Up to 70% of statin side effects are ‘all in the mind’, doctors say


Up to 70% of statin side effects are ‘all in the mind’, doctors say

  • A team of cardiologists estimates most of the symptoms caused by the “nocebo effect”
  • Occurs when a person experiences side effects from a medication because they expect
  • Opposite placebo effect seen in people feeling better after taking fake medicine

Most of the unwanted side effects of statins are “all in the mind”, doctors say.

One in four UK adults take cholesterol-lowering pills every day to protect against stroke or heart attack in the future.

Up to half of patients stop taking their prescription or use the drug irregularly due to side effects such as muscle aches, trouble sleeping and headaches.

But a team of cardiologists estimates that up to 70% of symptoms are actually caused by the “nocebo effect”.

Professor Maciej Banach, from the Medical University of Lodz in Poland, and his team made the estimate after reviewing 170 studies involving 4 million people.

The phenomenon occurs when a person experiences an uncomfortable side effect of a medication simply because they expected it.

This is the opposite placebo effect seen in people who feel better after being given a fake drug.

In an editorial published today in a scientific journal, Professor Banach said: “The ‘nocebo/drucebo’ effect occurs when patients expect them to experience side effects from statins, causing them to to experience these symptoms.

Statins (pictured) work by limiting the production of ‘bad cholesterol’ – low-density lipoprotein (LDL) cholesterol – which can harden and narrow arteries and increase the risk of cardiovascular disease

“Knowledge of them is gained through the internet, leaflets, friends and family and other sources, and the most common side effects are muscle pain and liver disease.

“This can cause them to discontinue their treatment and therefore increase their risk of heart problems, stroke and death.”

What are the common side effects of statins?

Most of the millions of people who take statins experience no side effects.

But about one in 100 people can say they experience it.

The most common side effects are:

  • Headache;
  • Dizziness;
  • feeling sick;
  • Feeling abnormally tired or physically weak;
  • digestive system problems;
  • Muscle pain;
  • sleep problems;
  • Low blood platelet count.

There are also less common side effects that affect 1 in 1,000 people. These are:

  • Be sick;
  • Memory issues;
  • Hair loss;
  • Have ants;
  • Inflammation of the liver, which can cause flu-like symptoms;
  • Inflammation of the pancreas, triggering stomach pain;
  • Achnea or red, itchy rash;
  • Loss of libido and erectile dysfunction.

Source: NHS England

Statins work by limiting the production of “bad cholesterol” – low-density lipoprotein (LDL) cholesterol – which can harden and narrow the arteries and increase the risk of cardiovascular disease.

Studies have repeatedly proven that the drug, which costs less than £5 for a month’s supply, saves lives.

Charities say around 8 million Britons and 35 million Americans are prescribed the drugs, which must be taken daily.

But doctors believe tens of thousands of people die each year because they avoid lifesaving pills, often due to side effects.

In today’s editorial, published in the Journal of Cachexia, Sarcopenia and Muscle, a team of cardiologists presented a series of recommendations for medical professionals prescribing the drugs.

First, he advises that patients continue to take treatments even if they begin to experience mild symptoms.

The document includes guidance on how to effectively diagnose statin intolerance and rule out the nocebo effect by testing for common problems such as statin-associated muscle symptoms (SAMS).

The paper’s co-author, Dr Peter Penson, of Liverpool John Moores University, said: ‘This is the first paper to explicitly address the nocebo/drucebo effect.

“It offers practical, evidence-based suggestions that we hope will be helpful to physicians in improving patient-centered care for people at risk for cardiovascular disease, but experiencing adverse effects attributable to their medications.

“We hope this document will facilitate shared decision-making between patients and prescribers. The guidelines recognize that the vast majority of patients can safely take statins and that the benefits far outweigh the potential risk of side effects.

The cardiologists based their recommendations on a meta-analysis of 170 studies.

In a study they referred to, 60 patients who had stopped taking statins were asked to resume the drugs, a placebo, or no treatment every month in random order.

The severity of symptoms was similar in the periods when statins and placebos were taken.

But it was much lower when someone had no treatment. It revealed that half of the patients restarted their statin treatment after the procedure.


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