Table 4.
Overview of studies regarding the effects of statins on depressive-inflammatory symptoms.
| Publication | Study design | Population |
Intervention/
exposure |
Comparison | Follow-up | Primary outcomes | Major Findings | Association |
|---|---|---|---|---|---|---|---|---|
| ANHEDONIA | ||||||||
| Psychomotor retardation | ||||||||
| Randomised Controlled Trials | ||||||||
| Harrison and Ashton (114) | RCT crossover | 25 healthy volunteers | Simvastatin 40 mg, pravastatin 40 mg | Placebo | 4 weeks | DSST | Pravastatin: mean = 74.3 95% CI = 70.3–78.3 Simvastatin: mean = 74.6 95% CI = 70.3–78.9 Placebo: mean = 74.6 95% CI = 70.9–78.3 SMD = NR 95% CI = NR P = NR | = |
| Muldoon et al. (118) | RCT | 209 hyperlipidaemic adults | Lovastatin 20 mg | Placebo | 6 months | DSST | MD = 0.06 95% CI = 0.01–0.12 P = 0.016 | + |
| Santanello et al. (121) | RCT | 431 adults aged >/= 65 years or older | Lovastatin 20, lovastatin 40 mg | Placebo | 6 months | DSST | Mean (SD) = Placebo 0.33 (13.6) Lovastatin 20 mg −0.80 (13.28) Lovastatin 40 mg 1.66 (8.98) SMD = NR 95% CI = NR P = 0.66 | = |
| ANXIETY | ||||||||
| Randomised controlled trials | ||||||||
| Berk et al. (132) | RCT | 130 MDD patients aged 15–25 years | TAU + rosuvastatin 10 mg | TAU + placebo | 12 weeks | GAD | SMD = −0.6 95% CI = −1.7 to 3.0 P = 0.684 | = |
| Harrison and Ashton (114) | RCT crossover | 25 healthy volunteers | Simvastatin 40 mg, pravastatin 40 mg | Placebo | 4 weeks | HADS (anxiety subscale) | Pravastatin: mean score = 3.2 95% CI = 2.0–4.4 Simvastatin: mean score = 2.5 95% CI = 1.7–3.3 Placebo mean score = 3.1 95% CI = 2.2–4.0 SMD = NR 95% CI = NR P = NR | = |
| Hyyppä et al. (115) | RCT crossover | 120 hyperlipidaemic men aged 35–64 years | Simvastatin 20 mg | Placebo | 24 weeks | BDI (anxiety items) | Mean change= 0.00 95%CI = −0.05 to 0.05 P= 0.9474 | = |
| Stewart et al. (122) | RCT | 1,130 adults with CAD and hyperlipidaemia | Pravastatin 40 mg | Placebo | 4 years | GHQ (anxiety items) | MD= NR 95% CI = NR P= “non-significant” | = |
| Wardle et al. (123) | RCT | 621 adults with CAD aged 40–75 years | Simvastatin 20–40 mg | Placebo | 152 weeks | POMS (tension/anxiety items) | X2 = 3.57 95% CI = NR P = “non-significant” | = |
| Cohort studies | ||||||||
| Hoogwegt et al. (126) | Cohort | 409 ICD-implanted patients | Statin use | No use | 1 year | HADS (anxiety subscale) | MD = −0.81 95% CI = −1.80 – 0.18 P = 0.11 | = |
| Molero et al. (87) | Historical cohort | 1,149,384 statin users aged >/= 15 years | Statin use | No use | 8 years | Diagnosis of anxiety disorder (unplanned hospital visit or specialised outpatient care) | HR = 0.99 95% CI = 0.95–1.02 P = NR | = |
| Young-xu et al. (98) | Cohort | 371 CAD patients | Statin use | No use | 4 years | Diagnosis of anxiety (Kellner Symptom questionnaire >/=8) | OR = 0.69 95% CI = 0.47 – 0.99 P = NR | + |
| SLEEP | ||||||||
| Randomised controlled trials | ||||||||
| Carlsson et al. (111) | RCT crossover | 41 hyperlipidaemic adults aged >/= 70 years | Pravastatin 20 mg pravastatin 20 mg + tocopherol 400 IU | Placebo + tocopherol pravastatin + tocopherol | 1 year | SDS | SMD = NR 95% CI = NR P = 0.761 | = |
| Harrison and Ashton (114) | RCT crossover | 25 healthy volunteers | Simvastatin 40 mg, pravastatin 40 mg | Placebo | 4 weeks | LSQ | Pravastatin: mean = 51.4 95% CI = 48.4–54.6 Simvastatin: mean = 47.0 95% CI = 44.9–49.1 Placebo: mean = 50.1 95% CI = 46.4–53.8 SMD = NR 95% CI = NR P = NR | = |
| Santanello et al. (121) | RCT | 431 adults aged >/= 65 years | Lovastatin 20–40 mg | Placebo | 6 months | SDS | Mean change (SD) = Placebo −0.07 (2.39) Lovastatin 20 mg −0.05 (2.53) Lovastatin 40 mg 0.46 (3.07) SMD = NR 95% CI = NR P = 0.93 | = |
| Wardle et al. (123) | RCT | 621 adults with CAD aged 40–75 years | Simvastatin 20–40 mg | Placebo | 152 weeks | Sleep symptoms report | Prevalence difference= −5.3% (statin users) MD = NR 95% CI = NR 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.
BDI, beck depression inventory; CAD, coronary artery disease; CI, confidence interval; DSST, digit symbol substitution test; GHQ, general health questionnaire; HADS, hospital anxiety and depression scale; HR, hazard ratio; ICD, implantable cardioverter-defibrillator; LSQ, leeds sleep questionnaire; MD, mean difference; MDD, major depressive disorder; POMS, profile of mood scores; PR, prevalence ratio; OR, odds ratio; RCT, randomised controlled trial; SD, standard deviation; SDS, sleep dysfunction scale; SMD, standardised mean difference; TAU, treatment as usual.