Statins and Global Transient Amnesia

Earlier this week a reader commented on a book by Dr. Duane Graveline entitled, Lipitor: Thief of Memory. I had heard of Dr. Graveline earlier and was intending to comment some time in future on his work. I have not yet read Lipitor Thief of Memory or Dr. Graveline's more recent work Statin Drug Side Effects however after reading the comment I realized that I can't always wait until I have become perfectly expert in hundreds of topics before deciding that they are worth discussion, really, there might be one post a season if I did that. I am entirely confident from what I do know now that this topic is worth further discussion.Dr. Graveline has an eclectic and storied background. He is both a former NASA astronaut as well as military flight surgeon and retired family practitioner. He holds a Doctorate of Medicine as well as a Masters degree in Public Health. Dr Graveline, it appears, did not start out to become a critic of statin drugs, rather the controversy found him. As he
describes on his website Spacedoc.net, after an annual physical as part of his astronaut program he was started on Lipitor for elevated cholesterol. While there were no immediate reactions, as Dr. Graveline relates,"All was well until six weeks later, when my wife found me walking aimlessly about the yard after I returned from my usual walk in the woods. I did not recognize her, and only reluctantly accepted cookies & milk--but refused to go into my now unfamiliar home.I "awoke" six hours later in the office of the examining Neurologist with a diagnosis of transient global amnesia, cause unknown."A full medical work-up found no obvious cause for this alarming event and Dr. Graveline over the protests of his doctors chose to discontinue his Lipitor treatment. Transient Global Amnesia is characterized by an inability to integrate short term memory. That is to say, whatever is happening around one cannot be put into any context involving one's past and identity. A patient
is able to speak, but cannot carry out a coherent conversation as they cannot recall more than the past few moments of words. Often they are described as quite earnestly repeating a question or statement, "as if a fragment of a sound track is being repeatedly rerun". Motor skills are unaffected and even complex behaviors may be carried out successfully, as one patient has been reported to have continued putting together the alternator in his car despite the attack. The victim also retains a knowledge of self and family members yet is disoriented to space and time and cannot put the events occurring around him or her into any coherent context. Fortunately, as the name implies, the amnesia is transient generally resolving after an average of about six hours.All went well for Dr. Graveline until one year later, when he again started on Lipitor, this time at one half his previous dose. As Dr. Graveline describes it,"Six weeks later I again descended into the black pit of amnesia
--this time for twelve hours, and with a retrograde loss of memory back to my high school days.During that terrible interval, when my entire adult life had been eradicated, I had no awareness of my marriage or my four children; my medical school days or my ten adventure-filled years as a USAF flight surgeon; my selection as a NASA scientist-astronaut or my post-retirement decade as a writer of medical fiction.The names of my books were like the names of my children - gone from my mind as completely as if they had never happened. Fortunately (and typically for this obscure condition), my memory returned spontaneously and again I drove home listening to my wife's amazing tale of how the day's events had unfolded."Dr. Graveline's article is well worth reading in its entirety, while his space.doc site contains a wealth of further information on this and other health topics. Transient Global Amnesia is a very rare if dramatic finding. Previously it has been reported in the medica
l literature as associated with precipitating events such as physcial exertion, cold water immersion, sexual intercourse, emotional crises and cerebral angiography. Dr. Graveline goes on to catalog eleven case histories of individuals who report incidents similar to his own. To my knowledge however, there is no article in the medical literature investigating or even speculating on these occurrences. Perhaps that needs to change.

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