Researchers from the University of Oxford observed no association between suicidality, anxiety disorders, or seizures with the use of statins. These results were published in The Lancet Psychiatry.
This population-based longitudinal cohort study used data from the Swedish nationwide registers. All Swedish individuals aged ³15 years (N=1,149,384) who had filled or collected a statin prescription between 2006 and 2013 were included. Patients were assessed for hospital or outpatient care for anxiety disorders, seizures, self-injury, or a suicide attempt, and for death by suicide.
Patients were 54.4% men and 88.4% were aged 50 years or older. Statins included simvastatin (87.6%), atorvastatin (21.3%), rosuvastatin (4.7%), pravastatin (3.6%), and fluvastatin (0.6%). Patients were treated with statins by a median of 3 (interquartile range, 2-5) periods for a median of 293 (range, 104-728) days.
Suicidal behavior was observed among 0.6% of statin users during the study period and diagnoses of anxiety disorders (2.5%), seizures (2.5%), and depressive disorders (2.1%) were recorded.
During the statin non-treatment periods, patients had lower rates of depressive disorders (hazard ratio [HR], 0.91; 95% CI, 0.87-1.08) and no difference of suicidal behavior (HR, 0.99; 95% CI, 0.90-1.08) or anxiety disorders (HR, 1.00; 95% CI, 0.97-1.04).
Patients treated with low (HR, 0.94; 95% CI, 0.90-0.97) or moderate (HR, 0.89; 95% CI, 0.84-0.93) doses of statins had lower rates of depressive disorders and high doses had no significant association (HR, 1.00; 95% CI, 0.92-1.09). Long- (HR, 0.91; 95% CI, 0.87-0.95) and short- (HR, 0.90; 95% CI, 0.83-0.97) term exposures did not significantly impact rates of depressive disorders.
Patients who used pravastatin or simvastatin had decreased rates of depressive disorders (HR, 0.72; 95% CI, 0.53-0.99 and HR, 0.87; 95% CI, 0.83-0.90, respectively) and anxiety disorders were reduced among patients who used atorvastatin (HR, 0.89; 95% CI, 0.81-0.97), pravastatin (HR, 0.73; 95% CI, 0.56-0.95), and rosuvastatin (HR, 0.84; 95% CI, 0.70-0.99).
To control for potential under reporting of suicides, statin use was correlated with rates of arrests for violent (HR, 0.81; 95% CI, 0.73-0.89) and non-violent (HR, 0.90; 95% CI, 0.88-0.93) crimes; neither of which were significantly associated with statin use.
This study did not include information of medication adherence, which may have limited these findings.
Although some evidence suggested that statin use increased the rates of depressive disorders, the causative factor remained unclear, but did not appear to be related with dosage or total exposure. These data indicated the use of statins was not associated with suicidal behaviors, anxiety disorders, or seizures, indicating they were a safe therapeutic option.
Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Molero Y, Cipriani A, Larsson H, Lichtenstein P, D’Onofrio BM, Fazel S. Associations between statin use and suicidality, depression, anxiety, and seizures: a Swedish total-population cohort study. Lancet Psychiatry. 2020;7(11):982-990. doi: 10.1016/S2215-0366(20)30311-4