confused older man, anticholinergic load

The top four statin-type cholesterol-lowering medications are atorvastatin, simvastatin, pravastatin and rosuvastatin. Our back of the envelope calculations suggest that over 200 million prescriptions were dispensed to over 40 million Americans last year. Can statins affect memory? Most health professionals say absolutely not. But many readers continue to wonder. Here is the most recent such question:

Q. I read somewhere about a statin that is not fat-soluble and doesn’t cross the blood-brain barrier. Unfortunately, I forgot the name. I am currently taking simvastatin and have noticed a decline in my memory. Can you help me?

Could Statins Affect Memory?

A. Physicians have been debating the relationship between statins and cognitive function for decades. The FDA requires this statement for simvastatin:

“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.”

How Do Clinical Trials Answer the Question: Do Statins Affect Memory?

Clinical trials have not demonstrated memory impairment due to statins (Journal of General Internal Medicine, March, 2015). The authors conclude:

“Statin therapy was not associated with cognitive impairment in RCTs [randomized controlled trials]. These results raise questions regarding the continued merit of the FDA warning about potential adverse effects of statins on cognition.”

A Contrary Perspective:

Despite this, published case reports link cognitive and psychiatric problems to statins (Pharmacotherapy, July, 2009; Drug Safety Case Reports, Dec., 2016; World Journal of Diabetes, June 15, 2017).

The authors of the last article on diabetes and statins introduce their research this way:

“Whether statins negatively affect cognitive function remains under dispute. Goldstein and Mascitelli (2014) propose that statins may negatively affect the brain and cognitive health, potentially via impaired myelination. Additionally, cell culture and animal studies show that statins exert neurotoxic effects. Four recent meta-analyses/reviews, however, found no significant relationship between statin use and cognitive impairment.”

Here is what they discovered in their research:

“This study analyzed correlations between statin use and cognitive impairment in a sub-group of participants with T1D [childhood-onset type 1 diabetes] from the on-going, observational Pittsburgh Epidemiology of Diabetes Complications Study. These now middle-aged adults were diagnosed with T1D prior to age 18 years, and have reported medication use biennially since the parent study baseline in 1986. Among the 108 participants with a cognitive assessment in 2010-2013, using statins more than tripled the odds of having cognitive impairment discernible by middle age. As duration of statin use increased (never, 1-6 years, 7-12 years), an increasing percentage of participants met the study definition of cognitive impairment (14%, 32% and 47%, respectively), independent of age or education.”

The authors noted that their results contradict the results of one other study that did not report such an association. They did find that statin use was linked to “poor performance of memory tasks.”

Canaries in the Coal Mine?

In a sense, people living with type 1 diabetes (T1D) since childhood are like canaries in the coal mines. They are more vulnerable to complications of this metabolic disorder. If statins affect memory, people with T1D may be more likely to experience such symptoms earlier in life than other individuals.

The authors’ conclusions from their relatively small study:

“Statin use was associated with cognitive impairment, particularly affecting memory, in these middle-aged adults with childhood-onset T1D, whom at this age, should not yet manifest age-related memory deficits.”

Statins and Memory Problems: An Old Question

We published this question in our March 12, 2001 syndicated newspaper column. The physician who contacted us was Duane Graveline:

Q. I am a retired family doctor and former astronaut (www.spacedoc.net). 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 did not seem to be aware of similar problems. Believing it must have been a simple coincidence, I decided a year later to restart Lipitor. Six weeks later I was brought to the ER with a twelve-hour episode of total global amnesia. I am more convinced than ever of a Lipitor relationship.

Do you have any information on other people who may have had such an experience? I have my astronaut physical again in a few weeks and would like to tell the doctors about this if you have any data. This drug is in common use at JSC and for all I know other astronauts may be on it as part of their enthusiasm for preventive medicine.

Our Response to Dr. Graveline:

A. Total global amnesia seems to be rare, but one person told us that Lipitor resulted in “big ugly holes burned through my memory.” According to Beatrice Golomb, M.D., Ph.D., Principal Investigator of the Statin Study at the University of California, San Diego:

“We have received dozens of reports from people citing significant memory problems with Lipitor that seem to resolve with discontinuation. Some are from older people who have gone from very bright and verbal to not recalling the names of their children or grandchildren, in short order; and others are from younger people who have rather abruptly developed memory problems. Several have gone so far as to get work-ups for early Alzheimer’s in their 40s or early 50s, only to find that the problems resolved when they discontinued statin drugs.”

 

Over the last decade or two we have received hundreds of reports from readers of our newspaper column and visitors to this website. Here is just one of many articles:

Can Statins Cause Memory Loss and Transient Global Amnesia?

The People’s Pharmacy Perspective:

The controversial question: Do Statins Affect Memory? remains unresolved to this day. We cannot disagree with researchers and physicians who say that it did not show up in the randomized controlled trials carried out by drug companies. That said, there may be susceptible individuals out there who are especially sensitive to statin side effects. We suspect that people who develop severe muscle pain and weakness when taking statins might also be vulnerable to cognitive complications.

Until this controversy is resolved, some experts recommend switching to a less fat-soluble statin, such as pravastatin or rosuvastatin (Canadian Pharmacists Journal, May, 2015).  You can learn more about other ways to lower cholesterol in our Guide to Cholesterol Control and Heart Health.

No one should ever stop any prescription medication without careful conversations with the prescribing physician. Most people do not appear to experience noticeable cognitive decline or memory problems while taking standard doses of statins. Others, however, may be affected in subtle or profound ways.

We would love to learn about your statin experience. Have you noticed any statin side effects? Share your statin story (positive or negative) in the comment section below.

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  1. shelley
    CA
    Reply

    I took prevastatin for 8 weeks, (only 10 mg a day). After week 6 I couldn’t remember names or nouns. My eyes seemed not to be able to remember that I saw something 30 seconds earlier. I have been off the drug for 1 week, and my memory hasn’t gotten any better. I’m waiting for the condition to clear up. It seems, after reading these comments, that it probably will. Fingers crossed.

  2. Leida
    Texas
    Reply

    Have been taking sinvastatin for several years. Noticed lately I have episodes of forgetfulness,confusion, memory loss and foggy brain. A couple of times while driving to work(a road that I was used for 15 yrs) suddenly got completely lost.Did no recognized the area at all. My doctor said there is no reports of statins causing the problem.I stopped taking the pills and try to flush it out of my system.A week later was normal again. Push by my doctor used again and got the same problem. Pharmacist denied any relation between the statins and cognitive problems.What is going on? i know I am not crazy.

  3. Mohammad
    Florida
    Reply

    I will be 80 years old on May 1, 2018 and have been in good health all of my life. I retired from the United States Air Force in October, 1978. I have been active all of my life and love all kinds of sports, especially tennis. I am still active in the Senior Olympics every year and still run the 100 and 200 meters on the track fields.
    Yesterday my primary doctors told me that my lab results indicated that I have high cholesterol and low Vitamin D. I will not take any Statin medication that he will prescribe for me and will go on eating health foods and all natural good foods that I have been eating all of my life. I really don’t believe the lab results and will continue my daily routine of exercising and watching my diet with only nutritional foods. Thank you.

  4. Mary
    North Carolina
    Reply

    I am taking Red Yeast Rice instead of prescription Statins. I took Atorvastatin for about 6 months and had hip pain. A blood test showed muscle enzymes, indicating muscle damage. My question is: Is Red yeast rice derived from statins and does it cause the same side effects.

  5. Todd
    Port Angeles, WA
    Reply

    I am a person that experienced side effects. Total time on Atorvastatin was 1.5 yrs. I had muscle pain in calves and deep, specific muscle fiber loss in shoulders. Urinated muscle, which looked like blood. Gamma enzymes high in liver with liver pain.

    My muscle, kidney and liver problems pale in comparison to my mental problems. I have full blown dementia that does not conform to natural disease perimeters. I am very aware of my decline. I was a counselor and knew upon the onset that I was experiencing a serious problem. I took extensive notes along the way and have been able to identify the problem was in fact atorvastatin. What I found is proof of demylenation in my brain through MRI’s.

    After one year cessation of Atorvastatin, I still cannot sense time or date. I am often very confused. I have double vertical vision of red and yellow lights and I have tremors. The confusion could be compared to grogginess, whereas a person makes mistakes in the simplest things, such as looking in the freezer for coffee cups, adding salt to coffee instead of sugar, etc.

    Where healthy people “wake up” fully and go about their day, I am stuck in this constant state 24/7. I can describe this also as, metaphorically, a healthy fruit tree in summer months full of leaves and fruit resembling my thought process mapping before, and now, a stark, bare fruit tree in winter months. I know the difference is mainly in recall causing amnesia symptoms. I can recall something later where I should have known before, so I know there is knowledge imprinted but I don’t think my mind has the ability to access “where” the knowledge was imprinted. This causes a cascade of effects, such as feeling remote, abstract consciousness, inability to put knowledge into action and constantly talking in circles because I have an inability to think linear.

    When I muscle through my mind actually derails and I lose awareness of what I was talking about mid sentence. This and much, much more. I do have extensive notes. Writing is a strength because I am/was an author and I can read what I am saying to retain linear.

    I never had a heart attack but I had a widowmaker. I was stented and put on atorvastatin. I am 49 years old and I was very intelligent, whereas now, I cannot care for myself. I did improve from 20% functioning to 40% functioning. A year off statins, I am still at 30 – 40% functioning. I graph this every day since the onset.

    At this time I am stable but my symptoms appear to be permanent. Specifically, this would be static toxic encephalopathy, or, metabolic encephalopathy. I was able to discover this because my case was presented to a panel of 70 psychiatrists at University of Washington. My symptoms are much more complex than I am relating here but what I have provided gives a perspective of the severity. I am more than willing to share my notes, graphs and finding, along with objective evidence to help understand why this medicine is effecting people like me. Thank you

  6. Barbara
    Florida
    Reply

    I have been taking a low dose (10mg.) simvastatin for approximately 20 years as I have a family history (both parents) of very high cholesterol and triglycerides. Twice I have experienced bouts of transient global amnesia, both about six hours. The second time I was on a ladder when it hit and I fell off the ladder and fractured my pelvis. I am 82 now and while my general (long term) memory is OK for my age, my short term (I’m talking seconds) memory is terrible. Also I cannot find words although I am an insatiable reader. I am thinking of stopping simvastatin gradually and see what happens. Fish oil has never shown any improvement in my condition nor have the other supplements I usually take. I am planning to research the red rice yeast thing and other suggestions. Wish me luck.

  7. Dot
    Seattle WA
    Reply

    In the early 2000’s, my dad started to immediately experience word retrieval problems after starting a statin. His word retrieval was so severe that he told me he didn’t want to talk to people. His cardiologist took him off the statin and his word retrieval was restored within a week.

  8. Pete
    New Zealand
    Reply

    My own experience with Lipitor mirrors many of those who have commented here. I ended up after only a month with total global amnesia, a term I only discovered after experiencing the frightening symptoms. It culminated in an event where I felt a bit headachey and then tried to answer some basic questions from a customer who came into my shop. I thought I must be having a stroke, I could not recall colours, products, numbers etc that I had used daily for many years.

    After quick research it was clear the culprit was Lipitor. I stopped the pills and soon regained my mental faculties. I would urge anyone taking a statin to consider carefully these testimonies.

    I have had high cholesterol for many years, I also have high unstable blood pressure due to a congenital heart defect (bicuspid aortic valve). I take Losartan and Doxazosin which keep my BP normal so I’m not just anti drugs. I tried many natural alternatives first though.

    A CT scan on my heart a few years ago measured the calcium levels as zero, that’s zero risk of plaque formation, despite high cholesterol. Take control of your health, don’t blindly follow everything the doctors say. Try alternatives. E.g. I study martial arts, Tai Chi, meditation, essential oils, supplements, herbs, and intermittent fasting with excellent results. Blessings and good health to you!

  9. Toni
    Reply

    My husband took Lipitor and then Lovastatin for a total of eighteen years. After about fifteen years, he began to have memory problems. Names escaped him and he became repetitive in his conversation. He eventually began to drop off in the middle of sentences.

    Another three years passed before we finally made the connection to the statin he was taking. He had also suffered dramatic muscle loss by then. Our doctor diagnosed early onset Alzheimer’s.

    Three years off the statins, he has recovered his ability to carry on a conversation and regained much of his muscle mass. I definitely believe the statins were responsible for the damage my husband experienced. I also disagree with the Alzheimer’s diagnosis, as my husband is improving. You can read more of our story here: https://toniumbarger.wordpress.com/2016/08/11/a-statin-drug-induced-nightmare/

  10. John
    USA
    Reply

    I’m going to keep screaming this to prevent others from going through what my mom went through. Doc put her on Crestor. She was on it for years, and developed total dementia. She didn’t even realize when her husband died in the bed next to her, nor did she ever realize he was gone. She also lost the use of legs, and developed diabetes. Statins are poison and this obsession with cholesterol levels is crazy.

  11. Tom
    Dallas, TX
    Reply

    Please take a look at another “marginal”, doctor denied impact of statins.

    Within six months I ruptured two tendons in my right arm and finally ruptured (complete) my right quadriceps tendon (I am right handed).

    The orthopedics clinic I had gone t for 15 years misdiagnosed me with tendinitis. After my quad rupture I went to the best local ER I could find..they had done both my knee replacements. I trusted them. The ER doctor discharged me to acute re-hab for a sprained knee. Only after changing orthopedic clinic following two week of rehab that did me more harm than good was I correctly diagnosed and so far the repair is holding. According to the literature I found statins are a risk factor for tendinosis, I ave others as well.

    My cardiologist repeated the mantra “statins are likely the most studied drug of all time. They can’t be a problem”.

  12. Pam
    Greenville,SC
    Reply

    I’ve gotten the doctor to keep me on the lowest dose of the “cleanest” statin, rosuvastatin. I find that the brain fogginess less than others I’d taken.
    It’s much less than the others I’d taken. My numbers over the two or more years on it are good so will probably keep going with this regimen for now.

  13. Mary C. C
    Newark, Calif.
    Reply

    Four years ago in April, I started getting coughs, hoarseness, throat clearing and severe digestive problems. I went to a pulmonologist, ENT physician, and a gastroenterologist. Over the years they could not answer my problems. I had been treated for COPD and took a steroid medicine for awhile. I was on GERD medicines also. Last January I had a scope put down my throat and nothing could be found to cause my problems. I even had a colonoscopy for my digestive problem.

    Finally, I was at my cardiologist last month and thought what have I got to lose, and told him my problems. He immediately told me to stop the Simvastatin cold turkey. With in a week all of my problems disappeared. He had not put me on the drug, but my primary doctor had, back in April of 2014.

    Now that I have read this article, I also realized I had noticeably been forgetful over the last few years also. But now I am aware my memory is also much better. Thank you for this information.

  14. Phil
    USA
    Reply

    I believe every word of what you’ve said is true.

    My friend’s doctor told him to reduce his carbs and up his healthy fats too. He recommended supplementing with Amla instead of using statins! I read some Amla study results on nutritionfacts .org that were VERY impressive Amla head-to-head against a statin; look it up if you want good clinical study results that are peer reviewed etc. My friend’s total cholesterol was 220 at last check. I will update this post after his next lipid profile lab results are in.

  15. Pat
    Reply

    Ten years ago I took Simvastatin when I found my cholesterol had spiked for some unknown reason. Around a year later at a political meeting my brain was so fogged I could not make a sentence and could not come up with common words to express myself. I shut up and went home to research what was then coming out about the possible effects of statins on brain function. Simvastatin was listed as one in the category of most effecting memory etc. I changed to Pravastatin and it seemed to be better.

    Then I got my cholesterol back into control and went off all statins. Brain seemed to return to normal for a 65+ year old. Then a year ago I had a non-cancerous thyroid tumor removed and then had a pace-maker put in for an electrical problem in my heart. I’ve been taking new thyroid & heart drugs since which suddenly raised my cholesterol again. Back on Simvastatin. I began experiencing severe muscle pain to the point that I stopped taking statins again and with ‘Cholestoff’ and severe diet changes have lowered my cholesterol. My good cholesterol was always great…

    There is NO MISTAKE in my mind that statins were the cause of brain fog/memory problems as well as muscle pain – which continues. I do not care what the drug companies say, I know these are real side-effects of statins. I’m a very active, healthy 73 year old and know there was an effect form taking these drugs.

  16. Jackie
    Reply

    When my doctor insisted I start taking statins due to family history of heart disease, I developed, leg cramps and muscle weakness, balance problems (forcing me to use a cane), and intense pain down to my fingertips. Legs would give out suddenly without warning, causing me to fall down steps three times. I could not climb steps very well, either.

    Dr switched me from one brand of statin to another, to another, about four times or more. Did not help. Pain and weakness intensified. Could not walk without assistance. Doctor finally agreed to take me off statins when my husband pushed me into the office in a wheelchair.

    Muscle pain immediately subsided. But it took me over a year to be able to walk without a cane. I am on ezetimibe and fenofibrate, which my doctor assured me are not statins, but now, after reading these articles, I’m beginning to wonder if they have side effects too. I have metabolic syndrome, (low thyroid, diabetes, high blood pressure, obesity), osteoarthritis, gout, and kidney disease (as a result of high doses of ibuprofen prescribed to offset pain caused by statins). All except thyroid dysfunction were not diagnosed until after I turned 50.

    I still have trouble finding the right words, and losing my train of thought mid sentence, but not sure if this is due to statin use, artificial sweeteners, or age. This is why I’m concerned about ezetmibe and fenofibrate. Are they statins or not?

  17. Grandma Goose
    VT
    Reply

    I was on Lipitor for 2-3 years with no apparent side effects, until I started “losing” nouns. It became so bad that my husband had to translate for me. I retained memory of pronouns, verbs, adjectives and adverbs and he could usually figure out what I was trying to say. We scheduled a doctor’s visit to discuss Alzheimer’s. Fortunately, we had a doctor who immediately recognized the effects of Lipitor and took me off the drug.

    As a result, my word recall gradually came back, but my cholesterol crept up and my doctor decided to try other statins. The last straw was Crestor when I became so fatigued that sweeping the kitchen was too difficult and I had to rest for 15 minutes to “catch my breath.” I felt so bad that I told my doctor that I could no longer take statins even if it shortened my life. He said diet — either no fats or no carbs. I chose no carbs. Within a year my cholesterol had dropped into a safe range.

    A very low carb diet is hard to maintain, and I must admit that I’ve had some bad months (and years?) since my initial success. Then it’s necessary to diet again. I also add garlic and B3 (niacin) after a particularly bad test. My current doctor (we moved out-of-state) thinks this is a rather silly idea and refuses to test for cholesterol more frequently than semi-annually. It would be encouraging to get feedback more often. It’s as if you were trying to lose weight but could weigh yourself only once a year and were not allowed to measure your waist size!

    The upside is that 15 years later I’m a healthy, active old gray-hair!

    • Elizabeth
      FL
      Reply

      https://www.medscape.com/viewarticle/788004

      I would not take fenofibrate. It is useless. Read the above link. Ezetimibe too has not been found to decrease mortality in heart disease. Besides, it has side effects of muscle weakness, etc. None of these are necessary for people over 75 years. They have not been studied in older adults, and the risks are greater than the benefits. Eat healthy, and say a Rosary daily!

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