Antidote: Statins are great drugs

Marc Siegel, MD
Marc Siegel, MD

Full disclosure—I have taken the cholesterol-lowering statin atorvastatin. This year I transitioned from taking the brand name Lipitor to the new generic version atorvastatin, without any noticeable change in symptoms or cholesterol levels. I also found out, after Ranbaxy recalled its generic atorvastatin for possible contamination with glass particles, that this was the version I was on. I consulted with my pharmacist and physician, and continued taking it, as the FDA advised.

I also continued taking it after the FDA issued new warnings about the potential for diabetes as well as cognitive difficulties. I have been aware of these concerns for many months now, but lacking direct proof, and because of the enormous benefit of these drugs, I continue to take them and prescribe them for a large number of my patients.

The real story here is not the risk of statin drugs but the media's presentation of it. Preying on patient fears risks obscuring the proven benefits for patients at risk of heart disease. Any time a possible side effect is presented, it is important to simultaneously remember the overall benefit of the drug. After all, practicing medicine is a cost/benefit analysis. The media often moves the needle too much in one direction or another, but for a good clinician taking care of an individual patient, it is always a question of whether the potential benefit outweighs the potential side effects for that patient.

Fear and hype should not be part of the prescribing equation, though they often are. As a recent Canadian pharmacy study concludes, problems with thinking or cognitive impairment arising from statins are a rare occurrence. This concern (which may be less for the less lipophilic rosuvastatin) is greatly outweighed by the vascular and long-term cognitive benefits of the drug itself.

Don't get me wrong, I monitor liver functions and muscle enzymes for all my patients on statin drugs, including myself. Muscle aches are important side effects for doctors prescribing statins to be on the lookout for. But I remain convinced that these drugs provide enormous benefits to my patients (and myself) that should not be jeopardized by media hype.