Latest news with #simvastatin
Medscape
a day ago
- Health
- Medscape
Add-On Simvastatin Shows No Benefit in Depression
In a trial of patients with major depressive disorder (MDD) and obesity, adding simvastatin to escitalopram treatment led to no significant reduction in depressive symptoms compared with placebo; however, the combination effectively reduced levels of low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP). METHODOLOGY: This confirmatory, double-blind, placebo-controlled trial included 160 adults (mean age, 39 years; 79% women) with MDD and comorbid obesity from nine tertiary care centres in Germany. Participants were randomly assigned to receive either simvastatin (40 mg/d; n = 81) or placebo (n = 79) as add-on to escitalopram (10 mg for the first 2 weeks, then increased to 20 mg until the end of the study) for 12 weeks. The primary outcome was the change in Montgomery-Åsberg Depression Rating Scale (MADRS) scores from baseline to week 12. The key secondary outcome was the change in self-reported Beck Depression Inventory II (BDI-II) scores. TAKEAWAY: Compared with the use of add-on placebo, the use of add-on simvastatin led to no significant change in MADRS scores ( P = .71) and BDI-II scores ( P = .70). = .71) and BDI-II scores ( = .70). Moreover, compared with the use of add-on placebo, the use of add-on simvastatin led to a significant reduction in levels of LDL cholesterol ( P < .001), total cholesterol ( P < .001), and CRP ( P = .003). < .001), total cholesterol ( < .001), and CRP ( = .003). Add-on simvastatin did not affect any mental health-related secondary endpoint, despite improving the cardiovascular risk profile. Four severe adverse events were reported, with no significant differences observed between the groups. IN PRACTICE: "Even though simvastatin did not exert additional antidepressive effects in our study, it had the expected and well-known effects on lipids and inflammatory activity. Given that both MDD and obesity are associated with increased cardiovascular risk and higher mortality, statins should be prescribed in this comorbid group of patients following the guidelines for statin use in primary prevention," the authors wrote. SOURCE: This study was led by Christian Otte, MD, Charité — Universitätsmedizin Berlin, Berlin, Germany. It was published online on June 04 in JAMA Psychiatry . LIMITATIONS: This study was conducted in tertiary care centres in a high-income country, with patients showing moderate symptom severity and a high response rate, which limited its generalisability. Additionally, participants with an established indication for statin treatment and those with a history of suicide attempt were not included. DISCLOSURES: This study was supported by a grant from the German Ministry of Education and Research and sponsored by Charité — Universitätsmedizin Berlin. Several authors reported receiving grants and personal fees from various sources, outside the submitted work. Details are provided in the original article.
Health Line
10-05-2025
- Health
- Health Line
What Are the Treatment Options for Familial Hypercholesterolemia?
Familial hypercholesterolemia treatment often involves HMG-CoA reductase inhibitors (statins) to reduce LDL cholesterol. Advances in gene therapy also show promising results. Familial Hypercholesterolemia (FH) is a genetic disorder characterized by extremely high levels of LDL (low-density lipoprotein) cholesterol. The primary goal of treatment is to reduce these LDL levels to lower the risk of cardiovascular disease. Lifestyle changes and medications can be useful in treating FH. Lifestyle changes Eating a diet lower in fat and trying to avoid less healthy foods can be a good way to help reduce your cholesterol levels. Other general health tips that may help include not smoking and making sure you get enough restful sleep each night. Exercise can also help keep your weight in a good range for you, which can also reduce cholesterol. Your doctor may suggest medications you can take in combination with lifestyle changes to help manage your condition. Statins (HMG-CoA Reductase Inhibitors) Statins are the standard drug doctors use to treat FH. However, since many patients with FH have such a high level of LDL, they often need additional therapies, such as monoclonal antibodies. Common examples include: simvastatin (Zocor) lovastatin (Mevacor, Altoprev) fluvastatin (Lescol) rosuvastatin (Crestor) atorvastatin (Lipitor) pravastatin (Pravachol) »Learn more about statins. Bile Acid Sequestrants Bile acid sequestrants help your body get rid of LDL cholesterol. Doctors typically prescribe these alongside statins. Bile acid is formed using cholesterol. Bile acid sequestrants work by binding to bile, so your body needs to procduce more bile for digestion. This means more cholesterol will be taken out of your blood to make the bile. Bile acid sequestrants include: cholestyramine (Locholest, Prevalite, and Questran) colesevelam (Welchol) colestipol (Colestid) Fibrates Fibrates typically lower triglycerides but may also have a slight effect in lowering LDL. Fibrates include: clofibrate (Atromid-S) gemfibrozil (Lopid) fenofibrate (Antara, Lofibra, and Triglide) Fibrates can decrease the risk of cardiovascular problems by reducing the levels of LDL cholesterol in your blood. Monoclonal antibodies These are a type of biologic medication. These medications inactivate PCSK9, a protein that binds to and breaks down LDL receptors in the liver. LDL receptors remove LDL from the blood. So, stopping PCSK9 from binding means that more of these receptors exist to remove cholesterol from the bloodstream. The two PCSK9 inhibitors available in the United States are: alirocumab (Praluent) evolocumab (Repatha) These monoclonal antibodies must be injected every 2 to 4 weeks. You might be prescribed a PCSK9 inhibitor alongside statins. »Learn more about PCSK9 inhibitors This medication inhibits a protein called ANGPTL3. ANGPTL3 slows the breakdown of fats in your bloodstream, so inhibiting it will allow fat to get broken down faster. This means less LDL will be circulating in your bloodstream. Evinacumab is usually used to treat homozygous FH and people whose LDL levels do not reduce enough with statins alone. For some patients, evinacumab may reduce LDL by an extra 10% to 30% than statins alone. Lipoprotein apheresis Lipoprotein apheresis is a procedure that may help lower cholesterol if lifestyle and other medications do not lower LDL cholesterol enough. It may also slow the progression of atherosclerosis and reduce the chance of cardiovascular problems. A 2019 study suggests lipoprotein apheresis may be useful in treating homozygous FH in children with xanthomata and high LDL cholesterol.
