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J Affect Disord. 2019 Mar 1;246:706-715. doi: 10.1016/j.jad.2018.12.110. Epub 2018 Dec 26.

Statin treatment and the risk of depression.

Author information

1
Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Palle Juul-Jensen Boulevard 175, DK-8200 Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. Electronic address: karkoe@rm.dk.
2
The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; Centre for Integrated Register-based Research, Aarhus University (CIRRAU), Aarhus, Denmark.
3
Dauten Family Center for Bipolar Treatment Innovation, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
4
Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Palle Juul-Jensen Boulevard 175, DK-8200 Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.
5
The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark; Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.

Abstract

BACKGROUND:

The effect of statin treatment on the risk of developing depression remains unclear. Therefore, we assessed the association between statin treatment and depression in a nationwide register-based cohort study with up to 20 years of follow up.

METHODS:

We identified all statin users in the period from 1996 to 2013 among individuals born in Denmark between 1920 and 1983. One non-user was matched to each statin user based on age, sex and a propensity score taking several potential confounders into account. Using Cox regression we investigated the association between statin use and: (I) redemption of prescriptions for antidepressants, (II) redemption of prescriptions for any other drug, (III) depression diagnosed at psychiatric hospitals, (IV) cardiovascular mortality and (V) all-cause mortality.

RESULTS:

A total of 193,977 statin users and 193,977 non-users were followed for 2,621,282 person-years. Statin use was associated with (I) increased risk of antidepressant use (hazard rate ratio (HRR) = 1.33; 95% confidence interval (95%-CI) = 1.31-1.36), (II) increased risk of any other prescription drug use (HRR = 1.33; 95%-CI = 1.31-1.35), (III) increased risk of receiving a depression diagnosis (HRR = 1.22, 95%-CI = 1.12-1.32) - but not after adjusting for antidepressant use (HRR = 1.07, 95%-CI = 0.99-1.15), (IV) reduced cardiovascular mortality (HRR = 0.92, 95%-CI = 0.87-0.97) and (V) reduced all-cause mortality (HRR = 0.90, 95%-CI = 0.88-0.92).

CONCLUSIONS:

These results suggest that the association between statin treatment and antidepressant use is unspecific (equivalent association between statins and most other drugs) and that the association between statin use and depression diagnoses is mediated by residual confounding, bias or by downstream effects of the statin prescription (seeing a physician more often).

PMID:
30611914
DOI:
10.1016/j.jad.2018.12.110
[Indexed for MEDLINE]

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