Cardiologists know that treating depression likely will benefit patients complaining of cardiovascular problems, but likely are completely unaware statin drugs may be a major contributing factor.

According to a recent report from a National Heart, Lung and Blood Institute (NHLBI) Working Group, and published simultaneously in "Annals of Behavioral Medicine" and "Psychosomatic Medicine", up to 20 percent of patients with heart disease meet the American Psychiatric Association's criteria for major depression, and identifying better treatments for depression in this population could lead to improved medical, financial and psychosocial outcomes.

At almost the same time Goldstein and others of the Department of Physiology, The Hebrew University-Hadassah Medical School, Jerusalem, Israel, report in Biol Psychiatry 60(5): 491-9 on the involvement of endogenous digitalis-like compounds in depressive disorders. Cholesterol is the major precursor of these endogenous digitalis-like compounds synthesized in our adrenals.

We might have predicted the effect of this new substance in something like heart failure because of the word digitalis but who would have predicted its impact on bipolar disorder and other forms of depressive reactions. These pleotrophic effects are due to the fact that the cellular effect of this class of drugs is on the sodium, potassium and ATPase cell wall channels in such a way as to induce calcium retention within the cells leading to altered response.
In a brain cell, mania can result from increased membrane excitability and depression from decreased transmitter release.

And these are only a few of the effects of these endogenous digitalis-like compounds synthesized from cholesterol.
What of the statin drugs with their ability to reduce natural cholesterol levels to values far below normal for the individual? Is there any real doubt that we now have another reason for the association of statin use with depression?

The drug industry proudly hails the ability of Lipitor, Crestor and Zocor and others to lower blood cholesterol some 40-50%. We already know what this does to the cognitive ability of many people and the erectile function of many others. And now we find another major body system completely dependant upon adequate cholesterol levels.

How could the designers of lucrative statin drugs two decades ago know of these effects? They obviously could not and now after 20 years of use have some very real economic reasons for not wanting to hear this before they are forced to. Need I add that every statement I have made is thoroughly referenced in medical literature.

Duane Graveline MD MPH
Former USAF Flight Surgeon
Former NASA Astronaut
Retired Family Doctor