Lipid Lowering Drugs: A Patient's Experience

Lipid lowering drugs (statins) have been vaunted as the "miracle" drug to reduce or prevent morbidities and mortalities due to heart attack. Experts quoted research findings testifying to that effect. But like any other drugs, statins have side-effects. The only difference is some patients suffer more than others. Another point worth mentioning is some patients accept the side-effects while others, perhaps too adversely affected might complain about them.

I have come across many patients with different behavioural responses to the medications prescribed to them. As I like to engage patients to talk about their health in relation to their medical conditions, I tend to get a lot of feedbacks from patients. I find these feedbacks valuable as they form a part of sharing of experiences which could help other patients who are less vocal or suffering in silence.

And so today I had one patient who came in without an appointment, insisting agitatedly to change one lipid lowering drug labelled S which she has been taking for the last four years with another labelled L.

Upon checking my medical notes, I actually changed the S statin to L statin four months ago when I discovered that her lipid was still elevated despite being on S for such a long time. However on her subsequent visit two months later I inadvertently reverted the statin prescription to S. After taking S for nearly a month she observed that her brain became "jammed" again, yes, that was how she described it. She felt she was more depressed and also forgetful. Her joints ached and she felt generally "down". she said her problems were greatly reduced ,in fact for the first time in many months, she felt much better when she was on L statin (for the two months she was on). She was adamant that she wanted it to be reverted to L. I happily obliged.

Well, I listen to my patient intently because she is the one taking the medication and she should know best what and how she feels while on the drugs. Compliant patients will report genuinely to enable us to individualise the medications and reduce adverse effects and consequently improve their quality of life.

In the meantime her lipid level is monitored every six months to observe the effects of the prescribed statin.

Statins are known to affect the muscle and some patients are affected more than others. While this is noted in the literature, large scale studies normally would not capture so called "isolated" observations. And there is always that possibility that pharmaceutical-sponsored research would somehow skip negative findings of the drug under trial. It may sound preposterous but it has been reported.

Taking cognizance of evidence-based medicine, medications are tailored to indicate the compliance with the standard practice. However anecdotal evidence needs to be looked at for optimisation of therapy for individual patients.

And you would not be able to optimise the treatment unless you engage your patients. Quite often patients complain that doctors do not talk enough to them or that they are scared to tell the doctors what they are experiencing. It is a tragedy for patients who are in this predicament, they see doctors regularly and yet are not able to express their  fear and anxiety. Try putting  yourself in their shoes.

For all doctors out there, do engage your patients because as the saying goes , we cannot always cure but we can always comfort. Addressing their fear and anxiety and listening to them is a major part of their therapy.