Can a Drug That Helps Hearts Be Harmful to the Brain?

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HEALTH JOURNAL
By MELINDA BECK
February 12, 2008; Page D1
(See Corrections & Amplifications item below.)

Cognitive side effects like memory loss and fuzzy thinking aren't listed on the patient information sheet for Lipitor, the popular cholesterol-lowering drug. But some doctors are voicing concerns that in a small portion of patients, statins like Lipitor may be helping hearts but hurting minds.

SIDE EFFECTS OF STATINS


• Like every medication, statins also have side effects such as muscle aches and memory loss that can be difficult to measure. What's your experience been with statins? Join a discussion1.

• Health Mailbox:2 Melinda Beck reviews the procedure recommended to care for someone who is unconscious.

"This drug makes women stupid," Orli Etingin, vice chairman of medicine at New York Presbyterian Hospital, declared at a recent luncheon discussion sponsored by Project A.L.S. to raise awareness of gender issues and the brain. Dr. Etingin, who is also founder and director of the Iris Cantor Women's Health Center in New York, told of a typical patient in her 40s, unable to concentrate or recall words. Tests found nothing amiss, but when the woman stopped taking Lipitor, the symptoms vanished. When she resumed taking Lipitor, they returned.

"I've seen this in maybe two dozen patients," Dr. Etingin said later, adding that they did better on other statins. "This is just observational, of course. We really need more studies, particularly on cognitive effects and women."

Pfizer Inc.'s Lipitor is the world's best-selling medicine, with revenues of $12.6 billion in 2007. The company says that its safety and efficacy have been demonstrated in more than 400 clinical trials and 145 million patient years of experience, and that the extensive data "do not establish a causal link between Lipitor and memory loss." Pfizer also says it draws conclusions about adverse events from a variety of sources "as opposed to anecdotal inferences by individual providers with a limited data pool."

World-wide, some 25 million people take statins, including Zocor, Mevacor, Crestor, Pravachol and Vytorin. As a group, they are widely credited with reducing heart attacks and strokes in people at high risk, though the benefits are less clear in people who are not at high risk, particularly women and the elderly. Some 15% of patients complain of side effects; muscle aches and liver toxicity are the most recognized to date. But anecdotes linking statins to memory problems have been rampant for years.

On balance, most cardiologists see . . .