Medicosnext
Many studies have linked decrease in cholesterol levels to increased aggression, and aggression has been reported in patients taking statins, with the increase higher in women. The risk of violence is different in men and women, with age also being a determining factor.
In an intriguing study published on July 1, 2015, in PlosOne (“Statin Effects on Aggression: Results from the UCSD Statin Study, a Randomized Control Trial”, shorturl.at/RUY35), 692 men and 324 postmenopausal women underwent a double-blind sex-stratified randomized trial involving pravastatin 40 mg, or simavastatin 20 mg (6 months), and placebo to assess changes in behavioral aggression of the subjects, using the Overt-Aggression-Scale-Modified–Aggression-Subscale (OASMa). The influence of baseline-aggression, testosterone-change (in men), age, and sleep were also analyzed.
Statins tended to decrease aggression in men, and this was more significant on those on pravastatin. Greater decline in aggression was seen in men under 40 years of age with low baseline aggression (no aggressive actions in prior week), and it was observed that statins, especially simvastatin, lowered testosterone levels, which predicted decline in aggression. Previous studies have shown simavastatin (but not pravastatin) to increase sleep problems, which is linked to aggression. This study found that change in sleep problems in men on combined statins, and simvastatin separately (but not on pravastatin or placebo), was a significant predictor of change in aggression. In short, a greater reduction in testosterone levels in those on simvastatin showed a greater reduction in aggression, while those with greater increase in sleep problems displayed greater increase in aggression, thus demonstrating the bidirectional mechanisms of simvastatin on aggression,
A significant increase in aggression was seen in postmenopausal women (over the age of 45) with no evident baseline aggression, where pravastatin contributed more strongly than simvastatin. No significant statin effect was seen in those with a recent aggression at baseline; reduction in aggression was observed in those taking pravastatin, while there was increase in those on simvastatin (rising with age). Unlike in men, there was no significant relationship seen between testosterone or sleep change and change in aggression in women.
The study concluded that sex and age were determining factors, as was baseline aggression, for statin’s effects on aggression, with statins generally decreasing aggression in men, and generally increasing aggression in women.
