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Crestor Mental Health and Mood Impact: What the Evidence Actually Shows

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At a glance

  • Drug and forms / rosuvastatin (Crestor), an HMG-CoA reductase inhibitor (statin); Crestor comes in 5 mg, 10 mg, 20 mg and 40 mg tablets [1][3]
  • Boxed warning / none [1]
  • Key trial / JUPITER: 17,802 adults, rosuvastatin 20 mg vs placebo, stopped at a median of 1.9 years [2]
  • JUPITER primary endpoint / myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina or cardiovascular death [2]
  • Adverse events recorded / myalgia 7.6% vs 6.6%, arthralgia 3.8% vs 3.2%, diabetes 2.8% vs 2.3% [1]
  • Behavioral research / low cholesterol and arrests for violent crimes in a 79,777-person Swedish cohort [4]

Does rosuvastatin cause depression or anxiety?

The evidence does not establish that it does. The adverse reactions the Crestor label reports from its placebo-controlled studies and from JUPITER are muscle, joint, digestive, headache and glucose-related events [1]. JUPITER itself was designed to test cardiovascular outcomes, not mood or anxiety [2].

What the JUPITER trial recorded

JUPITER enrolled 17,802 men aged 50 and older and women aged 60 and older with LDL cholesterol under 130 mg/dL and high-sensitivity C-reactive protein of 2.0 mg/L or higher. Participants took rosuvastatin 20 mg daily or placebo, and the trial was stopped at a median of 1.9 years [2]. LDL cholesterol fell 50% and hsCRP fell 37%; the primary endpoint occurred at 0.77 versus 1.36 per 100 person-years (hazard ratio 0.56, 95% CI 0.46-0.69) [2]. The label reports 142 versus 252 events, a 44% relative reduction and a 1.2% absolute reduction [1].

Adverse events the label reports from JUPITER: myalgia 7.6% vs 6.6%, arthralgia 3.8% vs 3.2%, constipation 3.3% vs 3.0%, nausea 2.4% vs 2.3%, and diabetes reported in 2.8% vs 2.3%, with mean HbA1c 0.1% higher on rosuvastatin [1]. None of these is a mood measure.

What about cholesterol and behavior?

One Swedish study merged single cholesterol measurements from 79,777 people enrolled in a health screening project with later police records of arrests for violent crimes; 100 people met the criteria for violent crime. Below-median cholesterol was associated with violent crime in the unadjusted analysis (risk ratio 1.94 in men, P=0.002; 2.32 overall, P<0.001), and after matching on age, sex, alcohol indices and education, violent offenders still had lower cholesterol (P=0.012 overall, P=0.035 in men) [4].

That study measured cholesterol in a population. It did not test rosuvastatin, did not randomize anyone to treatment, and cannot show that lowering cholesterol with a statin changes behavior.

Frequently asked questions

Does Crestor cause depression?
The evidence does not establish that it does. The adverse reactions the label reports from JUPITER are muscle, joint, digestive and glucose-related events [1].
Does rosuvastatin affect memory or cognition?
The Crestor label lists rare cognitive impairment among postmarketing reports [1]. The placebo-controlled trial data in the label report muscle, joint, digestive and metabolic events [1].
Can lowering cholesterol with Crestor change behavior?
A cohort study of 79,777 Swedish adults found below-median cholesterol associated with arrests for violent crimes, with a risk ratio of 2.32 in the unadjusted analysis [4]. That study measured cholesterol, not statin treatment, and cannot show that rosuvastatin changes behavior.

References

  1. DailyMed - CRESTOR- rosuvastatin tablet, film coated. DailyMed - CRESTOR- rosuvastatin tablet, film coated
  2. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM, Kastelein JJ, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195-207. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein
  3. Drugs@FDA: FDA-Approved Drugs. Drugs@FDA: FDA-Approved Drugs
  4. Golomb BA, Stattin H, Mednick S. Low cholesterol and violent crime. J Psychiatr Res. 2000;34(4-5):301-9. Low cholesterol and violent crime
Evidence overview for Crestor Mental Health and Mood Impact: What the Evidence Actually Shows