorders, with no increase in risk of suicidal outcomes (suicidal attempts and deaths from suicide), anxiety disorders and seizures, results of a recent Swedish population-based cohort study have shown.

In the study, data of 1149,384 individuals (male, 54.4 percent; age ≥50 years, 88.4 percent) with dispensed statin (simvastatin, 87.6 percent) prescriptions between 1 January 2006 and 31 December 2013 were extracted from the Swedish Prescribed Drug Register and linked with records of unplanned (emergency) hospital visits or specialized outpatient care for suicidal behaviour (including deaths from suicide), depressive disorders, anxiety disorders, and seizures available from the Swedish Patient Register and Cause of Death Register. [Lancet Psychiatry 2020;7:982-990]

The study consisted of 2,053,310 and 2,997,545 non-treatment and treatment periods, respectively, with 83.3 percent of patients having ≥1 medication status change (ie, from on statins to off statins, or vice versa).

Suicidal outcomes, depressive disorders, anxiety disorder and seizures were present in 0.6 percent, 2.1 percent, 2.6 percent and 2.5 percent of individuals, respectively.

Periods of statin treatment were associated with a significant reduction in rate of depressive disorders (hazard ratio [HR], 0.91; 95 percent confidence interval [CI], 0.87 to 0.94). No significant association was found between periods of statin treatment and suicidal outcomes (HR, 0.99; 95 Cl, 0.90 to 1.08), anxiety disorder (HR, 0.99; 95 percent Cl, 0.95 to 1.02), or seizures (HR, 1.00; 95 percent Cl, 0.97 to 1.04).

A similar magnitude of association between statin and depressive disorders was observed in sensitivity analyses, with an HR of 0.91 after adjustment for concurrent use of any antidepressant medication, including SSRI and non-SSRI treatment.

Compared with statin use, a numerical reduction in risk of depressive disorders was observed with use of thiazide diuretics (HR, 0.61; 95 percent CI, 0.38 to 1.00) and antihistamines (HR, 0.84; 95 percent CI, 0.67 to 1.06).

“Our study’s findings suggest that statin treatment is a safe therapeutic option with regards to some neuropsychiatric outcomes. Whether the observed association between statin use and reduced diagnoses of clinical depression is confounded by nonspecific benefits related to being prescribed medication needs further research,” concluded the researchers.