Statins, metformin, and calcium-channel blockers are associated with lower risk for psychiatric outcomes among patients with serious mental illnesses, suggests a JAMA Psychiatry study.
Using Swedish registries, researchers studied nearly 150,000 people diagnosed with a serious mental illness who were prescribed antipsychotics or mood stabilizers. Psychiatric outcomes during the time patients were taking statins, calcium-channel blockers, or biguanides (e.g., metformin) were compared with times when they weren’t taking the drugs.
After multivariable adjustment, exposure to statins, calcium-channel blockers, and biguanides were each individually associated with lower risk for psychiatric hospitalizations among all mental illness subgroups, compared with nonexposure periods. In addition, self-harm risk was lower with calcium-channel blocker use in all mental illness subgroups, and with statin and biguanide use in patients with bipolar disorder and schizophrenia.
The authors note each drug class has potential biological mechanisms that could affect psychiatric outcomes.
Dr. Steven Dubovsky of NEJM Journal Watch Psychiatry comments: “Of the three drug classes reported here, only calcium-channel blockers have been studied as primary treatments for bipolar disorder and to a lesser extent schizophrenia. Metformin is sometimes used to treat antipsychotic-induced weight gain and metabolic disturbances but has not yet been found to have psychotropic effects, and if the anti-inflammatory effect of statins is therapeutically useful in severe mental illness, one would expect NSAIDs to work for these conditions.”
He continues: “The authors contend that lack of an effect of thiazide diuretic prescriptions on psychiatric hospitalizations and self-harm proves that simple medication adherence does not explain the results. But this may not be entirely compelling, since taking the study medications may be an indication of more intense patient engagement with the medical system, or at least more aggressive interaction between patients and providers. We can at least conclude that the three classes of medication used to treat comorbid conditions do not seem risky form a psychiatric or a medical standpoint in patients with severe mental illness.”
Read the related article here.
Source: NEJM Journal Watch
