The Lipitor patient information insert does not list cognitive issues among its side effects; however, anecdotal reports linking statins—like Lipitor—to mental problems go back years and some doctors are voicing concerns that in some patients, statins like Lipitor may help hearts but hurt minds. According to the vice chairman of medicine at New York Presbyterian Hospital, Dr. Orli Etingin, “This drug makes women stupid.”
Lipitor—generically called atorvastatin—is a statin, one of a group of drugs that lower cholesterol and certain fats in the blood by inhibiting a key enzyme that helps produce cholesterol. Etingin told of a typical patient in her 40s unable to concentrate or recall words. Tests found nothing wrong, but when the woman stopped taking Lipitor, the symptoms disappeared; when she resumed Lipitor, they returned. “We really need more studies, particularly about cognitive effects and women,” Etingin said.
Pfizer Inc.’s—Lipitor’s maker—says Lipitor’s safety and efficacy have been demonstrated in over 400 clinical trials and 145 million patient years of experience, that data “do not establish a casual link between Lipitor and memory loss.” Many cardiologists are also not concerned. Statins are widely credited with reducing heart attacks and strokes in people at high risk with 15 percent complaining of side effects; muscle aches and liver toxicity are the most common “The benefits far outweigh the risks,” said Antonio Gotto, dean of the Weill-Cornell Medical School and past president of the American Heart Association. Gotto, who consulted for most of the statin makers and been involved in many of the trials, said, “I would hate to see people frightened off taking statins because they think it’s going to cause memory loss.”
Still, anecdotal evidence linking statins to memory problems have been rampant for years. The chronology can be very telling, said Dr. Gayatri Devi, associate professor of neurology and psychiatry at NYU School of Medicine, who said she’s seen at least six patients whose memory problems were traceable to statins in 12 years of practice. “The changes started to occur within six weeks of starting the statin, and the cognitive abilities returned very quickly when they went off,” Devi said. “It’s just a handful of patients, but for them, it made a huge difference.”
Researchers at the University of California at San Diego are completing a randomized, controlled trial examining statins’ effects on thinking, mood, behavior, and quality of life. “We have some compelling cases,” said Beatrice Golomb, lead researcher for the Statin Effect Study at the University of California, San Diego. In one, a San Diego woman was so forgetful her daughter explored Alzheimer’s care and refused to let her baby-sit her 9-year-old child. The mother stopped taking a statin, “Literally, within eight days, I was back to normal—it was that dramatic,” said Jane Brunzie, age 69.
The brain is largely cholesterol, much of it in the myelin sheaths that insulate nerve cells and in the synapses that transmit impulses. Some doctors believe lowering cholesterol could slow the connections that facilitate thought and memory and statins may lead to the formation of abnormal proteins such as those seen in the brains of Alzheimer’s patients
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