Atorvastatin Does Not Influence Cognition or Mood in Bipolar and Depressive Disorders

The use of atorvastatin did not affect cognition and mood in patients with bipolar disorder or major depressive disorder (MDD) and lithium-induced nephrogenic diabetes insipidus, according to results from a study published in the Journal of Affective Disorders. Researchers sought to address the possible link between cognitive or mood symptoms and statins.

Jocelyn Fotso Soh, MSc, Ahmad Almadani, MBBS, and colleagues at McGill University in Montreal, Quebec, Canada conducted a secondary analysis of data from a randomized controlled trial that explored the effects of atorvastatin in the treatment of lithium-induced diabetes insipidus in patients with bipolar disorder (n=54) or MDD (n=6). Study participants were randomly allocated to receive either atorvastatin (n=27) or placebo (n=33) for a total of 12 weeks. Atorvastatin was administered at 20 mg/day for the study duration.

In this analysis, the primary end point measured was adjusted global cognition Z-score. The primary mood end point was depression relapse at 12 weeks measured using the Mongomery Asberg Depression Rating Scale.

The researchers found no significant difference in global cognition Z-scores or depression relapse between the atorvastatin and placebo arms at 12 weeks (P =.91 and P =.70, respectively). Additionally, no significant differences in composite scores for executive functioning and secondary cognition or mood measures were observed. In regression analyses, there were no significant findings, and secondary analyses of the bipolar disorder subgroup were similarly unfruitful.

Despite the negative results, the researchers highlighted the benefits of statins for cardiovascular prevention in this population. One key limitation of the study was the underpowered statistical design. As a result, small effects of atorvastatin on mood outcomes could have gone undetected. The sample of patients with MDD was also quite small.

“These findings will be of interest to clinicians who are treating patients with [bipolar disorder] and MDD, who are often using statins for physical health comorbidities. In the context of existing literature, it is likely safe to use statins in [bipolar disorder] and MDD patients…” the investigators concluded.

Reference

Fotso Soh J, Almadani A, Beaulieu S, et al. The effect of atorvastatin on cognition and mood in bipolar disorder and unipolar depression patients: A secondary analysis of a randomized controlled trial [published online November 4, 2019]. J Affect Disord. doi:10.1016/j.jad.2019.11.013