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Medical Forum / General / Cardiology / January 2005memory loss after CABG
My father had a triple bypass this summer and had some problems with low oxygen sats. Since then, our family has noticed that he has recent memory loss. For example, he may not remember directions to a store that he started going to 3 years before surgery. But, he remembers everything from 10 years and longer. Has anyone experienced this? > My father had a triple bypass this summer and had some problems with > low oxygen sats. Since then, our family has noticed that he has > recent memory loss. For example, he may not remember directions to a > store that he started going to 3 years before surgery. But, he > remembers everything from 10 years and longer. Has anyone experienced > this? Take a look at these: http://tinyurl.com/658kz http://www.medhelp.org/forums/cardio/messages/33997a.html and http://tinyurl.com/6pajt Be aware that there are those here who will tell you that it's a statin that is causing your father's memory loss. Don't buy it. L. > My father had a triple bypass this summer and had some problems with low > oxygen sats. Since then, our family has noticed that he has recent memory > loss. For example, he may not remember directions to a store that he > started going to 3 years before surgery. But, he remembers everything from > 10 years and longer. Has anyone experienced this? Dear Tammy I am very sorry to hear about your father. Yes you are correct in thinking bypass surgery can cause cognitive deficits. However so can many medications given to heart disease patients, including medications known as statins; simvastatin (Zocor), atorvastatin (Lipitor) and rosuvastatin (Crestor) are the most commonly prescribed I know many people who have had memory loss from statins with or without bypass surgery, including many who did not have heart disease but took statins for prevention. I am one of the latter group and suffered short term memory loss, language loss, thinking and learning difficulties. At the time, my cognitive and memory problems were not recognized as coming from statins You may wish to take these studies to your father's physicians. They have been published in peer reviewed medical journals, and are available from the National Institutes of Health database. {http://www.ncbi.nlm.nih.gov/Entrez/} Each study is followed by a link to the abstract. Your father's physicians will have access to the complete studies. My very best wishes for your father's good health Tammy, and for you in a time of worry and concern. Your father is very fortunate in having such a caring and responsible daughter. In the words of the authors of one of the studies: "Clinicians should be aware of cognitive impairment and dementia as potential adverse effects associated with statin therapy." {see below}. Zee Statin induced memory loss and amnesia ~~~~~~~~~~~~~~~~~~~~~~~~ Cognitive impairment asssociated with atorvastatin and simvastatin. King DS, Wilburn AJ, et al. Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi 39216 "We report two women who experienced significant cognitive impairment temporally related to statin therapy. One woman took atorvastatin, and the other first took atorvastatin, then was rechallenged with simvastatin. Clinicians should be aware of cognitive impairment and dementia as potential adverse effects associated with statin therapy." PMID: 14695047 http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra ct&list_uids=14695047 ~~~~~~~~~~~~~~~~~~~ Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Am J Med. 2004 Dec 1;117(11):823-9. Muldoon MF, Ryan CM. et al. Center for Clinical Pharmacology, University of Pittsburgh, Pennsylvania 15260, USA. m...@pitt.edu "This study provides partial support for minor decrements in cognitive functioning with statins. Whether such effects have any long-term sequelae or occur with other cholesterol-lowering interventions is not known." http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra ct&list_uids=15589485 ~~~~~~~~~~~~~~~~~~ Effects of lovastatin on cognitive function and psychological well-being. Muldoon MF, Barger SD, et al. Am J Med. 2000 May;108(7):538-46. PMID: 10806282 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 0806282&dopt=Abstract ~~~~~~~~~~~~~~ Drugs that make you forget: Australian Adverse Drug Reactions Bulletin Volume 17, Number 3, August 1998, section 3, page 3 Simvastatin is listed under "Drugs that make you forget": www.health.gov.au/tga/docs/pdf/aadrbltn/aadr9808.pdf ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Statin-associated memory loss: analysis of 60 case reports and review of the literature. Wagstaff LR, Mitton MW, Arvik BM, Doraiswamy PM. Drug Information Service, Duke University Medical Center, Durham, North Carolina 27710, USA. Pharmacotherapy. 2003 Jul;23(7):871-80. Abstract: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 2885101&dopt=Abstract Full Study Text free on Medscape: http://www.medscape.com/viewarticle/458867 ~~~~~~~~~~~~~~~~~~ The Role of Lipid-Lowering Drugs in Cognitive Function: A Meta-Analysis of Observational Studies from Pharmacotherapy Mahyar Etminan, Pharm.D., Sudeep Gill, M.D., FRCPC, Ali Samii, M.D., FRCPC Abstract: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 2820814&dopt=Abstract Full Study Text free on Medscape: http://www.medscape.com/viewarticle/456866 ~~~~~~~~~~~~~~~~~~~ Simvastatin-Associated Memory Loss Amanda Orsi, Pharm.D., et al Abstract: The statins are widely used to treat dyslipidemias. They are generally associated with mild adverse effects, but rarely, more serious reactions may occur. A 51-year-old man experienced delayed-onset, progressive memory loss while receiving simvastatin for hypercholesterolemia. His therapy was switched to pravastatin, and memory loss resolved gradually over the next month, with no recurrence of the adverse effect. from Pharmacotherapy Page 1 of 3: http://www.medscape.com/viewarticle/409738?WebLogicSession=PXke2H8h99pyNVSCajAh5 clptzOAHJSZuNBobSwWmi9veWjdJ2A3%7C-1468812056489609316/184161392/6/7001/7001/700 2/7002/7001/-1 full printable version: http://www.medscape.com/viewarticle/409738_print ~~~~~~~~~~~~~~~~~~~~~~~~~ ADR of the Month September 2001 Vol. 6 No. 9 EDITORS Michelle W. McCarthy, Pharm.D. Anne E. Hendrick, Pharm.D. University of Virginia Health System Department of Pharmacy Services Drug Information Center PO Box 800674 Charlottesville, VA 22908-0674 http://hsc.virginia.edu/pharmacy-services/Newsletters/ADR%20of%20the%20Month/ADR Month%209-01htm.html ~~~~~~~~~~~~~~~~~~~~~~~~~~ Do HMG-CoA reductase inhibitors impair memory? The Tablet, British Columbia Pharmacy Association September 2001, Volume 10 no 8 Excerpt: Do HMG-CoA reductase inhibitors impair memory? After taking simvastatin for a year, a 51-year-old patient developed short term memory loss, to the extent of being unable to complete his sentences because he would forget what he was going to say. The drug was discontinued, replaced by pravastatin, and within one month his memory returned.14 In a separate case, a 67-year-old woman developed impaired short-term memory, altered mood, social impairment, cognitive impairment and dementia after one year of atorvastatin therapy. When atorvastatin was discontinued, her memory, mood and cognition improved completely.15 Memory impairment in a patient receiving atorvastatin has been reported to the BC Regional ADR Centre. REFERENCES: 14. Orsi A, Sherman O, Woldeselassie Z. Simvastatin-associated memory loss. 15. King DS, Jones DW, Wofford MR et al. First report of cognitive impairment in an elderly patient: case report. Pharmacotherapy 2001 Mar; 21: 371. http://www.bcpharmacy.ca/publications/thetablet/pdf_version/BCPhA_Tablet-Sep2001.pdf See page 11 of 16: ~~~~~~~~~~~~~~~~~~~~~~ Lipitor, Thief of Memory This book documents the experiences of Duane Graveline, M.D. retired family physician, USAF flight surgeon, former US Astronaut (science) who suffered memory loss and transient global amnesia from Lipitor. Graveline's website: http://www.spacedoc.net "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. Incidentally this ratio of 11/2502 (5/1000) translates into 150,000 expected cases of severe memory impairment this year alone among our 30 million Lipitor users." ~~~~~~~~~~~~~~~~~~~~~~~~ >Subject: Re: memory loss after CABG >From: "Zee" zwalanga@yahoo.com >Date: 1/18/2005 9:04 A.M. Pacific > Yes you are correct in >thinking bypass surgery can cause cognitive deficits. However so can >many medications given to heart disease patients, including >medications >known as statins; simvastatin (Zocor), atorvastatin (Lipitor) and >rosuvastatin (Crestor) are the most commonly prescribed blah blah blah Tammy did NOT mention that her DAd had been on statins..so your fear mongering is just that... It is well documented that "pump head" can and does occur to many who are on the heart lung machine...not sure of the percentages..but it if most often short lived A good reason to ask for "beating heart" or NO heart lung machine whenever possible..good reason to seek out a surgical group who are adept at this...not all are Just a BTW..hubby had beating heart CABG..AND hasbeen on statins for 4 years...his cognition is still sharp as a tack... sorry about your Dad Tammy...it may well resolve.... hawki..... Hi Tammy, Your story sounds so familiar, but it wasn't my Dad; it happened to my husband. That's when it all started. Quad bypass at age 52. It was clearly stated in the papers we signed that there could be memory problems. And that they may be temporary or permanent [covering all bases]. They did not have the beating heart option 8 years ago. We were told that if my husband left the hospital he would probably die. Not much choice. I hear this scare tactic in story after story of bypass patients. He was placed on the famous "low fat - low cholesterol" diet and fenofibrates [just as a precaution]. In a pretty short time, his triglycerides were going through the roof, so he was placed on Zocor. Incidentally, Zocor is not effective against triglycerides, but we did not know that at the time. Then came Lipitor. He ALWAYS had aches and pains but they were ignored [by the doctor]. He finally suggested going to a chiropractor. The only relief was Advil several times a day. For some reason, the cardiologist decided to increase Lipitor from 10mg to 20mg. I started to notice little thing about his memory. He'd forget the day of the week.... got him a watch with the days of the week. He started asking the same question several times, no recall of asking the question. He had trouble forming thoughts and sentences..... trouble problem solving. I tell you all this, not to scare you, but to make you aware of what might be in your father's future. I wish someone had warned us of the dangers and long lasting effects of both bypass and meds that bypass patients are usually encouraged to take. He is not taking Lipitor; we are trying nutritional supplements and trying to limit carbs. His memory is slowly returning and the aches and pains have subsided considerably. Frankie >Subject: Re: memory loss after CABG >From: "Frankie" birm47@gmail.com >Date: 1/18/2005 7:59 P.M. Pacific >We were told that if my husband left the hospital he would probably >die. Not much choice. I hear this scare tactic in story after story of >bypass patients. in many many people..this is not a "scare tactic" but the truth...like it or not >. I wish someone had warned us of the >dangers and long lasting effects of both bypass and meds that bypass >patients are usually encouraged to take. perhaps you would not have had to worry about memory loss..but of how to live without a husband... life is full of choices..and risks and benefits.. perhaps more need to SEE angiograms like my husband's....LAD being nearly 100% blocked...LAD is not dubbed "the widowmaker" for nothing...NOT having intervention is a bigger risk than taking a risk that you will be in the side effect risk group...as not all are... hawki..... Tammy, Certainly there are memory loss issues associated with bypass. However, you should clarify with the doctors when it would be expected to become evident. A friend's husband suffered such loss, but it was immediately apparent - not gradual onset. My own husband's memory loss, very similar to what you describe, came on gradually and was due to the adverse effects of Lipitor 10 mg for 4 years. The citations that Zee gave you are good ones to start with. The doctors owe it to you to eliminate or consider both causes (obviously, if he was not taking a statin drug, that option is ruled out). Do not let them off the hook, they need to address this, and fast. The Cholesterol-lowering Statin Drug Names: Lipitor, Crestor, Mevacor, Pravachol, Zocor, Lescol, and Baycol, aka atorvastatin, rosuvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, and simvastatin; This class of drugs is also known as HMG-CoA Reductase Inhibitors, short for 3-Hydroxy-3-Methyl-Glutaryl Coenzyme A Reductase. Good luck, Sharon > My father had a triple bypass this summer and had some problems with low > oxygen sats. Since then, our family has noticed that he has recent memory > loss. For example, he may not remember directions to a store that he > started going to 3 years before surgery. But, he remembers everything > from > 10 years and longer. Has anyone experienced this? One more piece of information. If your father was on a statin drug, there is now a way to verify if the cognitive/short-term memory loss damage is due to the statin adverse effects (List of statins is at the end of this message). Dr. Muldoon just published a second study that corroborates not only that people taking statins have a measurable loss of cognitive ability after only 6 months of treatment, he has determined the specific neuropsychological (NP) tests, within a battery of tests, that show statin damage. NP tests are standardized oral and written tests given by a neuropsychologist or a psychiatrist - the experience is almost like an interview. The NP tests that show Cognitive damage as a result of statin adverse effects: Statin-Sensitive Tests Elithorn Mazes* Planning and drawing time to complete complex lattice-type perceptual mazes (10). Digit Vigilance Number of target stimuli (the number "6") missed when required to scan two pages of numbers (11). Recurring Words* Percentage of words identified correctly as either "new" or "repeated" when words are read using a continuous recognition test format (12). Grooved Pegboard Time required to insert 25 grooved pegs into slotted holes (13). (the numbers in parentheses are references to footnotes in the study) The abstracts for Dr. Muldoon's studies are available at the National Institutes of Health website.: Dr. Muldoon's latest study: Randomized trial of the effects of simvastatin on cognitive functioning in hypercholesterolemic adults. Muldoon MF, Ryan CM, Sereika SM, Flory JD, Manuck SB. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra ct&list_uids=15589485 Am J Med. 2004 Dec 1;117(11):823-9. PMID: 15589485 [PubMed - indexed for MEDLINE] Dr. Muldoon's previous study, which the one above repeated using a different statin: Effects of lovastatin on cognitive function and psychological well-being. Muldoon MF, Barger SD, Ryan CM, Flory JD, Lehoczky JP, Matthews KA, Manuck SB. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra ct&list_uids=10806282 Am J Med. 2000 May;108(7):538-46. PMID: 10806282 [PubMed - indexed for MEDLINE] The Cholesterol-lowering Statin Drug Names: Lipitor, Crestor, Mevacor, Pravachol, Zocor, Lescol, and Baycol, aka atorvastatin, rosuvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, and simvastatin; This class of drugs is also known as HMG-CoA Reductase Inhibitors, short for 3-Hydroxy-3-Methyl-Glutaryl Coenzyme A Reductase. > My father had a triple bypass this summer and had some problems with low > oxygen sats. Since then, our family has noticed that he has recent memory > loss. For example, he may not remember directions to a store that he > started going to 3 years before surgery. But, he remembers everything > from > 10 years and longer. Has anyone experienced this? > One more piece of information. If your father was on a statin drug, there > is now a way to verify if the cognitive/short-term memory loss damage is due > to the statin adverse effects (List of statins is at the end of this > message). I think it is important to state the conclusion of the study: "CONCLUSION: This study provides partial support for minor decrements in cognitive functioning with statins. Whether such effects have any long-term sequelae or occur with other cholesterol-lowering interventions is not known." Also, I'm not really sure you can use the tests you cite below to attribute cognitive loss to statins - i.e. someone who is not on statins might also show cognitive loss in these areas might they not. I can see the cause and effect going in one direction - statins imply this pattern. But does he specifically say it works in reverse? (If you have this pattern, it must be statins.) TIA Bill > Dr. Muldoon just published a second study that corroborates not only that > people taking statins have a measurable loss of cognitive ability after only [quoted text clipped - 59 lines] >> started going to 3 years before surgery. But, he remembers everything from >> 10 years and longer. Has anyone experienced this? >> One more piece of information. If your father was on a statin drug, >> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 7 lines] > long-term sequelae or occur with other cholesterol-lowering interventions > is not known." That is not the conclusion of the study per se, it is the abstract conclusion. In the words of the study: " The results of this investigation stand as a partial replication of our earlier trial. Given the limitations of the findings, the evidence of decremental effects of statins on cognitive functioning remains preliminary. Further study is warranted because of both the extremely widespread use of these drugs and the decline in cognitive function that accompanies aging. Treatment effects may differ by patient group or with nonstatin cholesterol-lowering interventions, and may either amplify or resolve (via development of tolerance) with long-term treatment. In any case, this research challenges the current orthodoxy that cholesterol is of importance only as a risk factor for atherosclerosis." It really makes you wonder who writes these abstract conclusions, doesn't it? The DISCUSSION is also far more enlightening (excerpt): "In our re-examination of the effects of statins on cognitive functioning, we found that treatment adversely affected performance on neuropsychological tests that were sensitive to lovastatin in our initial investigation. Performance on new tests was also negatively affected by simvastatin, as compared with placebo. However, these effects were rather circumscribed; statistically significant treatment effects were observed on just three of six tests when analyzed individually, and baseline differences confound interpretation of one of these measures. The cognitive decrements with the 40-mg dose of simvastatin were no greater than those observed with the 10-mg dose, suggesting a threshold effect. As in our initial investigation, the treatment effects were small and were manifest not as an absolute decline in performance but as a lack of improvement between baseline and post-treatment assessments. Indeed, learning or practice effects are observed upon readministration of most neuropsychological tests within 1 year (22,23) and can obscure small or modest drug effects. Cognitive function is often divided into domains or skill areas, such as memory, psychomotor speed, attention, and mental flexibility. In our studies, the neuropsychological tests on which performance was affected by statins tap a variety of skills, and therefore our findings indicate that such cognitive effects are not specific to one or two domains of function. Tests found to be sensitive to the effects of statins tended to have relatively large learning or practice effects, as evidenced by the improvement seen in placebo-treated participants. This suggests that the effects of statins on cognition may affect patients' abilities to benefit from prior experience or devise performance- enhancing strategies." Failure to thrive, failure to learn from experience. Does that sound good to you? Put yourself in the role of an employer, who hires 2 new people. After 6 months only one has learned on the job what the job takes, the other has not mastered what has been a repetitive prior experience for the entire 6 months. Which one would you keep? > Also, I'm not really sure you can use the tests you cite below to > attribute cognitive loss to statins - i.e. someone who is not on statins [quoted text clipped - 6 lines] > > Bill So, you are saying you are really sure that TIA as the same exact pattern of deficit as two studies that showed the same pattern of deficiencies (vs placebo groups) for two different statins? Where is your evidence? Which tests would be affected for the TIA patient? Where is the statistical analysis of validity of your sample. Muldoon provided his in both studies. >> Dr. Muldoon just published a second study that corroborates not only that >> people taking statins have a measurable loss of cognitive ability after [quoted text clipped - 62 lines] >>> from >>> 10 years and longer. Has anyone experienced this? >> Also, I'm not really sure you can use the tests you cite below to attribute >> cognitive loss to statins - i.e. someone who is not on statins might also [quoted text clipped - 12 lines] > tests would be affected for the TIA patient? Where is the statistical > analysis of validity of your sample. Muldoon provided his in both studies. TIA means "Thanks in advance" in this context. I don't think you understood the question. The question is how do you know that a particular pattern on a test implies statin use. Could not something else cause this, e.g. another drug? In other words, you may have read too much into the study - i.e. statin use implies a particular pattern but not the other way around. As a suggestion, you would be more credible if you engaged in reasoned debate rather then asking "Where is the statistical analysis of validity of your sample?" Obviously, I have no such sample. Bill >>> Also, I'm not really sure you can use the tests you cite below to >>> attribute cognitive loss to statins - i.e. someone who is not on statins [quoted text clipped - 15 lines] > > TIA means "Thanks in advance" in this context. In this context, specific to reasons for cognitive deficiencies, it made far more sense meaning "transient ischaemic attacks (TIA)" >I don't think you understood You are correct > the question. The question is how do you know that a particular pattern on > a test implies statin use. Could not something else cause this, e.g. > another drug? The pattern would not be used to detect statin use - that is a matter of medical record. The pattern would be used to demonstrate evidence of statin damage in statin takers. Could other drugs cause a similar pattern of damage? That is beyond my area of research or experience, and was ruled out for the statin groups by the exclusionary rules for the studies Muldoon did. If cognitively damaged statin takers, who were not cognitively damaged prior to taking the statin, also take other drugs, those drugs would, of course, also ideally need to be checked to see if they produce the same pattern of cognitive damage on those specific tests while concurrently not showing damage on the other specified NP tests in placebo controlled studies. If cognitively damaged statin takers take no other drugs, were not cognitively damaged before, and demonstrate cognitive damage on the statin sensitive tests and not on the other specified NP tests, what would your conclusion be? It sounds to me like Dr. Muldoon has identified the beginning of the end of differential diagnosis for those cognitively disabled by Lipitor and other statins. > In other words, you may have read too much into the study - i.e. statin > use implies a particular pattern but not the other way around. I wasn't looking for the other way around, not sure how that is relevant. > As a suggestion, you would be more credible if you engaged in reasoned > debate rather then asking "Where is the statistical analysis of validity > of your sample?" Obviously, I have no such sample. See, I'm not here for the sport of debating, My interest in this smc ng is not remotely recreational. I'm here to learn how to get a treatment toward recovery for my statin disabled husband. Barring that, I'm here for an inkling as to what will help him at least improve. We are despearate for just an idea of how many more years it will take before we know if he has a chance at full recovery. So far, 7 years of pain, loss of cognitive ability, loss of muscle, loss of energy, loss of nerve function, loss of business, loss of all retirement savings, loss of dignity, etc., with no way of knowing how much improvement is possible, or how long it will take, but constantly hoping to get even a hint. I'm here to learn from the experience of others and to discover articles and references I may have missed. This is why I am here. And, if possible, to warn others of the possible adverse effects, if their doctors failed to do so, and of the signs to watch for before they or their loved ones are disabled, so they don't need to experience what we have for the past 7 years. Engaging in recreational and entertaining debate is appropriate in other venues. If and when I ever get that luxury, I will keep your advice in mind. Thanks for the tip. > Bill >>>> Also, I'm not really sure you can use the tests you cite below to >>>> attribute cognitive loss to statins - i.e. someone who is not on statins [quoted text clipped - 56 lines] > > I wasn't looking for the other way around, not sure how that is relevant. If you see a particular pattern, it may not be due to statins but some other cause. Perhaps one you could not identify. In other words, as I interprert what you have said (and I am looking for your to elaborate if I am wrong) you may be able to do certain tests to rule out statins as a cause of cognitive decline - i.e. if you do not fit the pattern, it is not statins. However, if you do see a particular pattern you may suspect statins but have not proven it. Is that correct? >> As a suggestion, you would be more credible if you engaged in reasoned >> debate rather then asking "Where is the statistical analysis of validity of >> your sample?" Obviously, I have no such sample. > > See, I'm not here for the sport of debating, My interest in this smc ng is > not remotely recreational. You are at it again. Attacking with no reason. Debating is not a sport. One debates in the Senate for example. The intention is to come to a reasoned conclusion. Bill > I'm here to learn how to get a treatment toward recovery for my statin > disabled husband. Barring that, I'm here for an inkling as to what will [quoted text clipped - 19 lines] > >> Bill snip > If you see a particular pattern, it may not be due to statins but some > other cause. In the case of Muldoon's 2 studies, the other causes were eliminated at the start. That is what makes this pattern of statin-sensitive and statin-insensitive test scores so significant. In an individual there will always be debate (that is what keeps the court dockets full), particularly with sums like Pfizer's this quarter profits of over 3 billion dollars at stake. However, where before there were rule outs to create a differential diagnosis (clear MRI, clear PET, Alzheimer's rule out, Tau and other FTDs ruled out, other mechanical and chemical causes ruled out) you are left with statins as a differential diagnosis. Now, since Muldoon has identified a set of statin-sensitive tests and a set of tests that are not statin-sensitive: 1) if you already have the differential diagnosis, and 2) you can demonstrate that the suspected statin damage shows up on the statin-sensitive tests, and 3) you can demonstrate that the suspected statin damage does not show up in statin-insensitive tests You are further along in determining that statins are the cause than you were before Muldoon published his second study. >Perhaps one you could not identify. Up to someone else to prove something unidentifiable did something non-quantifiable and that is more likely than the proven pattern. >In other words, as I interprert what you have said (and I am looking for >your to elaborate if I am wrong) you may be able to do certain tests to >rule out statins as a cause of cognitive decline - i.e. if you do not fit >the pattern, it is not statins. However, if you do see a particular pattern >you may suspect statins but have not proven it. Is that correct? In the circumstance described above, there is certainly an improvement in being able to demonstrate it. This is a major step for those who have been disabled by statins. Particularly because, once it is generally acknowledged that it is a problem that the largest selling class of all pharmaceutical products causes cognitive decline in all users, it puts us one step closer to some research into treatment and the potential for recovery. If you are still not convinced it is 'proof' then there are also advantages there for the statin disabled, because that stance completely eliminates any possibility of a statute of limitations. If people cannot possibly establish the certainty that they 'knew or should have known' due to lack of absolute proof in your construct, then the clock never starts on the statute of limitations. Thus giving the litigous plaintif an infinite amount of time for further evidence, perhaps leading to 'proof' in your construct. snip >>>> Also, I'm not really sure you can use the tests you cite below to >>>> attribute cognitive loss to statins - i.e. someone who is not on [quoted text clipped - 32 lines] > The pattern would be used to demonstrate evidence of statin damage in > statin takers. But it can't and won't, at least not based upon the information provided in the article. (See below.) And that is something that _you_ should know, and most likely _do_ know. > Could other drugs cause a similar pattern of damage? That is beyond my > area of research or experience, and was ruled out for the statin groups by > the exclusionary rules for the studies Muldoon did. And what of other causes of "cognitive disabilities", which the tests involved were designed and employed to detect before statins were ever marketed? > If cognitively damaged statin takers, who were not cognitively damaged > prior to taking the statin, also take other drugs, those drugs would, of [quoted text clipped - 7 lines] > sensitive tests and not on the other specified NP tests, what would your > conclusion be? That statins may, or may not, be the sole cause of cognitive damage. Or that statins may, or may not, work to enhance other causes of such damage. Or that the damage was the sole result of other causes of the cognitive damage. > It sounds to me like Dr. Muldoon has identified the beginning of the end > of differential diagnosis for those cognitively disabled by Lipitor and [quoted text clipped - 15 lines] > disabled husband. Barring that, I'm here for an inkling as to what will > help him at least improve. And of what benefit towards those goals is reporting studies such as this one? ISTM that the only thing that reporting studies such as you did in the original post is to "warn" (or scare, YMMV) people off of statins. I note that you did not address my initial response, which was pretty clear, and which is not answerable by mere reference to "problems" with people who "write the abstracts" for articles such as the one you posted. The tests you and Dr. Muldoon are discussing were around for years before statin, and were employed to detect "cognitive loss" issues. Such losses can be caused by a number of things not involving the use of _any_ drug, or perhaps by use/abuse of other drugs. The question I posed is that given the two sentences immediately prior to this one, how can one attribute "cognitive" loss detected by the tests used by Dr. Muldoon to statin use as opposed to any other cause? The silence in response to that question is deafening. > We are despearate for just an idea of how many more years it will take > before we know if he has a chance at full recovery. So far, 7 years of [quoted text clipped - 4 lines] > to learn from the experience of others and to discover articles and > references I may have missed. This is why I am here. And your circumstances are heart-breaking. But they have nothing to do with the article you posted. > And, if possible, to warn others of the possible adverse effects, if their > doctors failed to do so, and of the signs to watch for before they or > their loved ones are disabled, so they don't need to experience what we > have for the past 7 years. So there we have it, another agenda. And it's one having nothing to do with your husband's medical problems or potential for recovery therefrom. Ms. Hope, I had a good friend in childhood who died from a reaction to penicillen; a very healthy and vibrant young lady who got awards for 100% attendance in grades 1-9. Her first ever injection of penicillen killed her as she began the 10th grade. Should I spend my time shouting about the dangers of penicillen allergy and side effects of drugs, trying to warn others off of drugs? Can anyone out there with an IQ above 80 and access to any form of news media possibly be unaware of the potential for such side effects, or of the need to ask a doctor questions before blindly ingesting chemicals? > Engaging in recreational and entertaining debate is appropriate in other > venues. Agreed. The problem is, however, that I don't view this sort of "debate" as either recreational or entertaining. Statins are an important part of caring for patients form whom they are indicated. That makes this "debate" very important, at a minimum. That there are folks out there actually who post to newsgroups asking for medical advice, (as opposed to straight information or for experiences that others may have had) makes it more than very important; it's critical. > If and when I ever get that luxury, I will keep your advice in mind. > Thanks for the tip. > >> Bill Steve  SignatureThe above posting is neither a legal opinion nor legal advice, because we do not have an attorney-client relationship, and should not be construed as either. This posting does not represent the opinion of my employer, but is merely my personal view. To reply, delete _spamout_ and replace with the numeral 3 >>>>> snip> > > That statins may, or may not, be the sole cause of cognitive damage. Or > that statins may, or may not, work to enhance other causes of such damage. > Or that the damage was the sole result of other causes of the cognitive > damage. You are conveniently ignoring the differential diagnosis postulated as a prerequisite to the test. >> It sounds to me like Dr. Muldoon has identified the beginning of the end >> of differential diagnosis for those cognitively disabled by Lipitor and >> other statins. snip >> See, I'm not here for the sport of debating, My interest in this smc ng >> is not remotely recreational. >> >> I'm here to learn how to get a treatment toward recovery for my statin >> disabled husband. Barring that, I'm here for an inkling as to what will >> help him at least improve. > The tests you and Dr. Muldoon are discussing were around for years before > statin, and were employed to detect "cognitive loss" issues. That they are known, stable, professionally recognized, proven tests is exactly why it is so significant to have detected a specific pattern that is typical of statins. The full range of testing is given, the statin sensitive tests represent almost a statin 'thumbprint.' If that were a typical score, it would have shown up in the placebo groups as well. It did not, and both groups were screened the same and statistically significant. Do you also fantasize that the dogs who had massive brain trauma in response to statins from every manufacturer all had coincidental damage that could have been the result of something else? Try reading about it on Pfizer's Lipitor PI, or review the sworn testimony snippit from the Baycol Trial in Corpus Christi in the FAQ. >> We are despearate for just an idea of how many more years it will take >> before we know if he has a chance at full recovery. So far, 7 years of [quoted text clipped - 7 lines] > And your circumstances are heart-breaking. But they have nothing to do > with the article you posted. On the contrary, had we been able to detect the gradual onset cognitive damage and connect it to the statin at 6 months, rather than 4 years, the damage would not have been disabling and debilitating. Going from a slight deficit to below the 1 percentile is a drastic difference. NOW people can, if their doctors are ethical enough to screen for cognitive damage, reduce their risk. That is an incredibly important breakthrough. >> And, if possible, to warn others of the possible adverse effects, if >> their doctors failed to do so, and of the signs to watch for before they [quoted text clipped - 3 lines] > So there we have it, another agenda. And it's one having nothing to do > with your husband's medical problems or potential for recovery therefrom. Same 3 year old agenda that caused us to choose to exchange privacy for the chance to do some good by permitting my husband's case, a cautionary tale, to be featured in the Smart Money Magazine article, the Los Angeles Times Sunday Magazine article, and Dr. Duane Graveline's excellent book, "Lipitor, Thief of Memory." Agenda is "And, if possible, to warn others of the possible adverse effects, if their doctors failed to do so, and of the signs to watch for before they or their loved ones are disabled, so they don't need to experience what we have for the past 7 years." Almost daily, the DIT Lipitor board bears another post - could this [pick one or more: muscle pain, nerve pain, cognitive fog, memory loss, set of transient global amnesia episodes] possibly be due to the Lipitor I am taking? My doctor scoffs at the idea, but it all started after I started taking the Lipitor......... >Can anyone out there with an IQ above 80 Did you mean above 80 before or after the Lipitor? >and access to any form of news media Please find me some examples in the news media from 7 years ago that stated any of these dangers. OK, how about 6 years ago? Anacronysm is not a valid 'told you so' >possibly be unaware of the potential for such side effects, or of the need >to ask a doctor questions before blindly ingesting chemicals? We asked the doctors - internist and cardiolgist - hundreds of questions, some in writing, over the 4 years - the doctors did not have answers. One hospital release stated in writing, after multiple TGA and inability to speak coherently and massive short term memory loss, plus neuropathy, myopathy and elevated CK, "The doctor (cardiologist) says that no matter what the side effects might be, to stay on the Lipitor because his arteries look good." It is the BLINDLY FOLLOWING IGNORANCE that is at issue. Know the risks, make the choice, monitor for the downside. >> Engaging in recreational and entertaining debate is appropriate in other >> venues. [quoted text clipped - 6 lines] > straight information or for experiences that others may have had) makes it > more than very important; it's critical. The information is important - opinions by people of unknown qualifications who find it fun to debate over other's disabilties and pain are of marginal to negative value. >> If and when I ever get that luxury, I will keep your advice in mind. >> Thanks for the tip. >> >>> Bill > > Steve >>>>>> snip> >> [quoted text clipped - 5 lines] > You are conveniently ignoring the differential diagnosis postulated as a > prerequisite to the test. Postulated? Do you know what the word means? >>> It sounds to me like Dr. Muldoon has identified the beginning of the end >>> of differential diagnosis for those cognitively disabled by Lipitor and [quoted text clipped - 25 lines] > on Pfizer's Lipitor PI, or review the sworn testimony snippit from the > Baycol Trial in Corpus Christi in the FAQ. Well if testing on dogs was in anyway conclusive with respect to results in humans, it would seem that Dr. Muldoon's study was a waste of time and money, no? >>> We are despearate for just an idea of how many more years it will take >>> before we know if he has a chance at full recovery. So far, 7 years of [quoted text clipped - 12 lines] > damage would not have been disabling and debilitating. Going from a > slight deficit to below the 1 percentile is a drastic difference. You didn't need any test to obtain that result. If, after 6 months, there had been symptoms of any kind with respect to anything from cognitive disability to liver function, then your husband should have gotten with the doctor and demanded a change in the course of treatment. Going off the statin for, let's say 4 months, wouldn't have caused you husband any harm. > NOW people can, if their doctors are ethical enough to screen for > cognitive damage, reduce their risk. That is an incredibly important > breakthrough. And such screening, if substituted for the manifestation of symptoms, will cause some people who score a little worse on the test than one thinks they ought to to be taken off statins for reasons having nothing to do with their so-called cognitive disability. >>> And, if possible, to warn others of the possible adverse effects, if >>> their doctors failed to do so, and of the signs to watch for before they [quoted text clipped - 14 lines] > before they or their loved ones are disabled, so they don't need to > experience what we have for the past 7 years." Why do you think that I would need to be warned of a possible adverse effect that manifests itself symptomatically so that it can be easily observed? If _the_ change in my lifestyle is taking a new drug, or, for that matter, if the taking of a new drug is followed by a significant lifestyle change, you can bet that I'm going straight to the doctor and hashing the matter out. And here, we aren't speaking of increases in liver enzymes that would indicate potential liver damage; we are talking about something that manifests itself outwardly. People don't need a weatherman to know which way the wind blows; why do you think that people need you to tell them the wind direction? > Almost daily, the DIT Lipitor board bears another post - could this [pick > one or more: muscle pain, nerve pain, cognitive fog, memory loss, set of > transient global amnesia episodes] possibly be due to the Lipitor I am > taking? My doctor scoffs at the idea, but it all started after I started > taking the Lipitor......... And does the poor soul equate the doc with G-d, so as to be unable to discuss the matter and arrive at a way of determining what the cause of the problem is. BTW, just what is "nerve pain" and how does one distinguish between it and "muscle pain"? >>Can anyone out there with an IQ above 80 > > Did you mean above 80 before or after the Lipitor? Either. >>and access to any form of news media > [quoted text clipped - 18 lines] > > It is the BLINDLY FOLLOWING IGNORANCE that is at issue. So YOU are going to save the blind and ignorant patients of the world? They'll be less blind and ignorant if you tell them the dangers? > Know the risks, make the choice, monitor for the downside. Anyone who doesn't already know this, and in particular, doesn't monitor for any change that manifests itself in observable symptoms, is going to be one tough person to educate. >>> Engaging in recreational and entertaining debate is appropriate in other >>> venues. [quoted text clipped - 13 lines] >>> If and when I ever get that luxury, I will keep your advice in mind. >>> Thanks for the tip. Steve SignatureThe above posting is neither a legal opinion nor legal advice, because we do not have an attorney-client relationship, and should not be construed as either. This posting does not represent the opinion of my employer, but is merely my personal view. To reply, delete _spamout_ and replace with the numeral 3 >>> >>>> Bill >> >> Steve >>> One more piece of information. If your father was on a statin drug, there >>> is now a way to verify if the cognitive/short-term memory loss damage is [quoted text clipped - 10 lines] > That is not the conclusion of the study per se, it is the abstract > conclusion. In the words of the study: It is right in the paper. Presumably written by the authors. Bill > " The results of this investigation stand as a partial replication > of our earlier trial. Given the limitations of the > findings, the evidence of decremental effects of statins on > [quoted text clipped - 179 lines] >>>> from >>>> 10 years and longer. Has anyone experienced this? >>>> One more piece of information. If your father was on a statin >>>> drug, there is now a way to verify if the cognitive/short-term [quoted text clipped - 14 lines] > > Bill This is when we begin to enter the la-la zone. When they discount the very words they used to bolster their view. It's through the looking glass and back again. L. > One more piece of information. If your father was on a statin drug, there > is now a way to verify if the cognitive/short-term memory loss damage is [quoted text clipped - 8 lines] > neuropsychologist or a psychiatrist - the experience is almost like an > interview. Hmmmm..... These "standard test" presumably have been around long prior to the widespread use of statins, if not prior to the statins even existing. Presumably, they identify measurable loss of cognitive ability due to factors other than statin use. So how in the world does Dr. Muldoon propose to diagnose the actually reason that someone is suffering from cognitive disabilities as diagnosed by these test due to factors if that some has been on statins for 6 months? Is it impossible that someone taking statins suffers cognitive disability caused by factors other than the statin? If so, why? Steve SignatureThe above posting is neither a legal opinion nor legal advice, because we do not have an attorney-client relationship, and should not be construed as either. This posting does not represent the opinion of my employer, but is merely my personal view. To reply, delete _spamout_ and replace with the numeral 3 > > The NP tests that show Cognitive damage as a result of statin adverse [quoted text clipped - 55 lines] >> from >> 10 years and longer. Has anyone experienced this? >> One more piece of information. If your father was on a statin drug, >> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 20 lines] > > Steve It suddenly got very quiet here. I guess that's the end of *this* thread. L. Coenzyme Q-10 is supposed to counteract memory loss due to statins. I believe statins suppress natural Q-10. Try supplementing with Q-10 and see if it helps. And, try vitamin C and L-lysine to repair cardiovascular damage and dissolve plaque, ala Linus Pauling. cholesterol is likely irrelevant to heart attack. "TonyBones" <aeo6@cornell.edu> wrote in news:1106171223.935064.187490 @z14g2000cwz.googlegroups.com: > Coenzyme Q-10 is supposed to counteract memory loss due to statins. I > believe statins suppress natural Q-10. Try supplementing with Q-10 and > see if it helps. And, try vitamin C and L-lysine to repair > cardiovascular damage and dissolve plaque, ala Linus Pauling. > cholesterol is likely irrelevant to heart attack. TB, This thread was *not* about statins, but CABG. It was hijacked. L. > Coenzyme Q-10 is supposed to counteract memory loss due to statins. I > believe statins suppress natural Q-10. Try supplementing with Q-10 and > see if it helps. And, try vitamin C and L-lysine to repair > cardiovascular damage and dissolve plaque, ala Linus Pauling. > cholesterol is likely irrelevant to heart attack. Statins deplete coenzyme q10. We *know* that. And there are some people who take coenzyme q10 concurrently with their statin and some after they have suffered statin damage. But we do not *know* if using coenzyme q10 in either of those ways replenishes what has been depleted. Any reports of efficacy are anecdotal. We also do not know what is in those capsules because it is an unregulated supplement. (And please, do not get me going on how apparently useless FDA regulation is. I know. I think both acts need to be cleaned up before we have a production.) Zee >> One more piece of information. If your father was on a statin drug, >> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 18 lines] > taking statins suffers cognitive disability caused by factors other than > the statin? If so, why? Hmmmm..... Some one person of your imaginary choice? Of course. Maybe he was hit by a meteorite! But Muldoon did not study one patient. He used a statistically valid sample of sufficiently large statin and placebo groups to make it statistically significant, with careful exclusion criteria to eliminate other known factors, and the statin groups test results were absolutely in contrast to the placebo group. But Muldoon didn't stop with one study. He performed two different placebo controlled studies, carefully screening out other factors and using two different statins, with the statin group measuring below the placebo group in the second study, too, with all the results and the controls there for your analysis. > Steve >> [quoted text clipped - 56 lines] >>> from >>> 10 years and longer. Has anyone experienced this? > One more piece of information. If your father was on a statin drug, there > is now a way to verify if the cognitive/short-term memory loss damage is due [quoted text clipped - 7 lines] > are standardized oral and written tests given by a neuropsychologist or a > psychiatrist - the experience is almost like an interview. This study indeed suggests that you can find some minor changes on specific neuropsychological tests in patients taking statins. This may or may not support the notion of more severe memory impairment occurring in some people who take statins (overall, it probably doesn't tell you much either way about severe memory loss). One thing it definitely does not do is provide a diagnostic test for differentiating statin-induced memory problems from other causes of memory problems. This would require a completely different type of study from the two that were performed by Dr. Muldoon. SignatureDavid Rind drind@caregroup.harvard.edu >> One more piece of information. If your father was on a statin drug, >> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 19 lines] > memory problems. This would require a completely different type of > study from the two that were performed by Dr. Muldoon. I can hear the wind rustlin' in the trees.......... L. >>> One more piece of information. If your father was on a statin drug, >>> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 21 lines] > > I can hear the wind rustlin' in the trees.......... You are probably safe there, I haven't seen much on auditory interference due to statins. Probably is just wind in the trees. When are you going to share what you found out about ED & Statins? > L. >>>> One more piece of information. If your father was on a statin drug, >>>> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 24 lines] > You are probably safe there, I haven't seen much on auditory interference > due to statins. Probably is just wind in the trees. Sorry, I was wrong. You might want to worry. Per http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true&_pageLab el=prescribingInformation Under reported problems, Special Senses: tinnitus But don't worry, apparently you are among only 2% who get that problem. Does that make you feel better about it? > When are you going to share what you found out about ED & Statins? > >> L. >>>>> One more piece of information. If your father was on a statin >>>>> drug, there is now a way to verify if the cognitive/short-term [quoted text clipped - 38 lines] >> >>> L. Since my time has gotten limited lately because of travel, I'll just interject my sophmoric little comments here and there. I see there are others who are better able to expose your misinformation, which seems to have no limits. L. >>>>>> One more piece of information. If your father was on a statin >>>>>> drug, there is now a way to verify if the cognitive/short-term [quoted text clipped - 43 lines] > others who are better able to expose your misinformation, which seems to > have no limits. The bottom line: Unless a study involves giving cognitive tests to people who have not taken statins, and then subsequently (and relatively soon thereafter) starting them on statins and then retesting them, you cannot tell by reason of the tests whether a cognitive disability in any of those people is the result of having taken the statins. And even if tests administered under this sort of protocol does indicate that people previously not suffering from a cognitive disability prior to statin ingestion do evidence a cognitive disability after statin ingestion, one still has to rule out (perhaps by statistical analysis alone, perhaps not) that the cognitive disability is in fact caused by the statin ingestion, and not by other cause(s) such as other drugs, lifestyle issues, aging, or genetic predisposition. > L. Steve SignatureThe above posting is neither a legal opinion nor legal advice, because we do not have an attorney-client relationship, and should not be construed as either. This posting does not represent the opinion of my employer, but is merely my personal view. To reply, delete _spamout_ and replace with the numeral 3 > The bottom line: Unless a study involves giving cognitive tests to people > who have not taken statins, and then subsequently (and relatively soon [quoted text clipped - 8 lines] > and not by other cause(s) such as other drugs, lifestyle issues, aging, or > genetic predisposition. Have you even attempted to read the study? The P-L-A-C-E-B-O group took a P-L-A-C-E-B-O in the 2004 study. The P-L-A-C-E-B-O group took a P-L-A-C-E-B-O in the 2000 study. Different sets of people, different statins for the statin groups, NO STATINS FOR THE PLACEBO groups. PRE-TESTING for each group, then post testing. Extensive screen-out, exactly the same criteria for both groups, to prevent it. Actually, Dr. Muldoon took far more precautions than you described above to make it an excellent, statistically significant study, which is why he achieved such conclusive results. Interesting how much of this thread you used up with your faulty suppositions supporting your faulty conclusions. Read the study. >> L. > > Steve >> The bottom line: Unless a study involves giving cognitive tests to >> people who have not taken statins, and then subsequently (and relatively [quoted text clipped - 30 lines] > > Read the study. I did read what was provided, and it's you who are closing your mind. Cognitive disabilities are caused by many factors. You cannot know whether cognitive disabilities resulted solely from the statins, from the statins in combination with other factors, or the other factors per se. I would assume, for example, that the control group who took the P-L-A-C-E-B-O showed up with cognitive disabilities in the tests administered thereafter. Wasn't there an increase over the first round of testing? Why? Why would the increase after the administration of statins not be as a result of the same factors? And of course, we can all note that you've edited my originial post, without so indicating, to take out the comments I made re the difference between your stated goal of "helping your husband" and your propensity to post things intended to scare people away from statins. >>> L. >> >> Steve Steve SignatureThe above posting is neither a legal opinion nor legal advice, because we do not have an attorney-client relationship, and should not be construed as either. This posting does not represent the opinion of my employer, but is merely my personal view. To reply, delete _spamout_ and replace with the numeral 3 >> The above posting is neither a legal opinion nor legal advice, >> because we do not have an attorney-client relationship, and >> should not be construed as either. This posting does not >> represent the opinion of my employer, but is merely my personal >> view. To reply, delete _spamout_ and replace with the numeral 3 Sorry, I'm sure you have some dazzling logic behind what you wrote, but it is so vastly disconnected from the Muldoon study, its methodology, and its results that you have lost my interest entirely. Enjoy debating someone else. Probably there is something of interest in there to someone. I have two foci, and none of what you have input in the circuitous last message is within their scope. >>> The bottom line: Unless a study involves giving cognitive tests to >>> people who have not taken statins, and then subsequently (and relatively [quoted text clipped - 57 lines] >>> represent the opinion of my employer, but is merely my personal >>> view. To reply, delete _spamout_ and replace with the numeral 3 Godspeed Listener. Zee > >>>>> One more piece of information. If your father was on a statin > >>>>> drug, there is now a way to verify if the cognitive/short-term [quoted text clipped - 27 lines] > > > > Sorry, I was wrong. You might want to worry. Per http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true > > &_pageLabel=prescribingInformation > > [quoted text clipped - 13 lines] > > L. >>>>>> One more piece of information. If your father was on a statin >>>>>> drug, there is now a way to verify if the cognitive/short-term [quoted text clipped - 45 lines] > > L. Don't forget you owe us the answers on ED Bon voyage >> One more piece of information. If your father was on a statin drug, >> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 19 lines] > problems. This would require a completely different type of study from the > two that were performed by Dr. Muldoon. On the contrary, it establishes a set of tests that are sensitive to statin damage. Yes, there need to be longer studies exactly like these to chart the increase in cognitive/CNS damage over time. Does it hold constant for 2 years and then ramp up quickly, or does it steadily increase? We know that three populational studies by Gaist served to show that nerve damage is 26 times more likely at the combined threshold of 2 or more years on the statin and over 50 years of age, but that was blatant externally obvious nerve damage. He excluded all from the count except those who 1) had been referred to a neurologist for a specialist examination for neuropathy, AND 2) had undergone a diagnostic nerve conduction study, AND 3) showed nerve damage. How many others had neuropathy, but did not meet all three criteria? It is very interesting that Muldoon consistently identifies measurable cognitive/CNS damage in two different studies, which is at 6 months quite subtle, not outwardly detectable. Fast forward to 18 more months of treatment and Gaist identifies blatant, obvious neuropathy, as 26 TIMES more likely in statin takers, if the patient is over 50. Not a tremendous leap to think that the subtle damage measurable at 6 months continues until it is more obvious 18 months later. Certainly we need more studies to prove it. Further, it could illuminate why, when the entire group of statin takers showed measurable cognitive disadvantage in comparison to the placebo group, not all statin takers develop obvious neuropathy at 2 years, and not all continue to obvious short-term memory loss, amnesia, and cognitive damage at 4 years. What protects those folks at that end, even though they already had damage at 6 months? MEANWHILE, any individual asked to take a statin would do well to ask for a baseline NP test first, and repeat testing every 6 months, in addition to CK testing. Particularly if that patient's income depends in any way upon cognitive skills and the ability to learn. >>> One more piece of information. If your father was on a statin drug, >>> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 43 lines] > obvious neuropathy, as 26 TIMES more likely in statin takers, if the > patient is over 50. Sorry, I understated Gaist, writing from memory. "For patients treated with statins for 2 or more years the odds ratio of definite idiopathic polyneuropathy was 26.4 (7.8 to 45.4). Conclusions: Long-term exposure to statins may substantially increase the risk of polyneuropathy." Note also, that is POLYNEUROPATHY, i.e., involving both peripheral neuropathy and the larger nerves, not just neuropathy. > Not a tremendous leap to think that the subtle damage measurable at 6 > months continues until it is more obvious 18 months later. [quoted text clipped - 11 lines] > to CK testing. Particularly if that patient's income depends in any way > upon cognitive skills and the ability to learn. > >> One more piece of information. If your father was on a statin drug, > >> there is now a way to verify if the cognitive/short-term memory loss [quoted text clipped - 63 lines] > > David Rind > > drind@caregroup.harvard.edu Through my tears Sharon I thank you. Zee > On the contrary, it establishes a set of tests that are sensitive to statin > damage. No, not in the sense that is usually meant when people say "sensitive" in regard to a diagnostic test. The study did not look at a group of people known to have statin-induced memory loss and see how often these particular tests showed a problem while other tests did not, and did not compare groups of people with different kinds of memory loss from known causes to see if these particular tests differentiated them well. These are some of the things you would need to know before using the tests to try to make a dignosis of statin-induced memory loss. SignatureDavid Rind drind@caregroup.harvard.edu Read the study, not just the abstract. >> On the contrary, it establishes a set of tests that are sensitive to >> statin damage. [quoted text clipped - 7 lines] > are some of the things you would need to know before using the tests to > try to make a dignosis of statin-induced memory loss. >>>On the contrary, it establishes a set of tests that are sensitive to >>>statin damage. [quoted text clipped - 7 lines] >>are some of the things you would need to know before using the tests to >>try to make a dignosis of statin-induced memory loss. > Read the study, not just the abstract. I had read the entire paper before I posted. What, exactly, do you find in there that you think changes what I wrote above? Rather than repeatedly stating or implying that I don't know what I'm talking about, you might consider the possibility that I actually know something about how one designs studies of diagnostic tests and that you yourself might want to learn more about how such studies should be designed before dismissing what I wrote. By the way, I am not dismissing the results of Muldoon's studies. The most likely explanation for them is a real effect. That does not mean, however, that there is any evidence that one could use his neurocognitive tests as a method for determining which patients with memory loss have memory loss due to a statin. He makes no such claim in his paper and I strongly doubt he would make such a claim if you asked him. SignatureDavid Rind drind@caregroup.harvard.edu >>>>On the contrary, it establishes a set of tests that are sensitive to >>>>statin damage. [quoted text clipped - 24 lines] > to a statin. He makes no such claim in his paper and I strongly doubt he > would make such a claim if you asked him. I have his Email if you wish to formulate such a question. Ask and I will send it to you but not post it on a public board. Bill > >>>>On the contrary, it establishes a set of tests that are sensitive to > >>>>statin damage. [quoted text clipped - 37 lines] > > Bill We all, the statin injured, have his e-mail Bill. And all the other major researchers and players e-mails too. They are very co-opeative and sharing with us. They have seen statin damage, and they know. To us, and to them, it is more than just a game of who scored a point in a usenet argument. Zee snip > By the way, I am not dismissing the results of Muldoon's studies. The most > likely explanation for them is a real effect. That does not mean, however, > that there is any evidence that one could use his neurocognitive tests as > a method for determining which patients with memory loss have memory loss > due to a statin. He makes no such claim in his paper and I strongly doubt > he would make such a claim if you asked him. The set of standardized tests he has identified as statin-sensitive, taken with the rest of the standardized tests were used by him to determine the existence and extent of cognitive damage among statin users. We are in ageement he made no such claim of weeding out which memory loss patients have memory loss due to the statin. That is significant to the patients cognitively disabled by the statin, because there is now more than a differential diagnosis to show the statin was affecting them cognitively. If there were other influences, then there were other influences - every person is different as is their history of exposure to neurotoxin. However, given Muldoons repeated studies, for a statin patient with cognitive damage there is now verification of what that statin affected, which can be measured by these tests. Next step is to see what happens every 6 months thereafter through 3 or 4 years. Does the damage ramp slowly and steadily or are there peaks and valleys in charting the cognitive damage. At two years, for example, do all statin patients have measurable cognitive loss or do some recover somehow? And, if any do, what is it about them that helps them avoid the more serious cognitive damage? Once determined, can that lead to a treatment for recovery for those who do lose significant cognitive ability? These are essential questions. > Next step is to see what happens every 6 months thereafter through 3 or 4 > years. Does the damage ramp slowly and steadily or are there peaks and [quoted text clipped - 5 lines] > > These are essential questions. I agree with you as to the next steps. There would seem to be two parts - what happens with continued statin use and what happens when it is discontinued. Do you know if any of this is being done? Thanks. Bill Researchers who have been kind enough to correspond with me have indicated that doing such studies is important. However there are many steps that must be taken to be in a position to run such studies, not the least of which is funding. Part of the problem is the interests of the funding organization within the NIH. To date, most of the NIH-funded studies concerning statins have always come from the NHLBI (National Heart, Lung, Blood Institute) - so cardiology is the primary focus. It has been my contention for the past couple of years that NINDS (National Institute of Neurological Disorders and Stroke) needs to get involved. So far, their interest is in finding out if statins prevent Alzheimers, but those studies are not faring well. One journal published a concern expressed by some researchers in Arizona that they were hitting such a high rate of statin adverse effects washing out participants among the study population that they despaired of ever really getting the study started. There was so much spin and hype for a time on the possibility of preventing Alz that the known cognitive damage was largely forgotten. Clearly, as the body of literature grows on statin cognitive damage, there need to be such studies. However, other than Dr. Golomb's statin study, I am unaware of any others that have done this. That does not mean there might not be some extant but unpublished. BJM and JAMA both did full issues dedicated to the concern that the industry bias in publishing was preventing many of the other studies, i.e., those with conclusions negative to the industry, from being seen. Showing the extent of cognitive damage from statins over time and the length of time required off the statin to see any improvement would certainly be negative to the industry. Of course, I am living with such an experiment in microcosm. 4 years on Lipitor, 3 years off, with small, but statistically significant improvement; coupled with a very distinguished list of specialists who did the rule outs for all other known/possible causes with a very impressive battery of very thorough testing. From my perspective, waiting for a three to five year test that has not yet begun is discouraging to say the least. However, it is critical to do some of these, given statins are the most widely prescribed of all medications, and, at least from Muldoon's consistent results, no one on statins fully escapes a loss of cognitive ability within the first 6 months, and the current prescribing is intended for the duration of the patient's lifetime. >> Next step is to see what happens every 6 months thereafter through 3 or 4 >> years. Does the damage ramp slowly and steadily or are there peaks and [quoted text clipped - 16 lines] > > Bill However, it is critical to do some > of these, given statins are the most widely prescribed of all medications, > and, at least from Muldoon's consistent results, no one on statins fully > escapes a loss of cognitive ability within the first 6 months, and the > current prescribing is intended for the duration of the patient's lifetime. On that we disagree. There is no evidence that 100% of the people on statins have a loss of cognitive ability. Again, you misinterpreted a chart in the first study and assumed a 95% confidence interval was a range. You have not refuted this. Further even if this were true, which it is not, it would have been you who drew the line between loss and gain. Bill >Subject: Re: You can now verify positively if it is due to statin adverse >effects Re: memory loss after CABG >From: "Sharon Hope" shope@anet.net >Date: 1/21/2005 8:19 P.M. Pacific Standard Time >Message-id: >The set of standardized tests he has identified as statin-sensitive, taken >with the rest of the standardized tests were used by him to determine the >existence and extent of cognitiv >damage among statin users. actually these tests...standardized or other wise..."merely" test for cognitive damage... >We are in ageement he made no such claim of weeding out which memory loss >patients have memory loss due to the statin. OKKKKK....so then you...and he..are saying that whilst the person took a statin...AND the person "measured" some cognitive decline....there is NOOOO way of knowing the etiology of such...yes..statin use could be the issue...so could a myriad of other etiologies...having a control group does not obviate that it HAS to be statins... BTW...you don't seem to understand the full definition of "differential diagnosis"....a term used to "weed out" other etiologies.. at best..this study "suggests" that in some folk...statins may be involved...it does nada to point the finger definitely to statin use...the "person" could well have been down the road of cognitive decline well before the statin use... >That is significant to the patients cognitively disabled by the statin, >because there is now more than a differential diagnosis to show the statin >was affecting them cognitively. If again...you do not demonstrate any understanding of what a differential diagnosis actually is or does... and the "other influences??" could have nothing to do with ANY use of drugs.. for that matter ....those with CAD can flick off minute particles of plaque..which can lodge in the brain..also causing cognitive decline... hawki..... > >Subject: Re: You can now verify positively if it is due to statin adverse > >effects Re: memory loss after CABG [quoted text clipped - 42 lines] > > hawki..... hawki said: "for that matter....those with CAD can flick off minute particles of plaque..which can lodge in the brain..also causing cognitive decline..." ~~~~~~~~~~~~~~~~~~~~~~~~~~ Coronary artery disease (CAD) was included in exclusion criteria. Zee ~~~~~~~~~~~~~~~~~~~~~~~~~~ Randomized Trial of the Effects of Simvastatin on Cognitive Functioning in Hypercholesterolemic Adults Matthew F. Muldoon, MD, MPH, Christopher M. Ryan, PhD, Susan M. Sereika, PhD, Janine D. Flory, PhD, Stephen B. Manuck, PhD Exclusion criteria included the following medical conditions: secondary hyperlipidemia (lipid disorders attributable to chronic hepatitis, renal failure, or untreated hypothyroidism), severe hypertriglyceridemia (fasting serum triglyceride level 350 mg/dL), coronary artery disease, stroke, diabetes, untreated hypertension (diastolic blood pressure 95 mm Hg), cancer, and major neuropsychiatric conditions (e.g., schizophrenia, seizures, dementia). Subjects were also excluded if they reported current treatment with any lipid-lowering medication or supplement, psychotropic medication, glucocorticoid, or opiate analgesic. Sexually active premenopausal women were excluded unless they were using birth control. ~~~~~ Thanks for the post, Zee - maybe they will understand now. (or at least those following the thread will see clearly how distorted the arguments had become - the people attempting to discredit the study won't acknowledge the intentional distortions) This is such an interesting ng. Such hysteria any time a statin adverse effect is mentioned, or even hinted, about statins, with wild accusations of trying to scare people. Complete fear that the truth might be heard. Then, when actual statin damage is documented, the statin-disabled victim is accused of having a room temperature IQ and attacked for not knowing in advance that there were these adverse effects and watching out for them. This from the same people who attempt to drown out, challenge, ridicule, and otherwise distort, and prevent visibility of or mention of the very warnings they fault the person for not heeding. AND they suggest that the victim is stupid for not being informed about dangers that had not been available in print until years after the damage was already done, and the statin discontinued. Mention 52 specialist diagnosis consultations (including experts from 4 different world-class research medical universities), PET and MRI scans, mitochondrial respiration analysis, complete DNA workup, muscle biopsy, and myriad other tests, and NP testing, in a 12 month period, and be attacked for not understanding the meaning of "differential diagnosis" - (I guess those universities need to teach their expert instructors better about that). Then, mention that the pattern in NP test results can now augment that determination from all those experts and all those test results, and be attacked further. Nice to see a factual post. Please keep it up! The truth just keeps on being the truth. Hawki63 wrote: > >Subject: Re: You can now verify positively if it is due to statin adverse > >effects Re: memory loss after CABG > >From: "Sharon Hope" shope@anet.net > >Date: 1/21/2005 8:19 P.M. Pacific Standard Time > >Message-id: > > >The set of standardized tests he has identified as statin-sensitive, taken > >with the rest of the standardized tests were used by him to determine the > >existence and extent of cognitiv > > >damage among statin users. > > actually these tests...standardized or other wise..."merely" test for cognitive > damage... > > >We are in ageement he made no such claim of weeding out which memory loss > >patients have memory loss due to the statin. > > OKKKKK....so then you...and he..are saying that whilst the person took a > statin...AND the person "measured" some cognitive decline....there is NOOOO way > of knowing the etiology of such...yes..statin use could be the issue...so could > a myriad of other etiologies...having a control group does not obviate that it > HAS to be statins... > > BTW...you don't seem to understand the full definition of "differential > diagnosis"....a term used to "weed out" other etiologies.. > > at best..this study "suggests" that in some folk...statins may be involved...it > does nada to point the finger definitely to statin use...the "person" could > well have been down the road of cognitive decline well before the statin use... > >That is significant to the patients cognitively disabled by the statin, > >because there is now more than a differential diagnosis to show the statin > >was affecting them cognitively. If > > again...you do not demonstrate any understanding of what a differential > diagnosis actually is or does... > [quoted text clipped - 4 lines] > for that matter ....those with CAD can flick off minute particles of > plaque..which can lodge in the brain..also causing cognitive decline... > hawki..... hawki said: "for that matter....those with CAD can flick off minute particles of plaque..which can lodge in the brain..also causing cognitive decline..." ~~~~~~~~~~~~~~~~~~~~~~~~~~ Coronary artery disease (CAD) was included in exclusion criteria. Zee ~~~~~~~~~~~~~~~~~~~~~~~~~~ Randomized Trial of the Effects of Sim |
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