1. Can you give any general recommendation to readers who are already using statins, especially if they have experienced any of the symptoms related to global transient amnesia or other cognitive disturbances? Is there a preferred place that they should report their side effect experience, beyond discussing the event with their doctor?

Answer - All statin users experiencing memory lapses and/or increased forgetfulness, confusion, disorientation and worsening senility should be aware that their statin drug could be the cause. Their family doctor may not know of this. Report such complaints promptly to UCSD's statin study and FDA's Medwatch program.

2. Do you believe statins are over prescribed? In which cases do you believe that statins are appropriately prescribed?

Answer - Statin drugs are being flagrantly over prescribed, especially for so-called primary prevention,where the only justification is cholesterol elevation. Even children are becoming targets of the drug industry. Commercial airline pilots on statins bother me the most for amnesia attacks are completely unheralded. Imagine "waking up" at the controls of a jumbo jet, never having been there before! For high risk people and especially those genetically predisposed to elevated lipids, statins will remain a valuable treatment resource with full disclosure of potential side effects.

Answer - After 35 years of our "war on cholesterol," we now know that cholesterol is not our enemy, it is the most vital substance in our bodies. We also have learned that atherosclerosis, the basis of heart attacks and strokes, is an inflammatory process, with our "natural" cholesterol a passive bystander only. Statins drugs lower CV risk not by their effect on cholesterol but by their newly recognized anti-inflammatory action. Meanwhile the sales of 'cholesterol busting' drugs are booming.

4. When you stopped using Lipitor did you use any natural remedy (supplement, herb, etc.) to help lower your cholesterol?

Answer - Since my research into this subject and the books of Ravnskov and McCully I have reverted to supplements like omega 3, vitamins B6, B12 and folic acid, coenzyme Q10, buffered aspirin and anti-oxidants, and have replaced my low fat, low cholesterol diet (of 35 years) with a carbohydrate restrictive diet and have reverted to unlimited eggs, whole milk and real butter. Last year after my NASA physical their doctors called me, wondering why my cholesterol had dropped 100 points.

5. Where are the case reports on statin side effects/cognitive disturbance that you cite generally reported? (In your interview with Dr. Cohen on Medicationsense.com, you mention that "There are now thousands of case reports of amnesia, forgetfulness, confusion, etc."--)

Answer - case reports of statin associated cognitive events (and other side effects) are reported to the UCSD College of Medicine statin study and to FDA's Medwatch program. Those reported directly to me are referred to these two repositories. We now have several hundred reports of episodic amnesia associated with statin use and thousands of reports of lesser forms of memory impairment such as forgetfulness, confusion and disorientation. Amnesia is but the tip of a huge iceberg of cognitive impairment associated with statin drug use.

6. Why do you think that doctors generally fail to warn their patients about this lesser known side effect of statins? Has your book been acknowledged by the manufacturer of Lipitor? Do you see any acknowledgement within the pharmaceutical industry of the increasing reports of cognitive disturbance among patients taking statins? Is there anything readers can do to persuade their doctors to reconsider strong-dose statins?

Answer - Most prescribing physicians are completely unaware of the potential of cognitive
side effects from statin drug use. Doctors are victims, in a sense, much like their patients, for they have never been informed of statin's cognitive problems known for years by the drug industry. In a Pfizer paper, recently made available, they reported 7 cases of amnesia and 4 additional cases of severe memory loss in their 2502 study patients during the clinical evaluation phase of Lipitor development, over five years ago. Somehow this information never was effectively communicated to the doctors responsible to prescribe this drug, helping greatly to explain FAA allowance of statin drug use in commercial airline pilots.

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