Statins as an Adjuvant Therapy for Psychotic Disorders: Current Evidence with a Systematic Overview of Double-Blind Placebo-Controlled Trials

Abstract

Background: Evidence is accumulating that inflammatory processes play a role in the pathophysiology of schizophrenia. This suggests that anti-inflammatory drugs might have beneficial effects in the treatment of schizophrenia patients. Statins have cholesterol independent effects on inflammation and oxidative stress and could potentially improve positive, negative and/or cognitive symptoms of schizophrenia. We provide an overview of the literature regarding the effects of statins in the treatment of schizophrenia. Methods: We conducted a systematic search using the PubMed (Medline) and Embase databases. Articles describing the effect of all possible types of statins in patients diagnosed with a schizophrenia spectrum disorder were included. Results: We found four small Randomized Controlled Trials (RCTs) describing the effects of atorvastatin, lovastatin, pravastatin and simvastatin, in a total of 141 patients. No significant differences were reported when comparing statin treatment to placebo with regard to improvement of positive, negative and cognitive symptoms. Conclusion: At present, there is no solid evidence for the efficacy of statins in the treatment of schizophrenia spectrum disorders. All four included RCTs evaluated relatively small sample sizes. Furthermore, these studies assessed effects over 6-12 weeks, while the effects of other anti-inflammatory medications have only been observed after 6 months. Large longterm RCTs should be conducted, in order to assess the effects of statins as an adjuvant therapy for schizophrenia more accurately