Influence of Baseline Psychological Health on Muscle Pain During Atorvastatin Treatment
Amanda L Zaleski1, Beth A Taylor, Linda S Pescatello
1Amanda L. Zaleski, MS Exercise Physiologist, Henry Low Heart Center, Department of Cardiology, Hartford Hospital, Connecticut; and Department of Kinesiology, University of Connecticut, Storrs. Beth A. Taylor, PhD Senior Scientist, Henry Low Heart Center, Department of Cardiology, Hartford Hospital, Connecticut; and School of Pharmacy, University of Connecticut, Storrs. Linda S. Pescatello, PhD Professor, Department of Kinesiology, University of Connecticut, Storrs. Ellen A. Dornelas, PhD Director of Behavioral Programs, Hartford Hospital, Department of Cardiology, Hartford Hospital, Connecticut. Charles Michael White, PharmD Pharmacy Research Scientist, Henry Low Heart Center, Department of Cardiology, Hartford Hospital, Connecticut; and School of Pharmacy, University of Connecticut, Storrs. Paul D. Thompson, MD Chief, Henry Low Heart Center, Department of Cardiology, Hartford Hospital, Connecticut.
Background:
3-hydroxy-3-methylglutaryl coenzyme A reductase reductase inhibitors (statins) are generally well tolerated, with statin-associated muscle symptoms (SAMS) the most common side effect (~10%) seen in statin users. However, studies and clinical observations indicate that many of the self-reported SAMS appear to be nonspecific (ie, potentially not attributable to statins).
Objective:
Mental health and well-being influence self-perception of pain, so we sought to assess the effect of baseline well-being and depression on the development of muscle pain with 6 months of atorvastatin 80 mg/d (ATORVA) or placebo in healthy, statin-naive adults.
Methods:
The Psychological General Well-being Index (n = 83) and Beck Depression Inventory (n = 55) questionnaires were administered at baseline in participants (aged 59.5 ± 1.2 years) from the effect of Statins on Skeletal Muscle Function and Performance (STOMP) trial (NCT00609063). Muscle pain (Short-Form McGill Pain Questionnaire [SF-MPQ]), pain that interferes with daily life (Brief Pain Inventory [BPI]), and pain severity (BPI) were then measured before, throughout, and after treatment.
Results:
At baseline, there were no differences in well-being (Psychological General Well-being Index), depression (Beck Depression Inventory), or pain measures (SF-MPQ and BPI) (P values ≥ .05) between the placebo and ATORVA groups. Baseline well-being correlated negatively with baseline BPI pain severity (r = -0.290, P = .008). Baseline depression correlated with baseline pain (SF-MPQ; r = 0.314, P = .020). Baseline well-being and depression did not predict the change in pain severity or interference after 6 months among the total sample or between groups (P values ≥ .05).
Conclusion:
Baseline well-being and depression were not significant predictors of pain after 6 months of ATORVA (P values ≥ .05). Thus, they do not appear to increase the risk of SAMS in otherwise healthy adults.
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