Table 3.
Overview of studies regarding the effects of statins on the risk of developing depressive episodes or on depressive symptoms scores in depressed patients.
| References | Study design | Population |
Intervention/
exposure |
Comparison | Follow-up | Primary outcomes | Major Findings | Association |
|---|---|---|---|---|---|---|---|---|
| Meta-analysis | ||||||||
| Bai et al. (19) | Meta-analysis | 3 RCTs, 166 MDD patients | TAU + Statin | TAU + placebo | 6–12 weeks | HDRS | SMD = −0.65 95% CI = −0.96 to −0.33 P < 0.0001 | + |
| De Giorgi et al. (71) | Meta-analysis | 4 RCTs, 255 MDD patients | TAU + Statin | TAU + placebo | 8 weeks | HDRS/MADRS | SMD = −0.48 95% CI = −0.74 to −0. 22 P = NR | + |
| Salagre et al. (130) | Meta-analysis | 3 RCTs, 165 MDD patients | TAU + Statin | TAU + placebo | 6–12 weeks | HDRS | SMD = −0.73 95% CI = −1.04 to −0.42 P < 0.001 | + |
| Randomised controlled trials | ||||||||
| Abbasi et al. (131) | RCT | 46 post CABG patients with mild to moderate depression | Simvastatin 20 mg | Atorvastatin 20 mg | 6 weeks | HDRS | SMD = 3.63 95% CI = 0.44–6.51 P = 0.03 | + |
| Berk et al. (132) | RCT | 130 MDD patients aged 15–25 years | TAU + rosuvastatin 10 mg | TAU + placebo | 12 weeks | MADRS | SMD = −4.2 95% CI = −9.1 to 0.6 P = 0.089 | = |
| Ghanizadeh and Hedayati (133) | RCT | 68 MDD patients | Fluoxetine 40 mg + lovastatin 30 mg | Fluoxetine 40 mg + placebo | 6 weeks | HDRS | SMD = −0.77 95% CI = −1.30 to −0.24 P < 0.001 | + |
| Gougol et al. (134) | RCT | 48 MDD patients | Fluoxetine 20 mg + simvastatin 20 mg | Fluoxetine 20 mg + placebo | 6 weeks | HDRS | SMD = −0.73 95% CI = −1.34 to −0.11 P = NR | + |
| Haghighi et al. (135) | RCT | 60 MDD patients | Citalopram 40 mg + atorvastatin 20 mg | Citalopram 40 mg + placebo | 12 weeks | HDRS | SMD= −0.70 95% CI = −1.22 to −0.18 P = NR | + |
| Soh et al. (136) | RCT | 60 patients with mood disorder | Lithium + atorvastatin 20 mg | Lithium + placebo | 12 weeks | Relapse (MADRS≥10) | χ2 (1) = 0.148 95% CI = NR P = 0.70 | = |
| Cohort studies | ||||||||
| Kim et al. (68) | Cohort | 300 patients with comorbid ACS and depression | Escitalopram + statin, statin-only use | Escitalopram-only, placebo-only | 1 year | Response (HDRS, BDI) | HDRS response: OR = 2.23 95% CI = 1.11–4.51 P = 0.025 BDI response: OR = 2.82 95% CI = 1.35–5.90 P = 0.006 | + |
| 146 patients with comorbid ACS and depression | Statin use | TAU | 1 year | Response (HDRS, BDI) | HDRS response: OR = 1.19 95% CI = 0.45–3.18 P = 0.726 BDI response: OR = 0.89 95% CI = 0.36–2.22 P = 0.798 | = | ||
| Köhler et al. (137) | Historical cohort | 872,216 SSRI users | SSRI + statin use | SSRI-only use | 3 years | Depressive episode (hospital contact) | HR = 0.64 95% CI = 0.55–0.75 P = NR | + |
*The effect size of the main findings, either extracted from the study or calculated by the authors. Where this was not possible, we report the raw data.
ACS, acute coronary syndrome; BDI, beck depression inventory; CABG, coronary artery bypass graft; CI, confidence interval; HDRS, hamilton depression rating scale; HR, hazard ratio; MADRS, montgomery-åsberg depression rating scale; MD, mean difference; MDD, major depressive disorder; PR, prevalence ratio; OR, odds ratio; RCT, randomised controlled trial; SD, standard deviation; SMD, standardised mean difference; SSRI, selective serotonin reuptake inhibitors; TAU, treatment as usual.