Effects of statin therapies on individuals taking antipsychotics: A systematic review

Abstract

Introduction: Patients with a severe mental illness (SMI) taking antipsychotics may develop side effects such as dyslipidemia. Our objective is to provide an update to a previous systematic review showing statin therapy lowering lipid levels in individuals taking antipsychotics while further identifying changes, if present, in body mass index (BMI), blood pressure or any safety concerns.

Methods: In August 2022, we searched MEDLINE, Embase, PsycINFO, PubMed and Cochrane Central Register of Controlled Trials for studies pertaining to the effects of statins on lipid profile measures for those taking first or second generation antipsychotic medications, with a diagnosis related to SMI. Data extraction was performed in a masked duplicate fashion. Based on article type, each study’s risk of bias was assessed using ROBINS-I or RoB-2. The GRADE criteria were used for certainty assessment.

Results: Our initial search returned 396 articles, of which six were included. Five (of 6, 83.3%) articles identified significant change between baseline and post-treatment lipids. Of the articles recording blood pressure, BMI or weight and significant safety concerns, no significant changes were found. The certainty assessment for this systematic review is rated moderate. A meta-analysis was not performed.

Discussion: Studies continue to demonstrate statin therapy’s utilization in prevention and treatment for dyslipidemia and its related cardiovascular risk through significant reduction in LDL-C. Patients at risk of developing dyslipidemias secondarily to antipsychotic treatment for a SMI should be considered for lipid lowering therapy with a statin. The limited number of studies included and their heterogeneity demonstrates areas for improvement for future research.