Do statins have an effect on depressive symptoms? A systematic review and meta-analysis

Clinical trials of the effects of statins in people with and without depressive symptoms at baseline have yielded conflicting results with studies reporting both an increase and decrease in depressive symptoms. To address these inconsistences, a systematic review and meta-analysis has been conducted to determine the effects of statins on depression in those with or without clinical major depression.

A comprehensive literature search was conducted in MEDLINE, EMBASE and PsychINFO to identify relevant articles that met predefined inclusion and exclusion criteria. The primary outcome measure was the mean difference in depression scores at endpoint between the statin and placebo groups which was computed using random effects model.

10 articles were found and used to determine the effects of statins on depressive symptoms. Subgroup analyses were performed to determine the effects of statins in patients with and without depression at baseline. Overall, statin use was associated with significantly lower scores on depression rating scales compared with the placebo use (SMD: -0.309, CI: -0.525, -0.094; p = 0.005). The subgroup analysis showed significant effects in the depressed population (SMD: -0.796, CI: -1.107, -0.486, p = 0.001) but not in the non-depressed population (SMD: -0.153, CI: -0.353, 0.047, p = 0.113).

There was high heterogeneity in the studies included and only two studies had low risk of bias.

The results suggest that statins are effective in improving depressive symptoms, particularly in those with clinical depression and that they do not worsen depression in non-depressed subjects.