man with a confused and surprised expression, prevent dementia

The relationship between statin-type cholesterol-lowering drugs and memory problems has been controversial for decades. When we begin writing about a link between drugs like atorvastatin (Lipitor), lovastatin (Mevacor), or simvastatin (Zocor) and forgetfulness or brain fog 15 years ago, we were told it was all in our heads. Some health professionals were outraged that we dared to discuss this issue at all.

Transient Global Amnesia:

We first heard about a rare medical condition called TGA (transient global amnesia) in 2001 from a reader of this newspaper column. Duane Graveline, MD, MPH, wrote to us with a strange story:

“I am a retired family doctor and former astronaut. Two years ago at my annual astronaut physical at Johnson Space Center (JSC) I was started on Lipitor. Six weeks later I experienced my first episode of total global amnesia lasting six hours. They couldn’t find anything wrong with me so I suspected Lipitor and discontinued it.

“Other doctors and pharmacists were unaware of similar problems. Believing it must have been a coincidence, I restarted Lipitor a year later. After six weeks I landed in the ER with a twelve-hour episode of total global amnesia. I am more convinced than ever of a Lipitor relationship.”

Dr. Graveline’s Legacy:

Dr. Graveline died recently. He was convinced that his episodes of TGA and his subsequent degenerative neuromuscular condition were caused by statin-type cholesterol-lowering drugs. Over that time he wrote several books including Lipitor, Thief of Memory, and Statin Drug Side Effects.

After sharing Dr. Graveline’s story with readers we heard from many other people who had also suffered episodes of transient global amnesia. In honor of Dr. Graveline, we share some of those stories with you:

“I suffered from 10 hours of amnesia in 2009 when I was 63 years old. I had been on statins for ten years. I was hospitalized and thoroughly tested, including MRI, EEG and EKG. I was tested for stroke or other possible causes including blockage of carotid arteries.

“All of those tests were negative. My final diagnosis was that I had suffered TGA (Transient Global Amnesia). I came out of the amnesia feeling well. I went off statins and now control my cholesterol with other strategies. My cholesterol is not as low as it was on statins, but is in an acceptable range.”

William in Huntingdon, PA shared this scary situation:

“I, too, had amnesiac experiences on Lipitor: on one occasion I lost an entire day–bewildering. A second time I had a memory blackout: forgot my S.S.#, my telephone #, my bank card #, even my birthday date.

“I was a university professor for 30 years who remembered everything. I worried that I had had a minor stroke. I saw a neurologist for an Alzheimer’s test: I had no symptoms. Later, because I had leg and muscle pain on Lipitor, my family physician changed me to Pravachol. Both the muscle pain and the amnesiac experiences stopped!

“Physicians need to inform their patients on Lipitor–and probably some other statins–of this serious and upsetting side effect.”

We have had far fewer reports of memory problems associated with pravastatin than with atorvastatin. That may be because pravastatin (Pravachol) is prescribed less often than atorvastatin. It may also be that pravastatin doesn’t get into the brain as easily as some other statins such as simvastatin or atorvastatin.

Mel in Oregon wrote in October, 2008:

“My situation is similar to others in terms of cholesterol and TGA.  I was taking 5 mg of Lipitor (half of a 10 mg pill) and had been for over a year.  At a dinner business presentation, sitting and talking to people on one side and my wife on the other, I suddenly ‘woke up’ and realized I didn’t remember anything that had happened for the previous 40 minutes.

“According to my wife, I had continued to talk to her and the people on the other side until the meeting started.  But after I woke up I kept repeating myself and she thought I might have had a small stroke.  Doctors did ultra sound, CT Scan, EEG, stress tests and found no cause.  The Neurologist wanted to blame it on migraines — I think because I had a lingering stiff neck and slight headache at the back of my head.  But in my opinion it didn’t fit.  I had never had migraines. I was 73 years old at that time.

“My Internal medicine doctor had me switch to 5 mg of Crestor so I didn’t have to split the 10 mg Lipitor pill.  Six months later, while on the treadmill (after four days of taking 5 mg of left over Lipitor–I wanted to use it up before it expired and not waste it), I had a 10-minute memory loss.

“This time I ‘woke up’ much more confused than the first time and I could not think clearly. Less than an hour later at supper again my wife told me I was repeating myself.  It was then that I first understood that I had had another TGA attack.  Again I had the stiff neck and slight base of skull ache that started about an hour after the attack and lingered for several weeks.  My doctor was not interested in even talking about it.”

Another reader related this experience:

“I prodded my doctor to start me on Lipitor. The drug dropped my LDL cholesterol well below 80 but my HDL stayed in the mid-thirties.

“After being on atorvastatin for a couple of months I woke up one morning and had no idea what day of the week it was or that the company picnic had been the day before. At work I could not make simple postings of dollar amounts from hard copy to electronic spreadsheet (I would forget the amounts).

“At a meeting I could not remember names or how to structure sentences. At home I kept asking my wife the same question as I could not remember her answer. She became so concerned she forced me to see a doctor. He thought I had a mini-stroke but ultrasound, brain scans and all other tests were normal. I mentioned Lipitor but the doctor dismissed it (“no way”). At the end of the evaluation I was diagnosed with TGA.

I went back to the Niaspan my doctor had originally prescribed. My liver tests are good. My HDL improved to 43 and my LDL is now 80. What is most surprising is that my memory has improved (not just returned to normal) and my performance at work is outstanding.”

You can read more about Dr. Graveline’s story in an article he wrote, “Pilots & Statins: A Cause for Concern?” on our website: www.PeoplesPharmacy.com

Statins and General Memory Problems:

Transient Global Amnesia is a relatively rare condition. That’s why it stands out. Very few people spontaneously experience amnesia where they forget where they are, who they are married to or what they do for a living.

Here are just a few of the stories we have received:

Arlene shared this experience:

“I have tried many statins, but continue to have the same side affect, which is loss of memory. I also had what I can call amnesia episodes.  My doctor wants me to continue trying different statins, but I’ve just about had it. I’m beginning to think he doesn’t believe me about the regular memory problems or the two amnesia episodes.

“I also had a muscular problem with one statin which he quickly asked me to stop taking. I don’t know what to do. Maybe I should change doctors, but they’re all pretty much into statins these days.  Has anyone else had so many episodes with memory problems while taking statins?”

Linda is worried about her husband’s memory:

“My husband has been on the atorvastatin for over three years. He was always a very sharp individual with an excellent memory. Over the past two years he’s been having terrible bouts of severe depression and memory loss. He is always tired and at times cannot think of certain words. He’s mentioned this to his cardiologist but his doctor refuses to admit that it is from the atorvastatin. He istaking 80 mg of atorvastatin and his cholesterol levels are very low.”

Perhaps the most powerful story we have received about statins and memory problems came from Michael, a retired professor of business law and computer science. He was diagnosed with probable Alzheimer’s disease that was progressing very rapidly. He went to his 50th college reunion with a sign around his neck that said, “I’m Mike. I have Alzheimer’s disease.”

At his youngest daughter’s wedding, he did not recognize people he had known for more than 20 years. His decline made it clear that he would need long-term nursing care very soon. But then he read about statins and memory problems. With his doctor’s knowledge, he discontinued the simvastatin he had been taking. Although it took many months, he gradually regained his memory and cognitive ability.

He wrote to us and reported that he was back to reading three newspapers a day and is as sharp as a tack. A complete neurological workup showed no signs of Alzheimer’s disease.

The FDA’s Stance on Statins and Memory:

Of course not all symptoms related to forgetfulness or memory loss can be attributed to statins. Many people develop cognitive decline regardless of medications. This can happen even when someone is taking no drugs at all. That said, the FDA offers the following warning regarding statins and memory:

“There have been rare postmarketing reports of cognitive impairment (e.g., memory loss, forgetfulness, amnesia, memory impairment, confusion) associated with statin use. These cognitive issues have been reported for all statins. The reports are generally nonserious, and reversible upon statin discontinuation, with variable times to symptom onset (1 day to years) and symptom resolution (median of 3 weeks).”

What To Do?

The scientific literature is confusing when it comes to statins and transient global amnesia and other memory problems. We found one link in BMJ Case Reports (online, Feb. 26, 2009) titled:

“Transient Global Amnesia Associated with Statin Intake”

We advise that people never stop taking a statin without first consulting the prescriber. Patients with heart disease may find that the benefits of statins outweigh any risks of such drugs. Others, though, need to consider alternatives to statins if muscle pain, weakness or cognitive deficits are interfering with quality of life.

To learn more about statin side effects you may wish to consult our Guide to Cholesterol Control and Heart Health. It offers many non-drug strategies for lowering risks.

Cholesterol Control & Heart Health

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  1. Dana
    Missouri
    Reply

    I had a Transient Global Amnesia attack last week which lasted 12 hours. This was my first attack. I was on no medication before and upon release from the hospital they put me on atorvastatin and Lisinopril. My LDL was 140, and the HDL was 60. Blood Pressure spiked upon arrival at the ER. Personally, I didn’t think the LDL was high enough for a statin, and I took it for 2 days and stopped it. I had no idea it caused memory loss, and that is what I was in the ICU for! I had another blood test yesterday, and my LDL was 110 and HDL was 56.

    I just don’t think I need to be on a statin with these kind of numbers and risk the chance of another TGA. Those things are terrible! Is this just a common thing for doctors to prescribe these medications? I had such joint pain while on atorvastatin for only 2 days. My husband had a heart attack over a year ago and has had no issues with the atorvastatin.

  2. Reg
    Staffordshire, England
    Reply

    My failing heart was mended (Quintuple bypass) way back in 2003. Since then I have been prescribed a number of drugs (preventative) including statins. Two and a half years ago I had my first bout of GTA which lasted for about 2 hours. Since then I have had repeat attacks at roughly 3 month intervals and the severity and length of these attacks have been progressively stronger and longer respectively. After my last attack which is now 5 months ago I stopped taking the statins, much against my doctors advice but it is now 5 months since my last attack. I am hopeful.

    • bob
      tex
      Reply

      I had three TGA events: in dec 2017, July, 2018 and sept 2018. The cardio doc said to stop rosuvastatin NO. So I cut atenolol to 25 from 50 mg– had tests, leg, CT of brain and arteries. Awaiting results. I am 70 years old. if it is the statin causing my TGA, I’ll chose to contend with high cholesterol,rather lose the memory of my children and grandchildren.

  3. Olda
    Texas
    Reply

    Suggested to my mom’s MD that we stop pravastatin for a while, as she is having a lot of memory loss and excruciating leg cramps. I told him I had been researching the subject. He told me to stop reading the National Enquirer! I told him I had been reading medical journals as well as independent reports. He just ignored me. I am a registered nurse. I have never told him because I notice when MDs know I am a nurse the teaching or explaining is nil. Needless to say, I decided to not argue with him and will see how she does. Not all MDs are cold hearted but this one unfortunately is. I will be shopping for a new doctor who cares for my mom like I do.

  4. Cari
    Montara, California
    Reply

    I just had my first and hopefully last TGA on January 13, 2013.
    I just wanted to say that I am 56 years young, and I have never been on a statin drug nor have heart issues ir cholesterol problems.
    Everything I’ve read says thst it is most common in people with migraine.

  5. Anniee
    Kentucky
    Reply

    As a pharmacist I will recount my experience. I had taken Simvastatin, Crestor, pravastatin and then lipitor. With the Simvastatin I ached from the top of my head down to my feet. I could hardly put one foot in front of the other I was so fatigued. I was in my mid 50’s. Should not have felt like I was 100! I was then changed to Crestor, same scenario. Then on to pravastatin. This time I took 1/2 tab every other day for 3 doses. Same fatigue and aches.

    Next was lipitor: I took lipitor for 3 months with no apparent problems. As soon as I started the 4th month I began having memory lapses. I could not remember my patients names that I had known for 10 years! I immediately stopped the lipitor! That was about 2 years ago. I am still affected with lapses. I hope to get back to 100% but it is very concerning. I would never have taken this medication had I read about this side effect

  6. Gwen
    Australia
    Reply

    My husband had a heart attack 6 months ago and was put on a statin. Yesterday he had a Transient Global Amnesia episode. He was taken to emergency and was tested for stroke, seizure and had EEG, MRI of the brain. All test came back as normal. I think he should talk to his doctor about going off the statin. I have never liked the idea that he had to take a statin. He is 63 and has never had a problem with his memory before.

  7. Paul
    North Carolina
    Reply

    I was taking 20 mg of Lipitor twice weekly(Mon. & Thur.) LDL dropped to 72 and total cholesterol of 134. Wife called me at one day and talked for over an hour. Didn’t remember a word of it. Finally “woke up” as we were talking and noticed burger bag and wrappings on desk. Wife told me to stay put, she was coming to take me to emergency room. All test were negative. Neurologist visit determined it to be TGA. Had another episode one year later. Neurologist took me off Lipitor. Have not had recurrence in five years.

  8. Melissa, MD
    NC
    Reply

    The statement that most doctors don’t believe statins cause memory loss is misleading and not true. The FDA has warned doctors of this side effect (http://www.fda.news/2016-05-06-fda-mandates-new-safety-warnings-for-statin-drugs-due-to-risks-of-memory-loss-diabetes-and-muscle-pain.html) so it is well known and commonly accepted. Stop trying to pit folks against doctors! While it may drum up business for alternative providers, it ultimately will hurt patients, as it leads to mistrust of doctors. Your anti-doctor rhetoric is not fair to the majority of good doctors out there that enjoy your radio show and also keep up to date with medical literature.

    We all need to work together — From a doctor in NC.

    • Terry Graedon
      Reply

      Quite right, Dr. Melissa. Many doctors do keep up with the literature. Patients simply get frustrated, though, when doctors tell them the problem is not a side effect of the medication without checking to see whether it might be.

    • Judy
      Sanford NC
      Reply

      I disagree that doctors are informed and up to date. In fact, I think some doctors are so overloaded that they often can’t diagnose or misdiagnose patients issues. I have taken peer-reviewed research to my doctor when they were unable to determine the problem. I ended up with a 100% blocked subclavian artery. My cholesterol was well below acceptable numbers. Why did NO doctor ever tell me that radiation can cause the same problems as does cholesterol? Did they fail to mention it or were they lacking in knowledge that has been known for many years and published in medical journals? It took my own digging into research to learn this. Two years ago my cardiologist put me on a statin. Had this been done much earlier it might have prevented some of the damage that has been done to my veins, affecting some of my organs and potentially my heart. Let this be a wake-up call to those of you who had radiation decades age. Do your research.

      • Betsy
        California
        Reply

        My husband has had two TGAs under one doctor’s care and a third under a previous doctor. Neither doctor said ANYTHING about the statins he was on. TGAs are supposed to be a once in a lifetime event! He had his first about 10 years ago, the second one four years ago and the third almost two years ago.

        Worked over completely. Found to have diastolic dysfunction (he is 57). I insisted he start taking CoQ10 due to an article I found linking DD with CoQ10 deficiency. Let me tell you, it is no fun being the one having to take care of the TGA patient during the five hours (his average) that he can’t remember what happened three minutes ago and keeps asking the same questions! On this last one, we had lost a beloved dog to a hit-by-car a couple of months before and during his TGA he kept asking where “Nicky” was! It was devastating!

        Now we are in the trap of him being on them and it not being safe to stop suddenly.

  9. Carolyn
    Bermuda
    Reply

    I have been on statins for years due to my HDL and LDL. I have severe heart disease. Late January 2016, I had a slight heart attack. Received 2 stents. My statin was increased from 40mg to 80mg. I am now experiencing symptoms of numbness, tingling, minor pain. My right hand is more severe than my left hand, minor in both feet. The discomfort affects my right hand to shoulder. I had blood test which resulted in low B12, low magnesium, etc. I was given a shot B12,+ had taken a B12 supplement, no longer taking B12. B12 in now fine. I am taking a daily one-a-day multivitamin and magnesium 400mg. Blood test weekly for the magnesium and will visit my endocrinologist in 12 days. No change in my sysmptoms of tiredness, unsteadiness, pins & needles in body. The right hand severe, etc. I really feel that the increase in the atorvastation has an effect as to my present sysmptoms? What do you think?

  10. linda
    manchester
    Reply

    I have finally got it on record I cannot take statins or fibrate as I have side effects from all muscle damage ,depression and others.

    I am taking opti omega 3 , 3 plant sterols ,llysine ,lecithin, vitamin d every day and a vitamin k2 mk7 100mcg to repair the damage done by statins and I’m getting back to normal now except my leg muscles, don’t think they will ever be back to how they were.

  11. Cindy M. B.
    Seattle, WA
    Reply

    God willin’ and the creeks don’t rise, I will NEVER be in the sorry position of playing Russian Roulette with those horrible statins. I work hard to protect my memory and cognitive processes… the very last thing I need is something that works against those efforts — and that includes a lot more Rx meds than just statins. Thank you for this info, PP.

  12. Martha
    Colorado
    Reply

    To add a little balance to this discussion: In 2002 my partner had her first episode of Global Trancient Amnesia. It lasted 5 hours but she was hospitalized for 36 hours having numerous neurological tests done. All were negative. 5 years later, she had another episode lasting about 2-3 hours. 5 yrs after that 2nd episode the 3rd occurred and lasted about 2 hrs. Although taken to the ER each time, she was dismissed after her memory returned the lady 2 times. She has NEVER taken a statin.

    On the other hand, I (age 80) have been taking a statin for roughly 5 years, have difficulty remembering names (which has been a life long problem) and am beginning to have some short term memory loss.

  13. Nicki
    Oregon
    Reply

    Sixteen years ago, I had unexpected quintuple bypass surgery and have been on Lipitor (later atorvastatin) with a 20 mg dose daily with no adverse side effects that I have noticed. Recently my cardiologist urged me to go up to 40 mg for some reason, but I was reluctant to make a change. My primary care dr. and I decided I could try 30 mg and see how that worked.

    I’ve only been on it for about a week, but am beginning to suspect some muscle cramping. My thought is to return to 20 mg, especially after reading your article about forms of memory loss, etc. I need to consult my dr., but wonder if anyone has any helpful thoughts on the subject for me?

  14. Louise
    Potomac, Md.
    Reply

    HAVE THEY TAKEN BENICAR OFF THE MARKET YET? I had unbelievable leg muscle pain to the extent where I couldn’t even walk. My two doctors didn’t believe it was caused by the statin. I thought I was going to call the Rescue Squad one night it was so excruciating. Only soaking in a tub of very hot hot water saved me because that alone relaxed the muscle.

    I insisted on going to low dose of Pravastin. Within weeks, the disabling leg muscle, which I had suffered for years (with no explanation from my doctor) completely disappeared. My Gen. doctor and HEART SPECIALIST didn’t believe me when I told them I thought the pain might be caused by BENICAR. IT WAS !!

  15. Jacqueline
    Calgary Alberta
    Reply

    Could fenofibrite cause problems as well? I have been on fenobrite for quite a few years and notice my memory is getting bad.

  16. Mel
    Oregon
    Reply

    I’m “Mel in Oregon” that you mentioned above. I am now almost 83 years old and thought you might be interested to know that I have never had another TGA event since I quit taking Lipitor. I am still taking Crestor. However, I gradually reduced dosage by cutting those 5 mg pills into tiny pieces.

    I probably don’t need Crestor at all now due to being a few lbs. lighter and eating a bit better, as my cholesterol is below normal with a bit of Crestor. Your articles about memory loss and statin drugs are interesting. My memory is not as good as it once was.

    • Betsy
      California
      Reply

      That is interesting, Mel! I’ve heard that it is dangerous to stop taking statins. It is awful that the doctors are putting people on these statins preventatively when they are then locked into taking them for life because they are at risk of stroke etc. if they come off of them.

      I’ve been tapering off of antidepressants for three years because coming off too quickly caused such horrid withdrawal. The body pushes back against the action of drugs by making compensatory changes. Do we know all the impacts these statins have across the body, not just for cholesterol?

      My husband keeps saying he isn’t worried because he’s on the minimum dose of simvastatin, yet he has had THREE TGAs! Minimum doesn’t mean “ineffective.” Anyway, good on you for tapering down. What dosage do you think you are actually on?

  17. Judy
    Virginia
    Reply

    I have been taking Pravastatin since 2009 and have noticed aching of my legs in particular and more recently difficulty in recalling names and words I want to use. Some time ago, I got the dose reduced by half with some improvement in the leg pain, but am concerned about the memory problem.

    I don’t know what to do about this, since the doctor seems committed to the use of statins to reduce cholesterol risk.

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