Effects of Statins and Cholesterol on Patient Aggression: Is There a Connection?

| April 1, 2018 | 0 Comments

by Emily Leppien, PharmD, BCPS; Kimberly Mulcahy, PharmD, BCPS, BCPP; Tammie Lee Demler, BS, PharmD, MBA, BCGP, BCPP; Eileen Trigoboff, RN, PMHCNS-BC, DNS, DABFN; and Lewis Opler, MD, PhD†

Drs. Leppien, Mulcahy, Demler, and Trigoboff are with Buffalo Psychiatric Center, New York State Office of Mental Health, and State University of New York, University at Buffalo School of Pharmacy and Pharmaceutical Sciences in Buffalo, New York. Drs. Demler and Trigoboff are with State University of New York, University at Buffalo School of Medicine, Department of Psychiatry. in Buffalo, New York. Dr. Opler is affiliated with Long Island University in Long Island, New York. †deceased

Innov Clin Neurosci. 2018;15(3–4):24–27

Funding: None

Disclosures: The authors declare no conflicts of interest relevant to the content of this article.

Abstract: Overview. Psychiatric adverse effects, including aggression, have been reported with the use of statin medications; however, there is little data to support or refute the theory that statins or low serum cholesterol do in fact increase a patient’s risk of aggression.

Objective. This study examined 1) statin use and increased aggression, measured by the requirement of either emergent psychiatric intervention referred to as “Code Green”  (CG) or “Restraint and Seclusion” (RS) and 2) cholesterol level and increased aggression in psychiatric inpatients.

Materials and Methods. Patient charts from January 1, 2011, to December 31, 2015 were reviewed. Statin therapy, lipid panel, and requirement of a psychiatric emergency code CG or RS were noted. Inpatients who did not receive cholesterol-lowering therapy were used as controls. Analyses of variance (ANOVAs) were used to examine the relationship between statin use and increased aggression.

Results. Eleven (9.6%) patients receiving statins required a total of 57 CGs, and five (4.4%) required 27 RSs. Conversely, 33 (28.9%) patients not receiving statins required a total of 64 CGs, and 14 (12.3%) required 27 RSs. No statistically significant relationship between statin therapy and agitation was found as evidenced by a CG (F=0.068; p=0.795) or RS (F=0.001; p=1.000). A statistically significant relationship was found between total cholesterol level and requirement of a CG (F=1.435; p=0.029) or RS (F=2.89; p=0.000).

Conclusion. It is evident that psychiatric inpatients with lower total cholesterol levels are at an increased risk for loss of behavioral control.

Keywords: Statins, cholesterol, aggression, agitation, violence, psychiatric inpatients

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Category: Past Articles, Retrospective Analysis

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