Dr. Julian Whitaker on Statins and Memory Loss

CHOLESTEROL DRUGS CAN CAUSE MEMORY LOSS
Why Statins are Bad for the Brain

by Julian Whitaker, M.D.

A retired professor of business law and computer science who was taking Zocor to lower his cholesterol was diagnosed with rapidly progressing probable Alzheimer’s disease. It got to the point that he had trouble carrying on conversations and recognizing people he’d known for 20 years, and long-term care was looming. After hearing about the association between statins and memory loss, he stopped taking Zocor, and over the next few months his cognitive function returned to normal.

A successful 50-year-old business owner started taking Lipitor in 1998. Within three years he was wracked with pain and weakness, and his memory and concentration were so poor that he was forced to close his business. Although he’s improved somewhat since getting off Lipitor, he continues to have severe cognitive problems.

Seeing split wood scattered all over her porch, strange footprints in the snow, and a plate of partially eaten food in her kitchen, a 69-year-old woman became convinced that someone had broken into her house. The next day, she realized that the footprints were hers—but she had absolutely no memory of what happened. After stroke, blood clots, and other causes were ruled out in the ER a few days later, she was told she had experienced temporary loss of memory, or transient global amnesia (TGA), of unknown origin. She had started taking Lipitor four months before.

A woman reports, “My husband has been on Lipitor for years, and I/we have noticed that more and more his memory and focus have been impaired. We are told that there is no such evidence that Lipitor could cause this. I have watched my husband change from a Harvard Business School graduate who could accomplish more in four hours than most could in four days to someone who has already had a TGA attack and, in the two years since, has become more forgetful, unable to complete tasks, loses track of time...”

Statins’ Second-Most Common Side Effect
These are not isolated incidents. After muscle pain and weakness, cognitive problems are the second-most common side effect of Lipitor, Zocor, Pravachol, Mevacor, and other cholesterol-lowering statin drugs. Hundreds of cases of statin-induced memory loss and TGA have been reported to MedWatch, the FDA’s system for filing adverse drug events. And these are just the tip of the iceberg.

That’s because people taking these drugs—more than 12 million in the United States—who develop memory problems are unlikely to put the two together. They aren’t warned sufficiently on drug labels or inserts about this adverse effect, nor do they hear about it in TV, newspaper, and magazine ads. Doctors aren’t telling them about it either, largely because they don’t know about it themselves.

Doctors: Don’t Know, Don’t Tell
Take Lipitor, for example, the best-selling drug in the United States. The Physicians’ Desk Reference includes reasonable mentions of the potential for liver toxicity, muscle aches, and weakness. However, nowhere does it allude to Lipitor’s cognitive side effects other than a one-word mention of “amnesia” in a long list of things purported to have occurred in less than two percent of patients. And in the clinical studies on the drugs—virtually all of which are funded by drug companies—benefits are emphasized while adverse effects are downplayed. To make matters worse, government and cardiology “opinion leaders” are so conflicted by drug money that they ignore the obvious red flags.

Without this awareness, physicians and patients alike are much more likely to attribute declining memory or blackout spells to dementia, stroke, or just old age than to cholesterol-lowering drugs. In fact, if a patient complains about memory problems related to the drugs, the doctor will almost always discount it.

But the word is getting out, thanks to people like former astronaut Duane Graveline, MD, MPH, and researcher Beatrice Golomb, MD, PhD.

Lipitor Caused Complete Amnesia
In 1999, Dr. Graveline was put on Lipitor to lower his moderately elevated cholesterol. Six weeks later, his wife found him wandering around their driveway, unable to recognize her, or his surroundings. She managed to get him to his doctor, who was perplexed by this episode of severe memory loss, which passed after a few hours. Dr. Graveline, who was in excellent health, had a hunch that Lipitor was involved because he had just started taking it, and it was the only drug he was on. His doctor disregarded his concerns and, a year later, talked him into getting back on the drug. Sure enough, he had another episode of TGA, this one lasting 12 hours.

Despite his physician’s naysaying, Dr. Graveline was convinced that Lipitor had caused his problems. When he came across the Statin Effects Study, headed by Dr. Golomb of the University of California, San Diego, he was vindicated. Since 2000, Dr. Golomb has been gathering case reports of patients who have had changes in thinking, mood, and behavior while on statin drugs.

I recently interviewed Dr. Golomb on my radio show, and she told me that while physicians might not make the association between memory problems and statin drug use—or take the time to report adverse events—patients trying to get to the bottom of their problems have a vested interest in doing so. So far, she has received more than 4,000 reports of cognitive dysfunction—some of them so severe they were diagnosed as rapidly progressing Alzheimer’s disease.

Once Dr. Graveline made his experience public, he, too, was inundated with reports of statin-related amnesia, forgetfulness, disorientation, and other memory problems. His Web site, spacedoc.net, and message board contain nearly 10,000 accounts of statin damage, plus a plethora of information on the adverse effects of these drugs.

How Statins Harm the Brain
When you really think about it, it’s obvious that these drugs would adversely affect cognition. Your brain contains an abundance of cholesterol, much of it in the myelin sheaths that insulate the neurons and speed up nerve conduction. Recent research reveals that cholesterol is also required for the formation of synapses, the areas between neurons where nerve impulses are transmitted and received. In fact, cholesterol is so important that it is manufactured by the glial cells in the supportive tissues of the brain.

Curbing synthesis of such a crucial compound has an inevitable downside. Suicide and violent behavior have long been linked to very low cholesterol levels. Now, data from the ongoing Framingham Heart Study demonstrates that older people with low total cholesterol (under 200) are much more likely to perform poorly on tests of mental function than those with high cholesterol (over 240).

These drugs harm the brain in other ways as well. As you may know, the enzyme pathway that statins disrupt in order to suppress cholesterol production is also involved in the synthesis of coenzyme Q10, which is required for energy production in the mitochondria of the cells. When you block that enzyme, cholesterol goes down, but so does CoQ10—by as much as 50 percent in some patients!

Low CoQ10 Levels = Bad News
The brain, heart, and skeletal muscles are the body’s most voracious consumers of energy, and it’s only natural that these are the systems most acutely affected by inadequate stores of CoQ10. Deficiencies in this essential compound are known to underlie the muscle problems and heart failure so often linked with statins. It’s high time we recognize that CoQ10 depletion is also a factor in cognitive dysfunction and other neurological consequences of these drugs.

Statins also appear to adversely affect tau, a protein made by brain cells that helps maintain their structure. Abnormal tau proteins promote the formation of the neurofibrillary tangles that appear in the brains of patients with Alzheimer’s disease. Abnormalities in tau proteins are also linked to other neurodegenerative disorders, including Parkinson’s disease and amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease). Among the thousands of patient stories Dr. Graveline has amassed are a disturbing number with these and other serious neurological problems. He, I, and others believe the link with cholesterol-lowering drugs is clear and unequivocal.

More Reasons Not to Take Statins
Besides their serious side effects—cognitive problems, muscle pain and weakness, fatigue, liver damage, and even heart failure—these drugs are just not all that helpful. Yes, they lower cholesterol, but lowering cholesterol should not be an end in itself; rather, it should be a means of reducing risk of heart attack and death from heart disease. In this regard, statins fail miserably.

Not a single study shows that statins are beneficial for women. Not one! The largest randomized clinical trial of statins in women found that those who took Lipitor actually had 10 percent more heart attacks than women taking a placebo. Nor is there any research suggesting that these drugs prevent heart attacks or extend life for anyone over age 70—women or men—including those at high risk of heart disease.

The same goes for younger men who have a high cholesterol level but no other significant risk factors for heart disease—statins just don’t help. In fact, potential cardiovascular benefits are counterbalanced by equivalent increases in death and debility from other causes. Yet millions of low-risk men, older men, and women of all ages take these drugs daily.

The only people ever shown in clinical studies to benefit at all from these drugs are middle-aged men at high risk of heart attack (high risk being defined as having existing coronary artery disease, diabetes, disease of the blood vessels to the brain or extremities, or two or more risk factors, such as hypertension and smoking). But even for this group, there are far safer and more effective ways to lower risk than these very dangerous drugs.

References

  • Elias PK et al. Serum cholesterol and cognitive performance in the Framingham Heart Study. Psychosom Med. 2005 Jan-Feb;67(1):24–30.
  • Golomb BA. Impact of statin adverse events in the elderly. Expert Opin Drug Saf. 2005;4(3):389–397.
  • Muldoon MF et al. Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Am J Med. 2004;117(11):823–829.
  • Pfrieger FW. Role of cholesterol in synapse formation and function. Biochim Biophys Acta. 2003 Mar 10;1610(2):271–280.
  • Physicians’ Desk Reference, 61st Edition. Montvale, NJ: Thompson PDR; 2007.
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Julian Whitaker, MD, has practiced medicine for more than 30 years, after receiving degrees from Dartmouth College and Emory University. In 1979 he founded the Whitaker Wellness Institute, located in Newport Beach, CA. For more information on the clinic, call (800) 488-1500 or visit www.whitakerwellness.com.


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