Lipitor and memory

At first, I was skeptical. A book from a nutty author and physician named Duane Graveline kept on coming up in conversations with patients. His book, Lipitor: Thief of Memory , details his personal experience with dramatic changes in memory and thought while taking Lipitor.

Now this is a drug that I've seen used thousands of times. But I've now seen about a dozen people who have had distinct struggles with memory and clarity of thinking while taking Lipitor. Most took doses of 40 mg per day or more, though an occasional person takes as little as 10 mg. The association seems to be undeniable, since it improves after two weeks off the drug, recurs when resumed. Just today, I saw two people where this effect may be an issue.

Curiously, I've not seen it with any other statin agent. Unfortunately, uncovering any scientific data on the issue is a hopeless quest. Either it's very uncommon or, worse, the data has been suppressed.

Any way, I believe that Dr. Graveline was right: Lipitor, in a small number of people, does indeed seem to exert real detrimental effects on the mind.

If you take Lipitor, should you stop it in fear of long-term effects on your mental capacity? I think it's premature to toss the drug out based on this relatively uncommon relationship. This particular effect is likely to be idiosyncratic, i.e., peculiar to an occasional person but does not seem to apply to the majority, probably by some quirk of metabolism or penetrability of the barrier between the blood and nervous system tissue.

If, however, you feel that your thinking and memory have deteriorated on the drug, please speak to your doctor.

Comments (2) -

  • Jeffrey Dach MD

    6/18/2007 10:13:00 PM |

    Perhaps you have seen the Direct-to-Consumer TV and print advertisements with Robert Jarvik, the inventor of the Jarvik Heart, speaking on behalf of the Pfizer’s anti-cholesterol drug, Lipitor.

    Perhaps Jarvik is not the best choice for the Lipitor campaign which has had mixed reviews. Instead of Jarvik, a more convincing yet unlikely spokesman would be the popular Duane Graveline MD MPH, a former NASA astronaut, and author who was started on Lipitor during an annual astronaut physical at the Johnson Space Center, and 6 weeks later had an episode of transient global amnesia, a sudden form of total memory loss described in his book, Lipitor Thief of Memory.    

    Two more unlikely spokesmen for the Lipitor ad campaign include Mary Enig and Uffe Ravnskov.  

    Should either one be selected as Lipitor spokesman, I myself would run down to the corner drug store to buy up the drug.  It seems unlikey that even Pfizer’s deep pockets could ever induce them to recant their opposing position on the cholesterol theory of heart disease.  

    Mary G. Enig writes, ”hypercholesterolemia is the health issue of the 21st century. It is actually an invented disease, a problem that emerged when health professionals learned how to measure cholesterol levels in the blood.  

    Uffe Ravnskov MD PhD is spokesman for Thincs, The International Network of Cholesterol Skeptics, and author of “The Cholesterol Myths, Exposing the Fallacy That Saturated Fat and Cholesterol Cause Heart Disease”.  His controversial ideas have angered loyal cholesterol theory supporters in Finland who demonstrated by burning his book on live television.

    For more discussion on this, see my newsletter: Lipitor and The Dracula of Modern Technology

    Jeffrey Dach MD

  • Anonymous

    11/10/2008 7:50:00 PM |

    My mom went on lipitor for "high cholesterol".  I don't think it's all that high, but whatever.

    She ended up in the hospital with "transient global amnesia".  Cause: completely unknown.  It's just one of those things that happens.

    I've begged her to stop, and try something else.  Her doctor has been very relunctant, but at least he agreed to significantly reduce her dosage, and there has been no further problem.

    A book I read about this suggested that the problem came from the drug industry, and their competitive markets.  They want a drug that is as powerful as possible, to impress doctors.  They also want a drug that is simple to prescribe, without complicated tables.  So they create pills that are the maximum dose.  My 70 year old mom who is fairly small is taking the same dose a 300 pound linebacker would take.

    Lipitor is particularly bad about this, and is nearly 4 times as strong as the other statins.

    What really pisses me off is how the manufacturers ignore these reports, by showing that there are no known adverse side effects on memory.  Well, yeah.  That's because my mom's TGA was "unknown cause".  And my mom's doctor didn't file an FDA report on lipitor.  So how could it ever be linked?

Low HDL makes Dr. Friedewald a liar

Low HDL makes Dr. Friedewald a liar

There's a $22 billion industry based on treating LDL cholesterol, a fictitious number.

LDL cholesterol is calculated from the following equation:

LDL cholesterol = Total cholesterol - HDL cholesterol - triglycerides/5

So when your doctor tells you that your LDL cholesterol is X, 99% of the time it has been calculated. This is based on the empiric calculation developed by Dr. Friedwald in the 1960s. Back then, it was a reasonable solution, just like bacon and eggs was a reasonable breakfast and a '62 Rambler was a reasonable automobile.

One of the problems with Dr. Friedewald's calculation is that the lower HDL cholesterol, the less accurate LDL cholesterol becomes. If it were just a few points, so what? But what if it were commonly 50 to 100 mg/dl inaccurate? In other words, your doctor tells you that your LDL is 120 mg/dl, but the real number is somewhere between 170 and 220 mg/dl. Does this happen?

You bet it does. In my experience, it is an everyday event. In fact, I'm actually surprised when the Friedewald calculated LDL closely approximates true LDL--it's the exception.

Dr. Friedewald would likely have explained that, when applied to a large population of, say, 10,000 people, calculated LDL is a good representation of true LDL. However, just like saying that the average weight for an American woman is 176 lbs (that's true, by the way), does that mean if you weigh 125 lbs that you are "off" by 41 lbs? No, but it shows how you cannot apply the statistical observations made in large populations to a single individual.

The lower HDL goes, the more inaccurate LDL becomes. This would be acceptable if most HDLs still permitted reasonable estimation of LDL--but it does not. LDL begins to become significantly inaccurate with HDL below 60 mg/dl.

How to get around this antiquated formula? In order of most accurate to least accurate:

--LDL particle number (NMR)--the most accurate by far.

--Apoprotein B--available in most laboratories.

--"Direct" LDL

--Non-HDL--i.e., the calculation of total cholesterol minus HDL. But it's still a calculated with built-in flaws.

--LDL by Friedewald calculation.

My personal view: you need to get an NMR if you want to know what your LDL truly is. A month of Lipitor costs around $80-120. A basic NMR costs less than $90. It's a relative bargain.

Comments (5) -

  • Mike

    3/18/2007 1:52:00 AM |

    What is shocking is that enormous prescriptions for statins are written based on the calculated LDL.

  • Dr. Davis

    3/18/2007 1:16:00 PM |

    Yes, $22 billion last year, in fact. All prescribed for a number that is a crude estimate, sometimes a complete fiction. Imagine your state trooper ticketed you because his radar device said you were doing 60 mph when you were really doing 35 mph.

  • Anonymous

    2/6/2008 1:37:00 AM |

    Why NMR over the other tests Berkeley Heart Lab or VAP?

  • Anonymous

    7/2/2008 7:02:00 PM |

    I don't understand.  If in this example, the doctor (wrongly) thinks the LDL number is 120mg/dl, how does that cause the prescription of Lipitor? Unless I'm reading it backwards, and the doctor is actually telling the patient their LDL is 170mg-220mg, but unwittingly, it's actually 120mg/dl.

    And, if a low HDL causes the LDL number to be inaccurate, does that also cause the total cholesterol number to be inaccurate too?