The People's Perspective on Medicine

A Big Statin Controversy: Do Statins Impair Memory?

Statin-type cholesterol-lowering drugs such as atorvastatin, lovastatin, simvastatin and rosuvastatin remain highly popular. Can such statins impair memory?
A variety of statin drugs

Statins are a never-ending source of controversy. Over the last 30 years doctors have debated the pros and cons of statins with little resolution. Some maintain that side effects are extremely rare and benefits extremely explicit. Others suggest that side effects are more common than clinical trials reveal. They also point out that heart attack reduction is surprisingly modest. We will not revisit this debate in this article. You can read our many articles by putting “statins” into a search. Here, we are asking whether statins impair memory.

A Short Historical Perspective:

The first inkling we had that statins might impact cognitive function was in May of 2000.

That’s when a reader of our syndicated newspaper column wrote to ask:

“Last fall my doctor prescribed Lipitor, and after several months I found I was having trouble remembering names and coming up with the right word. At dinner once I said ‘please pass the elephant’ though I wanted the bread. I told my husband I thought I’d had a stroke.

“In January a friend came to visit. She was worried about her memory and couldn’t think of her daughter’s name on the telephone. She too was on Lipitor.

“I asked my doctor to prescribe a different cholesterol medicine. Within a couple of weeks I was more mentally alert. But my friend (still on Lipitor) was in worse shape and afraid she would lose her job. Her doctor said forgetfulness could not be due to the drug. She finally stopped taking Lipitor anyway and now is much sharper.

“I am concerned that some people taking Lipitor might think such a reaction was just due to getting older. Is this side effect well known?”

We responded with this answer:

A. This side effect is not reported in the official prescribing information for Lipitor (atorvastatin). Without a study it is impossible to determine whether this powerful cholesterol-lowering drug is causing confusion and memory loss.

Cholesterol is often viewed as a dangerous compound, but it is an essential building block for many crucial chemicals and is also important in nerve function. Studies suggest that people with very low cholesterol may be more vulnerable to depression, so it’s not inconceivable that lowering cholesterol significantly might affect mental function for some people.

That was the first trickle in what eventually turned into a raging flood. Over the last two decades we have heard from hundreds, if not thousands, of people who experienced memory problems or cognitive difficulties after taking statins. Most were convinced that statins impair memory.

Dr. Dwayne Graveline’s First Communication:

In March of 2001 we heard from Dr. Duane Graveline. Here is his original message:

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.

We checked the medical literature and concluded that total global amnesia was a pretty rare complication of statins. We also consulted Beatrice Golomb, M.D., Ph.D., Principal Investigator of the Statin Study at the University of California, San Diego.

She told us:

“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.”

Dr. Graveline went on to write several books including Lipitor, Thief of Memory; Statin Drugs, Side Effects and The Misguided War on Cholesterol; The Statin Damage Crisis and The Dark Side of Statins: Plus: The Wonder of Cholesterol. Dr. Graveline died on Sept. 5, 2016. 

Can Statins Impair Memory in 2019?

During the last two decades, we have continued to receive many reports of memory problems, fuzzy thinking and other cognitive difficulties associated with statins.

Here is a recent question that came in via email:

Q. I recently read that statins don’t cause memory problems. Let me tell you about my experience with statins.

Over the last two decades I have been prescribed simvastatin, atorvastatin, fluvastatin and pravastatin. I would not call my problem memory loss. What I get is stupid. Really! It was difficult to figure out slightly complex tasks at work. I was often in a daze, not able to focus. It was like my brain could not process information. I couldn’t think—literally. I eventually stopped the statins.

I recently tried atorvastatin again. Within a week or so I started having the same problems. Now I take gemfibrozil and niacin to control my cholesterol. They do not affect my brain.

So, Do Statins Impair Memory in 2019?

A. Doctors disagree about whether brain fog is a side effect of statin-type cholesterol-lowering medications.

An epidemiological study from Australia concluded that:

“statin therapy was not associated with any decline in memory or cognition over six years” (Journal of the American College of Cardiology, Nov. 2019). 

Another group of Australian scientists analyzed studies and case reports (Expert Reviews in Clinical Pharmacology, April 27, 2019).

They concluded that:

“statin-induced cognitive decline does exist, needs to be better recognized and requires more studies of prevention and treatment.”

You are forgiven if you find these contrasting statements confusing. We too are confused.

Does the FDA Say Statins Impair Memory?

The answer to that question is yes! Although many statin enthusiasts would prefer this not exist in the official prescribing information, here is what the FDA mandates for atorvastatin (Lipitor):

“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).”

Statin Side Effects in 2020?

We doubt that the statin side effect controversy will be resolved any time soon. Just as in politics, the statin enthusiasts and the statin critics are dug in to their respective positions. It is not likely that there will be agreement any time soon about the question: do statins impair memory?

Anyone who would like to read more about statin side effects and other drugs that could affect cognitive function may wish to consult our book Top Screwups. It is available at this link.

Share your own statin story in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Citations
  • Samaras, K., et al, "Effects of Statins on Memory, Cognition, and Brain Volume in the Elderly," Journal of the American College of Cardiology, November, 2019, DOI: 10.1016/j.jacc.2019.09.041
  • Tan, B., et al, "Evidence and mechanisms for statin-induced cognitive decline," Expert Review of Clinical Pharmacology, April 27, 2019, doi: 10.1080/17512433.2019.1606711
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Are women included in this research? (Research that shows statins don’t reduce heart attacks.) Because heart disease is the biggest killer of women.

I have found that adding a 200mg CoQ10 supplement when I take the statin (pravastatin) helps a lot with the brain fog/memory issues too. I stumbled across this supplement about 10 years ago when I was first put on the statin medication. My PCP was aware of the association of memory/cognitive/brain fog and statins, but really felt that the benefits outweighed the side effect. I mentioned CoQ10. She agreed it was worth a try. The effect was within days.

My husband was given statins back in 2000. The almost immediate terrible muscle pain crippled him. So, the doctor kept trying other statins. He then developed memory problems so severe that I thought I was going to have to put labels on everything in the house, and he took tests for dementia, which he did not have. Then he developed peripheral non-diabetic neuropathy. Finally he stopped the statins. But while his memory did improve, and the muscle pain eased, the neuropathy remained and got worse. He has only now gotten meds that will help that as well as acupuncture.

The doctor he has now took statins himself and after experiencing side effects, he won’t prescribe them for anyone if there is any way around it. To us,there is no controversy about statins at all. They are harmful. They damage the myelin sheath which protects the nerves in the body and the brain. We do not understand why doctors refuse to recognize that there are people who cannot take these drugs.

YES! Fortunately my doctor recognized it and took me off the drug.

While doctors go to school for many years and are there to help you I sometimes don’t think they understand that not all people are the same. My experience has been that when I tell my doctor something he doesn’t listen, and his mind is already made up before he walks in the door. The girl who takes me into the room and takes my blood pressure asks why I are there, questions me,and starts typing in the computer, then walks out to brief the doctor about my problem. The doctor really doesn’t talk to me that much and seems to base everything on what the girl who took me into the exam room says. He’s there, then rushes out without really listening to me.

I been diagnosed with high cholesterol. My doctor put me on 20mg of pravastatin, and after about one month of taking the pravastatin I began having bad muscle cramps that started on my feet and went up my leg up to my groin area. I reported it to my doctor on three separate occasions and paid three separate co-pays each time to have the doctor tell me that the muscle cramps were not from the pravastatin drug. He claimed it was because I was somewhat overweight and not active enough. I stopped taking the pravastatin myself without telling my PCP, and the cramps went away.

I then became scared that if I had high cholesterol and didn’t take medication to lower it I may have a heart attack so I made an appointment with a cardiologist and told him I stopped taking the medication my PCP had prescribed.The cardiologist then put me on a different statin drug–atorvastatin–at a lower dose 10mg and told me to go to the drug store and pick up a bottle of 200mg of Co Q 10, and it would do the trick and lower my cholesterol. I told him I didn’t want to take a statin drug anymore, as I felt they may have not been good for me. He told me that sometimes you needed to experiment with different statin drugs to see which one best suits you and that they were really a good tool in lowering your cholesterol. He said that my cramps would go away with the switch to atorvastatin, and my numbers would get better. I dropped 25 pounds and ate better, and six months later my cholesterol levels dropped to normal ranges. My doctor was pleased with the results, and the cramps never came back with the switch. My doctor told me to keep taking the atorvastatin and doing what I been doing.

It is now nine months later, and I am finding that my memory is slipping. For instance, I can’t recall a name or fact about something; then it will come to me about ten minutes later. I never had this problem before and, after reading this article, I believe the problem is caused by the statin. I am glad you published this because I thought it was because I’m getting older. I am 56 years old. I’m going to address this problem with my cardiologist at my next visit him.

If my numbers are still good I am going to see if I could discontinue taking the statin drug. While I believe statin drugs help lower cholesterol levels they should not be used by everyone and do cause serious side effects, as I have experienced. As for my PCP, he was angry that I went to a cardiologist, and he switched my medication. I am now looking for another PCP.Thanks for publishing this article.

I had been on Crestor and doing well. Then I had to switch insurance companies, and their first-line drug for hyperlipidemia was Lipitor. Six months later, I was fired from my job for routine details and steps that were missed, and I frantically called my doctor, thinking there was something organically wrong with my brain. He admitted that he was starting to see literature that Lipitor, especially, was suspected in cases of cognitive decline and memory loss. 2 weeks off of Lipitor, and the fog lifted but I couldn’t get my job back. This was around 2012-13. I’m now borderline diabetic, and statins can affect that negatively, so I recently started taking red yeast rice on recommendation from my Nurse Practitioner.

Lipitor caused a degree of brain fog. Lovastatin does not for me.

I was on a low dose statin for the first time in my life and I found myself needing to take daily afternoon naps due to fatigue each day. The naps started out short, then gradually increased to up to 2 hours per day at times, which is very unusual for me. At the time, I kept thinking I was losing energy as I age, but luckily I snapped myself out of it and connected the dots to the statin I had been taking for the first time (sorry, forgot which statin it is now since it was several years ago). Anyway, when I chose to simply stop taking the statins, I stopped needing to nap and have not had that need since.
Now I am working on natural ways to lower my cholesterol, such as eating less and moving more.

I am a retired university professor and I felt strongly that my cognitive functions were continuing at a high level…until I started taking Lipitor after coronary bypass surgery. The surgery became complicated and I was under for more than eight hours; not advised for someone my age (78 at that time).

I had clearly lost some of my cognitive skills, but after taking Lipitor for several months, my cognitive skills further declined. Then, I had three terrifying experiences: While driving, I suddenly realized I didn’t know where I was, where I was going or why. These were not momentary, they lasted several minutes. I had to stop driving to finally focus on where I was and where I was going. I seriously thought I was entering dementia.

I started reading up on the drugs I was taking and found that “confusion” was one of the side effects of taking statins. I stopped taking Lipitor and never had another spell of “confusion.” Moreover, the cognitive decline I had after bypass surgery quickly became a thing of the past. Today, at age 82, my mind is as sharp as it was many years ago when I was an active professor.

As a former Critical Care RN, whose Life and Career were all but destroyed by 3.5 years of 10mg Lipitor, I can personally testify to these FACTS. In 2002 I fell deathly ill, hospitalized at UW Madison in an end stage Alzheimer’s like state. I did not know my wife, my parents, my siblings nor my 2 year old son. Brain MRI revealed “Innumerable foci of increased T2 Signal scattered throughout the deep and subcortical white matter of supra and infratentorial brain, including Brainstem, and corpus callosum”…

Brain Biopsy revealed “Focal areas having vacuolization of both neurophil and neuronal cytoplasm. Some of the vacuolization is perivascular.”.. “The Changes seen by light and electron microscopy are most consistent with a Mitochondrial Encephalomyopathy such as MELAS”

After responding quite favorably to a mitochondrial cocktail with a robust dose of CoQ10, I began to answer simple questions, could communicate the need to use the restroom, and could walk with Physical assistance. And was discharged several days later, with aggressive rehab therapy.

A few weeks later, I saw Dr Beatrice Golomb on Good Morning America being interviewed by Diane Sawyer, re the UCSD Statin Effects Study, which I enrolled in, which concluded the Mitochondrial DNA Mutations, the Lesions on my brain, the subsequent neuropathy and the Neuropsychiatric eval findings of “his neurological deficits are of sufficient severity to significantly affect his occupational skills and efficiency” were a result of my taking Lipitor

I once lived in an apartment complex for people at least 50 years of age. In conversations with residents I discovered many who had ceased taking statins because of memory issues which were overcome when they ceased taking the statins. I understand this is all “anecdotal,” but it is also reality.

Personally, I quickly stopped taking a statin due to violent muscle spasms.

I noticed serious issues with concentration using atorvastatin (Lipitor). After reading about these side effects, I switched to rosuvastatin (Crestor) and have had much less difficulty. I think all statin users should be aware of these side effect risks and determine through their own experimentation which one is best for them.

What dosage of a statin is considered to create this cognitive problem? Small dosage such as 10mg daily or more?

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