Lipid Med Moods

September 19, 2009 8:13 PM

I was recently prescribed simvastatin for high cholesterol. About a year ago I tried Lexapro for anxiety, but didn't do well on it and stopped after a couple months, and otherwise haven't taken any medication for anything. See inside for where the two cross:

When I started taking simvastatin, it seemed to me that I had started sleeping better and had more energy when waking up in the mornings. The Wifey recently said - without having heard my thoughts - that she thinks my anxiety has been less since I've been taking simvastatin, too, although she didn't want to say anything since it didn't seem to make sense. I can't imagine placebo effect, since I, even now, don't see any reason for a statin to have any sort of seratonin-related improvement or other mental health impact. Searching for side effects only found the one my doctor warned about, joint pain that's a bad sign, which I don't have nor any other negative side effects. Also, in case you're stalking me, this all started before I started exercising, so it's not that. You're not my doctor, and I haven't brought it up to my doctor since it seems so unrelated, but are there any of you in the MeFi universe with any thoughts on why this might be?

posted by AzraelBrown to health & fitness (7 comments total)

It's not impossible. Occasionally drugs are found to have effects well outside their originally understood functionality.

Fifteen or twenty years ago, some poor bastard who was both bipolar and epileptic noticed that his mood swings were much less severe when he was taking his anti-seizure drugs. That was an unexpected result, but experimentation showed that it was true, and now drugs like Tegretol and Depakene are routinely used to help people with bipolar disorder whose mood swings don't respond to lithium.

Remember Thalidomide? It was a tranquilizer which got prescribed to pregnant women in Europe in the 1950's, and it turned out to sometimes cause really horrific birth defects in their babies. (It didn't happen in the US because the drug was hung up in the FDA's approval cycle for longer.)

It's been found that Thalidomide is effective against multiple myeloma, a kind of blood cancer, and now it's a standard part of treatment for that disease.

You should tell your doctor about your reaction, not because it's a problem for you (it isn't) but because it may become a solution for someone else.
posted by Chocolate Pickle at 9:28 PM on September 19 [1 favorite]

The BNF gives a vast list of possible side effects with statins, and simvastatin in particular - but improvement in anxiety isn't one of them. High cholesterol doesn't give you any neurological symptoms as far as I know, so lowering it shouldn't have changed anything.

The only thing I can think of is that statins (and exercising) should be improving your cardiovascular health, so it may be that the heart-thumping part of anxiety is less symptomatic? This is, I will freely admit, a clutching at straws sort of idea!
posted by Coobeastie at 2:58 AM on September 20

A lot of hormones are produced from cholesterol. If your anxiety is rooted in hormone imbalances, perhaps the reduced level of cholesterol is reducing the synthesis of same?
posted by gjc at 4:11 AM on September 20

I started a low dose of simvastatin about a year ago and I thought I felt some improvement in anxiety/depression. It wasn't earthshaking, it was just a bit of a difference; I felt a little more centered. I only noticed it for a few weeks though. It either wasn't a long-lived difference, or I got acclimatized to it. Maybe it was some sort of unconscious placebo effect (hey, pills are good, right?).
posted by DarkForest at 6:42 AM on September 20

Thanks all -- maybe I asked too soon; my wife and I compared notes yesterday evening and the sudden lightbulb illuminating above my head is why I AskedMeFi, but adjusting my search terms found these this morning:

"...statin use was associated with lower risk of abnormal depression scores, anxiety, and hostility after adjustment for the propensity for statin use and potential confounders" - NIH

"On the contrary, current statin use was associated with a substantially reduced risk of depression, even after controlling for measured baseline differences between cases and controls." - Archives of Internal Medicine

"It is possible that some people may also get a boost to their mood with low cholesterol, although this is less commonly reported." - UCSD statin study

So it seems it's not a placebo, there's actually some proof. On the other hand, there's data to prove that statins cause depression and anxiety as well, enough to make drug manufacturers include it as a side-effect warning, but unmedically-educated me wonders if there's some mechanism akin to giving ADHD people stimulants to calm them down, a cause can sometime be the cure. Even the smallest lexapro dose made me feel buzzy, ears ringing, sexual dysfunction (another statin warning I'm not experiencing), things smelling funny, and an uncomfortable 'disconnect' between thoughts and emotions, pretty much all the negative side-effects with no positives - but if statins help, heck, I'll stay on them. I go back for a check-up in a couple weeks; I'll mention it to the Dr. then.
posted by AzraelBrown at 7:11 AM on September 20

For any drug you'd care to mention there is almost always some subset of the population who has one or more weird responses. The thing is, unless damn near everyone on drug X has the same side effect (say a blood pressure medicine that also causes hair growth), or unless the side effects are massive (and these tend to be bad because it's easier to break things than fix them), then they tend to disappear into the background noise of our day to day lives.

The biochemistry of whatever is happening is probably odd since it's atypical. Given the number of diseases in which inflammation has been implicated in, I wouldn't be stunned if I someday read that statins prevent your body from making as much of some interleukin or another which reduces the stress of X, which prevents Y, which causes Z which puts you in a better mood. (Not that I'm saying this is likely, just that it could be anything.)
posted by Kid Charlemagne at 8:21 AM on September 20

If, as some people suspect, statins act mainly to reduce inflammation rather than cholesterol directly, this could potentially have an antidepressant effect. Chronic high stress states often produce both depression and inflammation via known stress chemistry, it's possible that interfering with the inflammation might calm the whole thing.

And since antidepressants can cause depression in some people, there's nothing unusual about a drug having opposite effects on different people-- even opposite effects on the same person at different times, in fact.
posted by Maias at 6:40 PM on September 20