Related Experiment Video
Updated: Sep 6, 2025
04:53
A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
10.8K
SAMSON and the Nocebo Effect: Management of Statin Intolerance
Amrita Krishnamurthy1, Corey Bradley2, Rebecca Ascunce1
1Department of Medicine, Division of Cardiology, Weill Cornell Medical College, New York Presbyterian Hospital, 1305 York Avenue, 8th Floor, New York, NY, 10021, USA.
Current Cardiology Reports
|June 27, 2022
Summary
The nocebo effect significantly contributes to statin intolerance, with 90% of symptoms linked to placebo. Many patients can successfully restart statin therapy with proper management strategies.
Area of Science:
- Cardiology
- Pharmacology
- Psychosomatic Medicine
Background:
- Statins are crucial for atherosclerotic cardiovascular disease (ASCVD) management.
- Underutilization of statins is often due to perceived adverse side effects.
- The nocebo effect plays a significant role in patient-reported statin intolerance.
Purpose of the Study:
- To elucidate the role of the nocebo effect in statin intolerance.
- To provide management strategies for statin intolerance.
- To review alternative lipid-lowering therapies.
Main Methods:
- Review of current literature on statin intolerance and the nocebo effect.
- Analysis of findings from the Self-Assessment Method for Statin side-effects Or Nocebo (SAMSON) trial.
- Discussion of clinical management approaches.
Main Results:
- The SAMSON trial showed 90% of statin-related adverse symptoms were elicited by placebo.
- Approximately 50% of patients in the SAMSON trial successfully reinitiated statin therapy.
- Statin intolerance can often be managed through expectation setting and dose/regimen adjustments.
Conclusions:
- The nocebo effect is a major contributor to perceived statin intolerance.
- Effective management strategies can enable statin re-challenge and adherence.
- Alternative lipid-lowering therapies are available for patients unable to tolerate statins.
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
857
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
857
01:26Atherosclerosis III: Management
31
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
31
01:25Antianginal Drugs: Calcium Channel Blockers and Ranolazine
661
Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
CCBs, a diverse class that includes dihydropyridines (nifedipine) and diphenylalkylamines (verapamil and diltiazem), exert their effect by blocking calcium channels in cardiac and smooth muscle cells. This...
661
01:54The Placebo Effect
6.3K
The placebo effect occurs when people's expectations or beliefs influence or determine their experience in a given situation. In other words, simply expecting something to happen can actually make it happen.
6.3K
01:26Angina IV: Management
21
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
21
01:19Pharmacovigilance
979
Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
979