Golomb B A, Kane T, Dimsdale J E
Department of Medicine, University of California, San Diego, CA 92093-0995, USA.
QJM. 2004 Apr;97(4):229-35. doi: 10.1093/qjmed/hch035.
As use of a drug becomes widespread, the full spectrum of its effects becomes clearer. Although a link has been suggested between low or lowered cholesterol and irritability/aggression, less is known about possible links between irritability and statins.
To assess the possible connection of statin usage to severe irritability.
Case series.
Six patients referred or self-referred with irritability and short temper on statin cholesterol-lowering drugs completed a survey providing information on character of behavioural effect, time-course of onset and recovery, and factors relevant to drug adverse effect causality.
In each case the personality disruption, once evident, was sustained until statin use was discontinued; and resolved promptly with drug cessation. In four patients, re-challenge with statins occurred, and led to recrudescence of the problem. All patients experienced other recognized statin adverse effects while on the drug. Manifestations of severe irritability included homicidal impulses, threats to others, road rage, generation of fear in family members, and damage to property.
Case series invariably raise more questions than they can answer. These case reports suggest that severe irritability may occur in some statin users. Although this adverse effect may be rare, potentially life-threatening adverse effects of drugs must be taken seriously.
随着一种药物的使用变得广泛，其全部效应会变得更加清晰。尽管有人提出低胆固醇或胆固醇降低与易怒/攻击性之间存在联系，但关于易怒与他汀类药物之间可能的联系却知之甚少。
评估他汀类药物使用与严重易怒之间的可能联系。
病例系列。
六名因服用他汀类降胆固醇药物而出现易怒和脾气暴躁症状前来就诊或自行前来的患者完成了一项调查，该调查提供了有关行为效应特征、发作和恢复的时间过程以及与药物不良反应因果关系相关因素的信息。
在每一个病例中，人格障碍一旦出现，就会持续到停用他汀类药物；停药后症状迅速缓解。四名患者再次服用他汀类药物，问题复发。所有患者在服药期间都经历了其他公认的他汀类药物不良反应。严重易怒的表现包括杀人冲动、威胁他人、路怒、让家庭成员产生恐惧以及破坏财产。
病例系列总是提出的问题比它们能回答的更多。这些病例报告表明，一些他汀类药物使用者可能会出现严重易怒。尽管这种不良反应可能很少见，但药物潜在的危及生命的不良反应必须予以重视。
