Statins in nervous system-associated diseases: angels or devils?

Statins are commonly prescribed lipid-lowering medications that significantly reduce the risk of cardiovascular events. In addition to their ability to lower cholesterol by affecting the rate-limiting step in cholesterol biosynthesis, statins also have anti-inflammatory, immunomodulatory, antioxidant, antiapoptotic, and antiplatelet effects. Because of these pleiotropic abilities, statins may have some beneficial effects on neurologic diseases, including cerebrovascular disease, neurodegenerative disease, multiple sclerosis, and brain tumors. Although statins are a well-tolerated class of drugs, they also have potential adverse effects (AEs). A growing body of evidence indicates that statins may have potential negative effects on nervous system-associated diseases, including myopathies, peripheral neuropathy, intracerebral hemorrhage (ICH), and other diseases of the central nervous system (e.g., cognitive impairment, depression, sleep disorders, nightmare, and headache). Clinicians, especially neurologists, should be aware of the potential risk of neuropathy in patients who take statins.