University of Arizona researchers have discovered why cholesterol-lowering drugs sometimes produce temporary memory loss — a finding that could point the way to alleviating the problem.
 

In a new study published in the journal Disease Models & Mechanisms, UA investigators determined statin drugs may cause unusual swellings within nerve cells that appear to cause cognitive declines in some patients taking the widely prescribed class of cholesterol-lowering drugs.

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The U.S. Food and Drug Administration and physicians have documented many cases of fuzzy thinking and memory loss among statin takers — symptoms that may prompt some patients to stop taking the drugs.
 

“What we think we've found is a laboratory demonstration of a problem in the neuron that is a more severe version for what is happening in some peoples' brains when they take statins,” said UA neuroscientist Linda L. Restifo, who helped conduct the study with Robert Kraft, a former research associate in the department of neuroscience.
 

Restifo and Kraft said statin users often are told by physicians that mental problems they experience while taking statins were likely due to aging or other effects. But the UA team's research suggests the likely cause for such declines is a negative response to statins. The researchers noted the nerve cells return to normal function when statins are stopped.
 

The UA team now plans to investigate how genetics may be involved in the response to cause hypersensitivity to the drugs in people — work that could lead to improved treatment.
 

“This is a great first step on the road toward more personalized medication and therapy,” said David M. Labiner, who heads the UA department of neurology. “If we can figure out a way to identify patients who will have certain side effects, we can improve therapeutic outcomes.”
 

The goal, Restifo said, is to come up with a predictive genetic test “so that a patient with high cholesterol could be tested first to determine whether they have a sensitivity to statins.”
 

Despite the team’s findings on the potential neurotoxicity of statins, Restifo added: “There is no question that these are very important and very useful drugs. Statins have been shown to lower cholesterol and prevent heart attacks and strokes.”
 

But too much remains unknown about how the drugs' effects may contribute to muscular, cognitive, and behavioral changes, she added.
 

“Most physicians assume that if a patient doesn't report side effects, there are no side effects,” Labiner said. “The paternalistic days of medication are hopefully behind us. They should be.
 

“We can treat lots of things, but the problem is if there are side effects that worsen the treatment, the patient is more likely to shy away from the medication. That's a bad outcome. There's got to be a give and take between the patient and physician.”
 

Restifo said the findings suggest better patient-physician communication is important for those on statins who have a family history of side effects from statins. Physicians should also work more closely with patients to investigate family history and determine a better dosage plan. Even placing additional questions on the family history questionnaire could be useful, she said.

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“There is good clinical data that every-other-day dosing give you most of the benefits, and maybe even prevents some of the accumulation of things that result in side effects,” Restifo said, suggesting that physicians should try and get a better longitudinal picture on how people react while on statins.
 

“Statins have been around now for long enough and are widely prescribed to so many people. But increased awareness could be very helpful.”