European Journal of Clinical Pharmacology

, Volume 70, Issue 12, pp 1413–1422 | Cite as

Statins, mood, sleep, and physical function: a systematic review

  • Kristopher J. Swiger
  • Raoul J. Manalac
  • Michael J. Blaha
  • Roger S. Blumenthal
  • Seth S. Martin
Review Article
First Online:
Received:
Accepted:

Abstract

Purpose

We aimed to evaluate the effects of statins on mood, sleep, and physical function.

Methods

We performed a systematic computer-aided search of MEDLINE/PubMed, EMBASE, and the Cochrane Central Register and augmented this search by scrutinizing reference lists and making inquiries among colleagues and experts in the field. All patient populations and study types were considered. We selected studies of statin therapy compared with no statin or placebo. Outcome measures included mood, sleep, and physical function.

Results

Thirty-four studies were included in qualitative synthesis. Seven of eight (88 %) observational studies, 4/6 (66 %) randomized trials with mood as a primary endpoint (487 total participants; exposure 4 weeks to 1 year), and 3/3 (100 %) randomized trials with mood as a secondary endpoint (2,851 total participants; exposure 1–4 years) were not compatible with a negative mood effect of statins. Comparatively, fewer studies examined statin effects on sleep and physical function. Studies reporting negative effects contained potential sources of bias, including multiple testing or lack of adjustment for confounders in observational studies, and failure to prespecify outcomes or report blinding in trials.

Conclusions

A limited body of available evidence is most compatible with no adverse effect of statins on quality of life measures, namely, mood, sleep, and physical function. Studies suggesting such effects suffer from an increased risk of bias. High-quality, prospective, and adequately powered studies are needed, especially in the domains of sleep and physical function, with careful attention to patients who may be most vulnerable to adverse effects.

Keywords

Statin therapy Mood Sleep Physical function Energy 
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Notes

Acknowledgments

The authors would like to acknowledge Jaime Blanck from the Johns Hopkins Welch library for contributing to the search strategy on this study. SSM is supported by the Pollin Cardiovascular Prevention Fellowship, Marie-Josée and Henry R Kravis endowed fellowship, and a National Institutes of Health training grant (T32HL07024). RSB is supported by the Kenneth Jay Pollin professorship in cardiology.

Conflict of interest

Dr. Martin is listed as a coinventor on a pending patent filed by Johns Hopkins University for a method of low-density lipoprotein cholesterol estimation. The other authors have no conflicts of interest to disclose.

Contributions of authors statement

KJS and RJM systematically searched the literature, selected studies, and performed risk of bias assessments. All authors synthesized the data. KJS drafted the manuscript, and all other authors edited it for intellectual content.

Supplementary material

228_2014_1758_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 16 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Kristopher J. Swiger
    • 1
  • Raoul J. Manalac
    • 1
  • Michael J. Blaha
    • 1
  • Roger S. Blumenthal
    • 1
  • Seth S. Martin
    • 1
  1. 1.Johns Hopkins Ciccarone Center for the Prevention of Heart DiseaseBaltimoreUSA

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