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Negative expectations lead to statin side effects, research suggests

Bee Kee Ng, 08 May 2017
A recent study has found that patients who are unaware of their intake of statins report fewer side effects than when they know they are taking a statin. The findings correspond with a psychological phenomenon known as the nocebo effect, in which the researchers hope to end the debate over the benefits and harms of statins.

The cholesterol-lowering statin drugs are said to have been falsely claimed for symptoms such as muscle pain and weakness, as the study refuted. The patients’ negative beliefs of the medication are found to be the root cause.

“You only get the muscle-related symptoms when you know you are taking the drug,” said Peter Sever, lead author of the study from the national heart and lung institute at Imperial College London.

Large studies prove the claims wrong


Statins are commonly prescribed for lowering levels of “bad cholesterol” or low-density lipoprotein to reduce the risk of a heart attack or stroke. Many adults are also taking the drugs as a precaution of heart attack, stroke and cardiovascular disease.

Although statins have been recently reported to prevent approximately 80,000 such incidents a year in the UK, they have brought up a lot of controversies regarding its safety and efficacy as NHS advised extending its prescriptions to those at lower risk of heart attack.

The large studies gathered randomised and blinded clinical trial data from more than 10,000 patients in Britain, Ireland and Scandinavia between 1998 and 2004. The findings demonstrated that statins are safe and effective as patients who did not know they were on statin therapy did not report muscle pain.

However, an increase of 41% of patients started complaining of muscle pain after being informed that they were taking a statin. The study also did not find any evidence of a heightened risk of erectile dysfunction or sleep disturbance from the use of statins.

The results of the latest research echoed findings from other studies, which have also suggested the side effects of statins are minimal although up to a fifth of patients who reported side effects outside of clinical trial context are estimated to stop taking the drugs.

Bottom line: Benefits outweigh risks


“Patients genuinely get the symptoms,” Sever said. “But you cannot attribute that, in this case, to the drug.”

“The problem is that patients and doctors are not prescribing statins or patients are not taking them for fear of side effects. They need to weigh up the benefit of the statins and the risks. The latter are minimal,” added Sever.

Meanwhile, Liam Smeeth, professor of clinical epidemiology at the London School of Hygiene and Tropical Medicine, welcomed the study and commented that it highlights the potential danger behind the exaggerated side effects of statins.

An estimated six million people at risk in the UK are either not taking statins or taking low dosages. Hence, the researchers said they hope the latest research will quash the debate around statins and save people’s lives that are at risk.

“There are people out there who are dying because they are not taking statins and the numbers are huge – the numbers are tens of thousands if not hundreds of thousands, and they are dying because of a nocebo effect, in my opinion,” said Sever. MIMS

Read more:
The power of belief: 6 startling facts about the placebo effect
The great debate on statins continues
Pharmacist-led treatment: Using ideal choloesterol goals as an example

Sources:
https://www.theguardian.com/society/2017/may/02/statin-side-effects-down-to-negative-expectations-not-the-drugs-nocebo
http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_2-5-2017-16-54-57
http://www.indialivetoday.com/statins-prescribed-help-lower-levels-bad-cholesterolbut-nocebo-effects-also-present/154434.html
http://lifestyle.mb.com.ph/2017/05/03/statins-dont-cause-muscle-pain-study/
http://www.shropshirestar.com/news/uk-news/2017/05/03/thousands-dying-because-of-nocebo-effect-statins-study-author-claims/
http://www.telegraph.co.uk/news/2017/05/03/statins-myth-thousands-dying-warnings-non-existent-side-effects/
https://www.scimex.org/newsfeed/statin-side-effects-more-common-in-those-who-know-theyre-taking-them
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