Statins show no additional benefit for the treatment of depression

Statins show no additional benefit for the treatment of depression

Lipid-lowering drugs known as statins are prescribed in cases of high cholesterol to reduce the risk of atherosclerosis, heart attack and stroke. The results of some small studies suggest that statins may also have an antidepressant effect. Researchers from Charité – Universitätsmedizin Berlin have now conducted an extensive study to investigate this claim. However, they could not test whether statins cause additional antidepressant effects. As a result, researchers suggest following general guidelines and prescribing statins to lower cholesterol levels, but not to treat depression. The study has now been published in theJama PsychiatryMagazine.

Cholesterol-lowering medications are the most commonly prescribed medications worldwide. They have anti-inflammatory effects and reduce the production of cholesterol in the liver, which in turn reduces the risk of developing cardiovascular diseases. In the past, numerous small studies have suggested that statins may also have antidepressant effects in addition to these more common properties. “If statins really had this antidepressant effect, we could kill two birds with one stone,” says Prof. Christian Otte, director of the Department of Psychiatry and Neuroscience at the Charité Benjamin Franklin campus and leader of the study. "Depression and obesity, or obesity, are among the most common medical illnesses worldwide. And they often occur together: Those who are overweight are at higher risk of depression. Those with depression are at higher risk of obesity." Obese patients often have higher cholesterol levels, so statins are given to reduce the risk of cardiovascular disease. But could they also relieve depression?

A large, controlled study

Led by Christian Otte, the research team conducted a comprehensive study to investigate the potential antidepressant effects of proposed statins. A total of 161 patients took part in the study, all of whom suffered from both depression and obesity. During the 12-week study, all participants were treated with a standard antidepressant (escitalopram). Half of the participants also received a cholesterol-lowering drug (simvastatin), while the other half received a placebo. Who would receive statins and who would receive the placebo was randomly decided - the recipients of each were unknown to both the medical team and the participants. This ensured a randomized and double-blind study that would provide reliable results.

This method should show us whether we can observe a stronger antidepressant effect in participants treated with statins compared to those in the placebo group. “

Dr. Woo Ri Chae, co-lead author, physician scientist at the Charité BIH clinician in the Department of Psychiatry and Neuroscience

Researchers used established clinical interviews and self-administered questionnaires to assess patients' depression severity at the start and end of the study. Blood samples were taken from the participants to determine their blood lipid levels and C-reactive protein (CRP) levels, which are known indicators of inflammatory processes in the body. "People with obesity and/or depression usually have slightly elevated inflammatory markers in their blood. For some of those affected, this can actually be the cause of depression," explains Christian Otte. “And this is where we began our hypothesis about the potential antidepressant effect of statins: If the administration of statins leads to an improvement in inflammatory markers, could this possibly also be accompanied by an antidepressant effect for some of the study participants?”

Traditional antidepressants remain the gold standard

At the start of the study, participants ranged from moderately to severely depressed. Over the course of the 12-week study, depression symptoms showed clear improvement in all patients - but there was no difference between those who received statins and those in the placebo group. “Administration of the cholesterol-lowering drug improved blood lipid levels as expected, and the inflammatory marker CRP also showed a significant reduction,” says Woo Ri Chae. “Unfortunately, this does not indicate any additional antidepressant effect.” Christian Otte adds: "When it comes to treating depression, statins therefore have no additional advantage. Based on our current knowledge, traditional antidepressants remain the gold standard." According to current guidelines, statins should be prescribed to reduce the risk of atherosclerosis and cardiovascular disease. The researchers recommend that the same should of course also apply to patients suffering from depression.

In further studies, Christian Otte's team will conduct a more thorough analysis of the blood samples collected as part of this research at the cellular and molecular level to uncover possible differences and correlations. Researchers continue to work at full speed on improved strategies to treat patients with depression who also suffer from other illnesses.

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