There has recently been a lot of coverage in the mainstream media about statins reducing the risk of dementia and Parkinson’s disease. They forgot to mention though, that this was only shown to be true for simvastatin, and not for atorvastatin or lovastatin. Other statins have not been investigated by this study.
"We were very surprised by the size of the effect associated with simvastatin and that it worked for both Parkinson's disease and dementia. We were also surprised that atorvastatin hardly had any impact on the incidence of either disease," said Dr. Benjamin Wolozin, MD, the principal investigator from Boston University School of Medicine in Massachusetts.
"Simvastatin crosses into the brain very effectively, whereas atorvastatin just doesn't achieve as high a level [in the brain]. Lovastatin crosses the blood-brain barrier nicely, but it is a first generation statin and therefore is just not as potent as some of the newer agents," he continued.
Based on the study's results, Dr. Wolozin said clinicians might want to consider an individual patient's family history when choosing a statin.
"If a patient has a family history of dementia, simvastatin may be a better choice than other agents. On the other hand, we know atorvastatin is somewhat better than simvastatin at preventing morbidity from cardiovascular disease, so if a patient has no dementia history but has cardiovascular risk factors, they may be better off taking atorvastatin. It really boils down to personalized medicine," said Dr. Wolozin.
Currently, in terms of volume, atorvastatin (Lipitor) is not only the highest volume statin, but also the most sold drug of 2006. Even though these findings need to be confirmed by other prospective population-based studies, it will be interesting to see if that changes in 2008.
Source: Simvastatin Linked to Reduced Incidence of Dementia, Parkinson's Disease (Medscape) [1]
Links:
[1] http://www.medscape.com/viewarticle/560248