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Chen-Chang Yang, MD, MPH, DrPH; Susan S. Jick, DSc; Hershel Jick, MD

Arch Intern Med. 2003;163:1926-1932.

Background  A possible association between lipid-lowering drug therapy and psychological well-being remains an issue of debate. To provide more information, we performed a nested case-control study to evaluate the effect of lipid-lowering drugs on depression and suicidal behavior.

Methods  Within the United Kingdom General Practice Research Database, we identified all cases with newly treated depression needing a referral or hospitalization and all cases with first-recorded diagnosis of suicidal behavior between January 1, 1991, and December 31, 1999, from a study base that comprised all patients who were aged between 40 and 79 years and who had various exposures of interest. Each case was matched with up to 4 controls, randomly selected from the study base, on age, sex, medical practice, calendar time, and years since enrollment in the General Practice Research Database.

Results  A nested case-control analysis comprised 458 newly diagnosed cases of depression with 1830 controls, and 105 cases of suicidal behavior with 420 controls. The adjusted odds ratio of depression was 0.4 (95% confidence interval, 0.2-0.9) for current statin use, compared with hyperlipidemic nonuse. The adjusted odds ratios for other exposures were all around 1.0. None of the adjusted odds ratios for suicidal behavior were significantly different from unity.

Conclusions  The use of statins and other lipid-lowering drugs is not associated with an increased risk of depression or suicide. On the contrary, individuals with current statin use may have a lower risk of developing depression, an effect that could be explained by improved quality of life due to decreased risk of cardiovascular events or more health consciousness in patients receiving long-term treatment.

From the Department of Internal Medicine, Faculty of Medicine, School of Medicine, National Yang-Ming University, and Division of Clinical Toxicology, Department of Medicine, Veterans General Hospital–Taipei, Taipei, Taiwan, and Department of Epidemiology, Harvard School of Public Health, Boston Mass (Dr Yang); and the Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Mass (Drs Yang, S. Jick, and H. Jick). The authors have no relevant financial interest in this article.

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