Cholesterol Medication: Fight Depression and Survive lung infection?

Millions of us have high cholesterol and take medication for it, usually a class of drugs called “statins”.
 
As a psychiatrist, I’ve been interested in statins because they are cheap, safe, and might help treat depression and schizophrenia. 

And it gets better: statins may also improve survival and reduce symptoms during viral lung infections.
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One of the worst outcomes from COVID-19 (and the flu) is pneumonia. This is often what puts people in the ICU or kills them. 

Taking a statin was associated with a dramatically lower risk of being intubated or dying from viral pneumonia. It’s also associated with reduced length of stay in the hospital. 

So we have compelling data that a safe, cheap, easy-to-get drug may help with mental illness and serious viral infections. Why isn’t this being more definitively followed up on? It may partly have to do with how difficult it is for we humans to change the mental labels we have already assigned to things, including medications.

A cholesterol pill is just not supposed to be an antidepressant or antipsychotic, so we don’t think to use it that way. A cholesterol pill is also not supposed to be a treatment for viral pneumonia, so maybe again we just aren’t thinking to use it that way. Cognitive traps like this can be sticky, and hard to get out of.

Since I am writing this during a pandemic, it hit home to read this 2008 Lancet paper. The authors warn that in a future pandemic, “supplies of affordable vaccines and antiviral agents will be unavailable to most people in the world.”  

They call for cheaper, generic agents such as statins (and chloroquine) to be considered as potential treatments because they “are inexpensive, could be stockpiled, and would be available on the first pandemic day”. 

The authors close by warning that “with a lack of realistic alternatives for confronting the next pandemic, research is urgently needed to determine whether these and other generic agents could mitigate the effects of what might otherwise become an unprecedented global public-health crisis.” 

What a shame that we didn’t aggressively follow up on the potential use of statins and other generic agents before this 2020 pandemic hit. Could cognitive labeling traps be partly to blame?

Looking forward, we should keep an open mind about repurposing drugs, and not allow their labels to get so stuck on our heads that we can’t see the forest for the trees. And that includes their use in mental health. 

THE TAKE HOME:
​Statins are cheap, safe, and already used by millions. They may be effective agents in treating depression and psychosis, and perhaps even viral infections. Talk with your doctor about what this may mean for you.