[How to cope with the nocebo effects of statins?]

Abstract

Statins are effective drugs that can reduce the risk of new cardiovascular events. Although in randomized, placebo-controlled trials statins are associated with a low risk of mild muscle complaints such as myalgia, in daily practice up to 30% of patients report complaints attributed to statin use. Two recent studies have shown statin-associated muscle complaints are mainly related to the nocebo effect. The nocebo effect is a decrease in benefit and/or a new onset or worsening of adverse effects due to an expectation of harm associated with the treatment. Statins face reputational challenges due to a vast amount of negative attention on the internet. We need to address the nocebo effect by managing the perception of statins and provide patients with objective information about statin treatment, reduce the negative expectations, and placing discussion about the likelihood of adverse effects into the context of treatment benefit.