103. Statins, depression and the inflammatory hypothesis of depression: A meta-analysis of randomized controlled trials

Abstract

Early evidence from randomized controlled trials indicates that primary or adjunct treatment with anti-inflammatory medications improves outcomes for some patients with depression. One of the most highly prescribed classes of medications are statins, and evidence is mounting that these have anti-inflammatory effects. Consequently, we examined whether treatment with statins, compared with placebo, is associated with improved depression outcomes. Random effects meta-analysis was conducted on studies meeting eligibility criteria: randomized controlled trial of any type of statin vs. placebo, measured depression as a continuous score or binary outcome, in any patient group, published in a peer reviewed journal. Computerised searches of Embase, Medline, PsycInfo, Cochrane Library and Web of Science were undertaken using derivatives of terms related to depression, statins and randomized controlled trial. Two authors independently assessed eligibility and extracted data. Treatment with statins was associated with a significantly greater reduction in depressive symptoms compared with placebo treatment, d = −0.11 (95%CI −0.20, −0.02), p = .02, I 2 = 0. Treatment with statins was also significantly associated with fewer depression adverse events, RR = 0.90 (95%CI 0.81, 1.00), p = .05, I 2 = 0. Statin use was associated with improved depression outcomes across clinically diverse samples. The small benefits demonstrated may have substantial public health benefits, due to their widespread use. This data provides tentative support for the inflammatory hypothesis of depression. However, measuring inflammatory markers and depression simultaneously in future trials of statin use is warranted.