Nightmares Associated with Atorvastatin (LIPITOR)

On Apr. 22, 2006, The British Medical Journal posted a case report submitted by a Dutch physician about a 72 year old woman who experienced nightmares after taking the cholesterol lowering statin drug atorvastatin (LIPITOR).

Atorvastatin (LIPITOR) was approved by the Food and Drug Administration (FDA) in December 1996 to lower cholesterol. In 2005, more than 63 million prescriptions were dispensed for the drug and sales topped $ 6.3 billion.

The patient had a long history of high blood pressure and was being treated for low thyroid (hypothyroidism), heart failure, and chronic kidney failure. She began taking 10 milligrams of atorvastatin per day for her high cholesterol. After five days of treatment with atorvastatin, she experienced extreme nightmares every night for two and one-half weeks. Other drugs she was using were continued but, because her physician was aware of a possible connection between statins and nightmares, atorvastatin was discontinued and the nightmares promptly stopped. The patient reluctantly agreed to start the drug again and the nightmares reappeared. Once again, when atorvastatin was stopped, the nightmares disappeared.

This type of sequence of events is strong evidence of a cause-and-effect relationship between the drug and the adverse event. A new drug is prescribed, and an adverse drug reaction develops. The drug is stopped, and the problem resolves. When the drug is started again-called a rechallenge — the adverse reaction reappears, thus firmly linking the occurrence of the adverse event with the use of the drug.  

The author of this case report noted that an association between the use of the statin drug simvastatin (ZOCOR), too, when taken in combination with the beta-blocking drug metoprolol (LOPRESSOR), had been linked to the occurrence of nightmares.

The FDA-approved professional product label for atorvastatin lists abnormal dreams as having occurred in less than two percent of the patients who participated in pre-approval clinical trials of the drug. This means that fewer than two people out of 100 people who took atorvastatin experienced abnormal dreams, which could indicate nightmares.

What You Can Do

Assume that any new symptom you develop after starting a new drug may be caused by the drug. If you develop a new symptom after starting atorvastatin or other statins (such as nightmares), report it to your doctor. The drug may be responsible.