Statin intolerance and the drucebo effect.

Hypercholesterolemia is a well-described risk factor for atherosclerotic cardiovascular disease. Statins remain the cornerstone of therapy. Statin intolerance (SI) particularly statin associated muscle symptoms (SAMS) and inappropriate stopping of treatment is associated with increased cardiovascular risk. A significant proportion of reported SAMS relates to expectation of side effects and can be termed the 'negative drucebo effect'. Patients should be educated about SI, the negative drucebo effect, in addition to the benefits of adherence to the therapy when first prescribed a statin. The aim of this commentary is to discuss the issue of SI, the negative drucebo effect and to suggest some interventions that may be used to address this issue.