Statins and metformin could be used to treat serious mental illness

Cardiovascular disease and diabetes treatments were found to reduce the risk of self-harm and admission to hospital in patients with bipolar disorder, schizophrenia or non-affective psychosis. 

Hospital corridor

Existing medicines for physical conditions such as diabetes and hypertension could be used to treat serious mental illness (SMI), concluded the authors of a recent study in JAMA Psychiatry (9 January 2019)[1]
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The researchers studied data from a Swedish national database to compare rates of psychiatric hospitalisation and self-harm in 142,691 individuals with bipolar disorder, schizophrenia or nonaffective psychosis during periods of exposure and nonexposure to statins, metformin or L-type calcium channel (LTCC) antagonists, such as verapamil.

The results showed reduced rates of admission to hospital and self-harm during exposure to all three drug classes in bipolar disorder and schizophrenia. In nonaffective psychosis, LTCC antagonists were associated with reduced rates of admission to hospital and self-harm, while metformin and statins were associated with a reduced rate of admission to hospital.

The researchers said they chose these three particular drug classes because they had plausible mechanisms of action by which they could affect SMI. For example, statins are known to reduce systemic inflammation, which has also been implicated in psychiatric disorders.

“Understanding their mode of action on the central nervous system may facilitate better understanding of the pathophysiology of SMI and offer opportunities for innovative pharmacotherapy development,” the authors concluded.

References

[1] Hayes J, Lundin A, Wicks S et al. Association of hydroxylmethyl glutaryl coenzyme A reductase inhibitors, L-type calcium channel antagonists, and biguanides with rates of psychiatric hospitalization and self-harm in individuals with serious mental illness. JAMA Psych 2019; In press. doi: 10.1001/jamapsychiatry.2018.3907

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Citation
Clinical Pharmacist, CP, March 2019, Vol 11, No 3;11(3):DOI:10.1211/PJ.2019.20206060