Roth T, Richardson G R, Sullivan J P, Lee R M, Merlotti L, Roehrs T
Sleep Disorders Laboratory, Brigham and Women's Hospital, Boston, Massachusetts.
Clin Cardiol. 1992 Jun;15(6):426-32. doi: 10.1002/clc.4960150607.
Pravastatin and lovastatin, two HMG-CoA reductase inhibitors with similar cholesterol-lowering effects, differ in their lipid solubility. The hydrophilic characteristics of pravastatin may explain why the drug has not been detected in cerebrospinal fluid. On the other hand, lovastatin, a lipophilic compound, has been detected in the cerebrospinal fluid. Previous reports have suggested that lovastatin administration may be associated with insomnia, which reflects an action in the central nervous system. The effects of the two drugs on nocturnal sleep and day-time performance in young, healthy men have been assessed in randomized, double-blind, placebo-controlled studies. Computer-based performance tests were administered on two consecutive days before drug administration and at the end of a 3-week active drug or placebo treatment period. Results from both sites were combined for analysis. Neither pravastatin nor lovastatin significantly affected nocturnal sleep or daytime sleepiness in this study population, but lovastatin significantly affected daytime performance. In subjects treated with lovastatin, the results showed that two measures of performance, divided attention (p less than 0.05) and vigilance (p less than 0.01), worsened significantly from baseline as did global performance (p less than 0.01). Performance was not affected in the pravastatin and placebo groups. These results provide preliminary evidence of an adverse effect of lovastatin on daytime performance.
普伐他汀和洛伐他汀是两种具有相似降胆固醇作用的HMG - CoA还原酶抑制剂，它们的脂溶性不同。普伐他汀的亲水性特征或许可以解释为何在脑脊液中未检测到该药物。另一方面，洛伐他汀作为一种亲脂性化合物，已在脑脊液中被检测到。既往报道提示，服用洛伐他汀可能与失眠有关，这反映出其在中枢神经系统中的作用。在随机、双盲、安慰剂对照研究中，评估了这两种药物对年轻健康男性夜间睡眠和日间表现的影响。在给药前连续两天以及3周的活性药物或安慰剂治疗期结束时，进行基于计算机的性能测试。将两个研究地点的结果合并进行分析。在该研究人群中，普伐他汀和洛伐他汀均未显著影响夜间睡眠或日间嗜睡，但洛伐他汀显著影响日间表现。在接受洛伐他汀治疗的受试者中，结果显示，两项性能指标，即注意力分散（p＜0.05）和警觉性（p＜0.01），与总体表现（p＜0.01）一样，较基线水平显著恶化。在普伐他汀组和安慰剂组中，性能未受影响。这些结果为洛伐他汀对日间表现的不良影响提供了初步证据。
