Statins, prescribed to combat high cholesterol, are the best-selling class of drugs in the United States, and Lipitor (atorvastatin) is the best-selling prescription drug in history. I've been using Lipitor since age 60, and it's one of the priciest drugs I take. Currently a 30-day supply costs about $200, or $2,400 a year. That means -- to date -- my insurers and I have shelled out about $52,800 to Pfizer... unnecessarily, if Neel is right!
And this guy is not a quack.
Armon B. Neal, Jr. -- Credentials
Armon Neel, Jr., PharmD, CGP, is a board-certified geriatric pharmacist who has been counseling older patients and their caregivers on the safe, effective use of medications for more than 40 years. His work has been featured in AARP Bulletin, Prevention, and Reader’s Digest.
In 2010, the American Society of Consultant Pharmacists gave Neel its annual achievement award. The organization then announced it was renaming the award for him! Neel serves as a resource on drug therapy management for seniors through his website, MedicationXpert.com, and is AARP.org’s “Ask the Pharmacist” columnist. At age 73, he also maintains an active private consulting practice.
The Case Against Statins for the Elderly
Neel has concluded that statins are "among the most ineffective and dangerous drugs on the market, largely because the doctors who prescribe them haven't done their homework, relying instead on information supplied by the manufacturers of statins and the studies they've underwritten."
Not one to pull his punches, he says:
I stop these drugs on all the older patients I see because they are invariably at the root of nearly all their problems.You can have high cholesterol without having coronary artery disease -- what we use to call "hardening of the arteries." Neel points to the significance of HDL, the so-called "good cholesterol":
If your HDL is above 45, then high LDL is not that important to treat.Here's the report I got from my internist after my annual check-up this spring:
Your total cholesterol was 161. The HDL, the desirable component, was splendid at 68. The less desirable LDL was 81. These are certainly very nice numbers, indeed. Please stay on the same dose of Atorvastatin (Lipitor), 20 mg every day.Hmmm. My HDL sure is well above 45! Due to Lipitor or not? That is the question.
If you don't have hardening of the arteries by the time you're 70 or 80, you most likely never will, Neel says. And if you do have this problem, it's too late for statins to do any good.
In a recent study by the Cochrane Collaboration, data from 14 randomized control trials involving 34,272 patients was reviewed, and researchers found no "strong evidence" that statins reduce death from coronary heart disease among patients who had no prior history of it. They concluded:
We recommend that caution should be taken in prescribing statins for primary prevention among people with low cardiovascular risk."Statins Can Cause Problems
According to Neel, the most common unwanted side effect of statins involves muscles. "When I see an older patient who complains about muscle pain, fatigue, and weakness, I know from experience that a statin drug is the most likely culprit."
Neel claims that statins also cause serious cognitive problems. He cites a study based on patient surveys published in the journal Pharmacotherapy in 2009. That study found that 75 percent of the subjects "experienced cognitive ADRs [adverse drug reactions] determined to be probably or definitely related to statin therapy."
However: I checked for the latest reports on this by searching "statins and cognitive problems" at NIH's PubMed site and found these two recent studies:
- A review of previous research conducted at the University of Waterloo in Canada -- reported this past April -- concluded: "Despite several reports of statin-associated cognitive impairment, this adverse effect remains a rare occurrence among the totality of the literature. If statin-associated cognitive impairment is suspected, a trial discontinuation can reveal a temporal relationship. Switching from lipophilic to hydrophilic statins may resolve cognitive impairment. The vascular benefits and putative cognitive benefits outweigh the risk of cognitive impairment associated with statin use; therefore, the current evidence does not support changing practice with respect to statin use, given this adverse effect." http://www.ncbi.nlm.nih.gov/pubmed/22474137
- Another April report, this one from McGill University in Montreal, Canada, dealt with an experiment using the statin simvastatin (brand name Zocor) in tests on mice, concluding "simvastatin and, possibly, other brain penetrant statins bear high therapeutic promise in early AD and in patients with vascular diseases who are at risk of developing AD." http://www.ncbi.nlm.nih.gov/pubmed/22492027
- Statins may increase your risk of developing diabetes.
- If you've had a hemorrhagic stroke, taking statins may increase your risk of having another one.
- Statins can interfere with your ability to metabolize other drugs.
That did it. I'm stopping the Lipitor (generic). I'll get my cholesterol rechecked in six months or so.