Innovations In Clinical Neuroscience

MAR-APR 2018

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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27 ICNS INNOVATIONS IN CLINICAL NEUROSCIENCE March-April 2018 • Volume 15 • Number 3–4 R E T R O S P E C T I V E S T U D Y overall statin prescribing in the United States, it has been noted that psychiatric inpatient providers might be cautious, often deviating from guideline protocol, when prescribing statin therapy to inpatient psychiatric patients, possibly due to the concern of potentiating increased aggression. Further investigation is warranted to determine if other potential factors influence non-standard statin prescribing trends in a psychiatric population. Low or lowered cholesterol has been linked with low serotonin activity, which can result in increased depression, violence, and impulsivity. Our analysis suggests that statin therapy alone does not increase patient aggression. However, it is unclear whether rapid lowering of cholesterol or simply having low cholesterol levels contribute to the observed psychiatric changes, and further research in this area is needed. More studies need to be completed before determining if statin prescribing should be changed in psychiatric patients. REFERENCES 1. Cham S, Koslik HJ, Golomb BA. Mood, personality, and behavior changes during treatment with statins: a case series. Drug Saf Cas Rep. 2016;3(1):1. 2. Golomb BA, Kane T, Dimsdale JE. Severe irritability associated with statin cholesterol- lowering drugs. QJM. 2004;97:229–35. 3. Tatley M, Savage R. Psychiatric adverse reactions with statins, fibrates, and ezetimibe: implications for the use of lipid- lowering agents. Drug Saf. 2007;30:195– 201. 4. Tuccori M, Lapi F, Testi A, et al. Statin- associated psychiatric adverse events: a case/ noncase evaluation of an Italian database of spontaneous adverse drug reaction reporting. Drug Saf. 2008;31:1115–23. 5. Sahebzamani FM, D'Aoust RF, Friedrich D, et al. Relationship among low cholesterol levels, depressive symptoms, aggression, hostility, and cynicism. J Clin Lipidol. 2013;7(3):208–16. 6. Muldoon MF, Manuck SB, Mendelsohn AB, et al. Cholesterol reduction and non-illness mortality: meta-analysis of randomized clinical trials. BMJ (Clinical Research Ed). 2001;322:11–5. 7. Golomb BA. Cholesterol and violence: is there a connection? Ann Intern Med. 1998;128:478–87. 8. Golomb BA, Stattin H, Mednick S. Low cholesterol and violent crime. J Psychiatr Res. 2000;34:301–9. 9. Conklin SM, Harris JI, Manuck SB, et al. Serum omega-3 fatty acids are associated with variation in mood, personality and behavior in hypercholesterolemic community volunteers. Psychiatry Res. 2007;152:1–10. 10. Littarru GP and Langsjoen P. Coenzyme Q10 and statins: biochemical and clinical implications. Mitochondrion. 2007;7 Suppl: S168–74. 11. Golomb BA, Dimsdale JE, Koslik HJ, et al. Statin effects on aggression: results from the UCSD statin study, a randomized control trial. PLoS One. 2015;10(7):e0124451. 12. Walker ER, McGee RE, Druss BG. Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry. 2015;72(4): 334–341. ICNS

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