Lipitor® Cognitive Side Effect Concerns ( Atorvastatin Calcium )


dr_duane_graveline_m.d._134By Duane Graveline, M.D., M.P.H.

With 10 years of experience behind us we have learned that there is something special about Lipitor (atorvastatin). There is something about the makeup of this drug that makes it stand out from all the other statins in one outstanding respect - Lipitor appears to have a greater tendency than all the others to cause cognitive side effects. If you are on Lipitor - atorvastatin - or are planning to start on Lipitor, you must read my book - Lipitor® Thief of Memory. You must know Lipitor's true legacy.

In 1999, NASA flight surgeons decided my cholesterol had climbed sufficiently high over the years to justify asking me to start taking10 mg of Lipitor daily. Six weeks later I experienced an episode of transient global amnesia of six hours duration.

Despite strong protests from all the examining doctors, I stopped the Lipitor. One year later at my next astronaut physical, my NASA colleagues chided me and insisted I restart Lipitor, this time at only 5 mg daily, for "Statins don't do that" and my cholesterol was still elevated. Six weeks later I experienced my second episode of transient global amnesia, this time for 12 hours during which time I was a 13-year old with absolutely no recall of my entire adult life.

Again the examining doctors chorused that "Statins don't do that" but I was convinced and began my investigation into this curious characteristic of Lipitor in me and presumably in at least some other people as well.

True to my personal expectation other reports of statin associated TGA soon began to occur. We now have received many hundreds of reports of strange and horrifying experiences with transient global amnesia while taking a statin drug.

All statins in use today can be associated with cognitive side effects such as amnesia, forgetfulness, confusion and disorientation. The mechanism of action seems to be excessive reduction in the bio-availability of cholesterol for proper brain function.

For some reason Lipitor "does this better" than the others just as Baycol caused rhabdomyolysis so much more than the other statins that it had to be removed from the market. But, in truth, all the statins can cause this dreaded muscle breakdown.

Associated with this distortion of memory is a tendency for prolonged, even permanent impairment of the process of short-term memory with the use of Lipitor. We have a growing list of these reports where former breadwinners have been reduced to dependents and the entire family structure has been drastically altered.

The following are but a few examples of this legacy of Lipitor - atorvastatin - sent to me by readers.

1) Three weeks ago I had an eight-hour episode of TGA. I had been on Lipitor and Lisinopril for about six weeks prior. I have stopped both medications for the time being until I get back to normal. Even after stopping the Lipitor I was disoriented (especially in the morning) and "just wasn't feeling right (poorly described by a physician).

2) Four months ago I was put on Lipitor to reduce my bad cholesterol to 100. Suddenly I found I could not handle basic math or remember how to spell. It became so bad that I was in a constant fog. I should tell you I spent most of my career in Silicon Valley writing specifications for software and hold a patent on expert system technology. I had an MRI to rule out a brain tumor or stroke. Since the only thing that had changed was the addition of Lipitor I stopped taking it. Five weeks later I am still having problems spelling and frequently forget things.

3) We have recently taken my mother off of the Statins because she is suffering from memory loss. Ten days after removing her from Statins, her doctor sent her for neuropsych testing and a CT scan. CT results are still pending. The neuropsychologist diagnosed Alzheimer's disease and referred her back to her internist to begin cholinesterase inhibitors. We believe that this is a premature diagnosis, as her memory loss has not progressed beyond the initial stages observed over 2.5 years ago and that she has only been off Statins for ten days when she was tested. She has been on statin therapy for nine years.

4) I was put on Lipitor when Mevacor didn't appear to be doing its job. I was started on Mevacor at approximately 30 years of age....I'm 49 now. The Lipitor was started approximately two years ago...I'd have to have the Doctor's office check as I can't really remember when I was switched! I noticed my memory was getting bad and every doctor I saw blamed it on menopause and / or my fibromyalgia.

Within the past few months however, new and frightening symptoms appeared. While talking to friends, out shopping or just sitting home and watching television I would have the strangest and most unsettling sensation that I didn't know who I was. It would last for seconds and felt so odd- like an out of body experience...who was this person talking...oh, it must be me.

I was always a voracious reader and now it's so hard for me to concentrate and remember things that I've all but given up reading. Crossword puzzles were a favorite pastime. Now I have a hard time carrying on a conversation since I stutter and ummm and uhhh trying to think of a word or name. Names of old friends escape me and sometimes I can't recall if I've done something just seconds after I've done it.

The muscles in my forearms began to be so sore I found it difficult to take a half-gallon container of soymilk out of the fridge, and pushing the button on the remote to change channels actually hurt. I was terrified that I had Alzheimer's, or worse yet a brain tumor. I was prepared to ask my Doctor for a CT scan or MRI to rule out that possibility when I received the e-newsletter and discovered the root of my problem. I immediately discontinued my Lipitor.

When I showed my physician the information I had gathered about Statins she was very interested as her own husband is on 20mg of Lipitor and had been complaining of memory problems and brain fog! She said she had no idea the two were linked.

5) My mother just turned 80. She has been taking Lipitor for her cholesterol for several years but has stopped since her episode. Last October she was off of work and out in her yard raking and bagging leaves. Her neighbors were outside working in their yard also. They came over and asked my mother how she was doing. She told them she had just gotten home from work and wanted to know who had done all her yard work. They told her she did because they had seen her. She insisted she didn't do it and that she had been working. They took her in the house because they were concerned and wanted to call me.

She couldn't remember my phone number, where I worked or anything. They found her address book and called my house. My husband went over. She knew him but swore she had been at work. They called an ambulance because we were scared she had suffered a stroke. I was on my way home from work and when I got there they were putting her in the ambulance. I went to the emergency room with her.

She was in the ER for about 5 or 6 hours. For the first 3 or 4 she kept asking me the same questions over and over and over. "Where was she?" "How did she get there?" "Who called the ambulance?" "What was she in there for?" No sooner had she finished the last question and she would start over. After about 4 hours, this eased off some. They admitted her to the hospital and ran and MRI, EKG, and other tests to determine if she had had a stroke. They all came back fine.

The next day she could remember where she was and what I had told her about how she got there and why, but she can still remember nothing about those 5 or 6 hours that day. A neurologist saw her finally after 3 or 4 days and he told her she had suffered an episode of "TGA".

6) I take 10 mgs of Lipitor daily and have for the past year. Recently, I was out in my truck before daylight (I don't know why?) driving along when a wave of visions came into view, distorted things and the next thing I knew I had run into another car stopped at a light. The police came made an investigation of the wreck. A wrecker hauled off my truck and the policeman took me home. My Son came over took me to get a rent car, we did and I hardly remember any of this.

I drove to a service station and filled up with gas, had trouble using my card at the "pay at the pump" but after a few tries and some help made it and drove home! My Son said I drove all right and I can't remember it all clearly but, I made it home and in a few hours I was back to normal and remember everything that has happened since! Now I think back and get bits and pieces of the morning but it is all very confusing!

7) I just this past hour ran into info on memory loss and the use of Lipitor. I have been on 20 mg Lipitor for about 1 year now. Shortly after I started the drug I began to notice short-term memory loss. I did not however relate it to Lipitor. I have become drastically worse. My physician has not made the connection. He has sent me for a CAT scan and next month I have an appointment with a neurologist.

Having read some of the articles online I believe it could well be associated to the Lipitor. My memory does not affect my past memories. It affects me instantly. I think, oh I must clean that spot on the floor after I finish my coffee. Well I finish my coffee and for the life of me I simply cannot remember what I wanted to do. I might be walking from my desk to the water cooler and forget halfway there where I was going. My family will tell me details that I forget. In a half hour conversation I might repeat myself several times, much to the annoyance of my family. It has been very noticeable the past 6 months. I have a difficult time recalling what I had to eat for supper the day before.

8) I truly appreciate your efforts to research the side effects of Statins (such as Lipitor) and 'blow the whistle' on those prescribing it. My father began taking Lipitor around May 2002. It was shortly after that time that I noticed some changes in him. Sometimes he'd start a story then lose his place and other things were happening that he'd forget. This past summer (July 04) after being on Lipitor for almost 18 months, my Mom watched as he paused in writing a check to pay a bill. This is something he has always done, manage / pay all household bills. He couldn't remember how to write out the long hand form of the amount of money. He also became very quiet.

Normally, he's the life of the party and wanting to chat with everyone. Instead he became quiet and would sit by himself at parties or with my Mom. Usually he'd be the one that would be the 'social butterfly' and leave my Mom. After my Mom mentioned this to her chiropractor, she was given an article on some of the side effects of Lipitor (it was an article from Newsweek). After reading this article, my Mom insisted that my Dad's primary care stop his Lipitor. My father has undergone a CAT scan, and MRI which have proved to all be normal. He also had some cognitive testing done which ruled out Alzheimer's.

9) My Dad (who's 63 yr old) did stop Lipitor about 3-4 months ago. We're still seeing signs of memory / cognitive problems. (i.e. in his exam he was asked to explain 9/11 -- he mentioned buildings being hit by airplanes but could not recall the name, World Trade Center -- couldn't recall the name of the Pentagon -- he said it was some government building and didn't remember at all the 4th plane involved) That's why we're consulting a Neurologist.

10) I've written to you before about my husband's case. He stopped Statins on July '04 but has lingering cognitive issues; repetitive questioning, short term memory type. He is 60, quad bypass age 52, Statins for 8 years. BP meds are: enalapril and atenolol. Supplements: CoQ10, Omega 3; B5, 6, 12, Folic acid, cinnamon, Vit C & E. I'm in tears today. I feel like I just fell down a tunnel. We received the report from the neuropsychology tests. My husband scored in 9th percentile, which he interprets as a 9th grade education, and he has an IQ of 91.

The neuropsychologist informed us that my husband should not drive until he is evaluated. Neuropsychologist exact words: "Given the magnitude of his executive function difficulties, I am concerned about his ability to safely drive an automobile. It is suggested that his driving skills be formally evaluated through the Agency of Aging "Getting in Gear" program. Important driving variables such as reaction time and field of view can be validly assessed. It is suggested that his driving be curtailed until his driving abilities can be validly assessed." I called the neuropsychologist for Q&A's, but have not received a call-back yet.

These are the tests administered. Just the names were provided; no raw data. Abbreviated Wechsler Adult Intelligence Scale-III, mental status examination, Verbal Learning Test-II, Rey Complex Figure Test and Recall, Train Making Tests A/B, Boston Naming Test, Verbal Fluency (FAS), Grooved Pegboard, Sensory-Perceptual Screening and Beck Depression Inventory-II. I feel really terrible right now. I feel like I've let my husband down.

He is an excellent driver. If I thought he wasn't, I'd be the first to admit it. He does 99% of the driving and in an average summer, we might drive anywhere from 11,000 to 15,000 miles. This is such a slap in the face. All I was trying to do was find someone that would understand what Statins have done to my husband and it's like they've quarantined him to stay home in a rocking chair. We did get some good news today. My husband's CRP is <0.2.

BACKGROUND 
I am a retired family doctor and former NASA scientist astronaut.
My personal concerns began in May 1999 when I experienced my first episode of transient global amnesia and again in May 2000, when my second attack of this harrowing condition occurred seemingly out of the blue.

In both cases, Lipitor had been started six weeks earlier, at the time of my annual astronaut physical. Naturally, I was suspicious of a possible relationship to Lipitor but could find only a statement of "possible memory problems" in the drug literature and no confirmation among the several doctors and pharmacists I consulted.

I had to consider the possibility of underlying disease despite consistently negative workups. An editorial by Joe and Teresa Graedon ( People's Pharmacy ) on the more uncommon side effects of Lipitor directed me to Doctor Golomb at the Statin Study at UCSD. After consulting with Doctor Golomb about her findings, I found that I was not alone in this "black hole" of significant cognitive defects from Lipitor use.

Now there are hundreds of other transient global amnesia cases which have been reported to her statin Study of Lipitor and other statin drugs. None have the slightest recall of the event, relying solely on the history from a friend or family member who happened to be there.

Some come to their senses in the wrong place, perhaps miles away. Most have tremendous difficulty in accepting that alien state of awareness which controlled them for hours. Many other patients have reported severe transient confusion and inordinate difficulty remembering things they always have known.
Not all are senior citizens. Some are in their forties and fifties. A common thread among the amnesia sufferers is that the effect seems to occur indiscriminately in statin users and abruptly, with no warning.

CONCLUSIONS
Supporting this is the publication by Wagstaff et al in the medical journal Phamacotherapy of 60 cases of Transient Global Amnesia associated with the use of Lipitor and other Statins.

I do not wish to malign a drug or class of drugs which are of such established benefit to public health. However it seems prudent to consider these preliminary findings, however anecdotal, in medical decision making. In medical school there is an old adage, "Listen carefully to what the patient is telling you, Doctor, for he is telling you the diagnosis."

As a former USAF flight surgeon for ten years, an ANG flight surgeon with a helicopter squadron for an additional fourteen years and as an FAA flight examiner for the entire time, I suggest that flight surgeons especially should be extremely discriminating in the use of Lipitor and that all doctors follow closely the research of Doctor Beatrice Golomb.

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

Updated July 2011
 
 


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