Korean J Biol Psychiatry.  2024 Oct;31(2):51-58. 10.22857/kjbp.2024.31.2.005.

Association of Statin Use With Risk of Bipolar Disorder: A Nationwide Cohort Study

• Shin J
• Jung J
• Han K
• Kim H
• Jeon HJ

• KMID: 2561302
• DOI: http://doi.org/10.22857/kjbp.2024.31.2.005

Abstract

Objectives
The association between statin use and depression is well studied, but the studies on the association of statin use and bipolar disorders are limited. Thus, we aimed to investigate the effects of taking statin on risk of bipolar disorder using national claims data of South Korea.
Methods
A total of 5713871 subjects who did not take statin and were not diagnosed with bipolar disorder before the health examination were included. Among eligible subjects, 315537 subjects started taking statin within 1 year after taking the health examination and 5398334 subjects did not. After 9 years of follow-up, the incidence of bipolar disorder was determined for each group.
Results
Compared to subjects who were not exposed to statin, subjects who were exposed to statin showed a greater incidence of bipolar disorder and an increased risk of bipolar disorder (hazard ratio [HR]: 1.66; 95% confidence interval [CI]: 1.58 to 1.75), and after adjusting for age, sex, low income, regular exercise, smoking, drinking, diabetes mellitus, hypertension, body mass index, cholesterol and depression (adjusted HR: 1.32; 95% CI: 1.24 to 1.40).
Conclusions
This result showed an increased risk of bipolar disorder after taking statin, but the underlying biological mechanism needs further investigations. This study has clinical implications for patients taking statins, which require early assessment and response in addition to drug treatment and lifestyle modification, considering the possibility that unhealthy lifestyle habits may appear as part of the mood symptoms of bipolar disorder.

Keyword

Bipolar disorder; Mood disorder; Statin; Dyslipidemia; Metabolic syndrome