Statins and Delirium: Is There a Role?

Taburyanskaya, Margarita; Hassig, Tanna

doi:10.1007/s11883-014-0470-9

Cited by 6 publications

(6 citation statements)

References 40 publications

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“…Differential effects of statins on neuroinflammation during delirium may be due to treatment with lipophilic vs. hydrophilic statins. The current study demonstrated that the use of a hydrophilic statin (pravastatin) was associated with reduced delirium incidence compared with a lipophilic statin (atorvastatin), but the reverse has also been found (129). A recent comprehensive meta-analysis found that statins did not reduce the incidence of delirium in physically ill patients (130).…”

Section: Statins For Other Psychiatric Disordersmentioning

confidence: 64%

Statins and Inflammation: New Therapeutic Opportunities in Psychiatry

et al. 2019

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Statins, which are widely used to treat hypercholesterolemia, have anti-inflammatory and anti-oxidant effects. These are thought to be responsible for the potential effects of statins on various psychiatric disorders. In this study, we comprehensively review the literature to investigate the effects of statins on various psychiatric disorders including depression, schizophrenia, and dementia. In addition, we review adverse effects and drug interactions of statins to give clinically useful information guiding statin use in the psychiatric field. Statins seem useful in reducing depression, particularly in patients with physical disorders such as cardiovascular disease. In patients with schizophrenia, negative symptoms may be reduced by adjuvant statin therapy. Studies on cohorts at risk for dementia have generally shown protective effects of statins, while those on treatment for dementia show inconsistent results. In conclusion, statins used in combination with conventional psychotropic medications may be effective for various psychiatric disorders including depression, schizophrenia, and dementia. Further study is required to determine optimal doses and duration of statin use for the treatment of psychiatric disorders.

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Section: Statins For Other Psychiatric Disordersmentioning

confidence: 64%

Statins and Inflammation: New Therapeutic Opportunities in Psychiatry

et al. 2019

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“…A biochemical explanation may be the pleiotropic effects of statins and their role in reducing the neuroinflammatory response. 38 Statin use has been shown in one multicenter prospective analysis to have a role in reducing delirium rates in the context of acute illness. 39 A recent review into the relationship between statins and delirium rates concluded that more work was needed to examine this link, with particular attention paid to the role of statins in postoperative delirium.…”

Section: Discussionmentioning

confidence: 99%

“…39 A recent review into the relationship between statins and delirium rates concluded that more work was needed to examine this link, with particular attention paid to the role of statins in postoperative delirium. 38 Fig 2 . Results of meta-analysis. ASA, American Society of Anesthesiologists; eGFR, estimated glomerular filtration rate; ICU, intensive care unit; TIA, transient ischemic attack.…”

Section: Discussionmentioning

confidence: 99%

A systematic review and meta-analysis of factors for delirium in vascular surgical patients

Oldroyd

Scholz

Hinchliffe

et al. 2017

Journal of Vascular Surgery

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“…20 Consequently, there is great interest in further evaluating the effect of statins on delirium in intensive care and subsequent cognitive function in randomised trials. 8,19–22 …”

Section: Introductionmentioning

confidence: 99%

Rosuvastatin versus placebo for delirium in intensive care and subsequent cognitive impairment in patients with sepsis-associated acute respiratory distress syndrome: an ancillary study to a randomised controlled trial

Needham

Colantuoni

Dinglas

et al. 2016

The Lancet Respiratory Medicine

130

118

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Summary Background Delirium is common in mechanically ventilated patients and is associated with cognitive impairment lasting at least 1 year after hospital discharge. Preclinical and observational studies suggest that the use of statins might reduce delirium in intensive care. We assessed whether the pleiotropic effects of statins can reduce delirium in intensive care and decrease subsequent cognitive impairment in a randomised controlled trial. Methods We did this ancillary study within the SAILS trial, a randomised controlled trial assessing mortality and ventilator-free days for rosuvastatin versus placebo for patients with sepsis-associated acute respiratory distress syndrome. This study was done at 35 hospitals in the USA. Patients were randomly assigned in permuted blocks of eight and stratified by hospital to receive either rosuvastatin (40 mg loading dose and then 20 mg daily until the earliest of 3 days after discharge from intensive care, study day 28, or death) or placebo. Patients and investigators were masked to treatment assignment. Delirium was assessed with the validated Confusion Assessment Method for intensive care. Cognitive function was assessed with tests for executive function, language, verbal reasoning and concept formation, and working, immediate, and delayed memory. We defined cognitive impairment as having one of these domains at least two SDs below population norms or at least two domains at least 1·5 SDs below norms. The primary endpoint was daily delirium status in intensive care up to 28 days in the intention-to-treat population and secondary endpoints were cognitive function at 6 months and 12 months. This trial is registered with ClinicalTrials.gov (NCT00979121 and NCT00719446). Findings 272 patients were assessed for delirium daily in intensive care. The mean proportion of days with delirium was 34% (SD 30%) in the rosuvastatin group versus 31% (29%) in the placebo group; hazard ratio 1·14, 95% CI 0·92–1·41, p=0·22. At 6 months, 19 (36%) of 53 patients in the rosuvastatin group versus 29 (38%) of 77 in the placebo group had cognitive impairment, with no significant difference between groups (treatment effect 0·93, 95% CI 0·39–2·22; p=0·87). At 12 months, 20 (30%) of 67 patients versus 23 (28%) of 81 patients had cognitive impairment, with no significant difference between groups (treatment effect 1·1, 95% CI 0·5–2·6; p=0·82). Interpretation Most patients had delirium, with around a third of survivors having cognitive impairment over 1 year of follow-up. Despite encouraging preclinical and observational studies, this trial shows no benefit of rosuvastatin in reducing delirium in intensive care or cognitive impairment during 12 months of follow-up although the study was not powered for superiority. Thus, there is continued need to evaluate interventions aimed at attenuating intensive care and post-intensive-care cognitive impairments commonly observed in this population.

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Statins and Delirium: Is There a Role?

Cited by 6 publications

References 40 publications

Statins and Inflammation: New Therapeutic Opportunities in Psychiatry

Statins and Inflammation: New Therapeutic Opportunities in Psychiatry

A systematic review and meta-analysis of factors for delirium in vascular surgical patients

Rosuvastatin versus placebo for delirium in intensive care and subsequent cognitive impairment in patients with sepsis-associated acute respiratory distress syndrome: an ancillary study to a randomised controlled trial

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