Nocebo Effect and Statins

Medical Q&A [Moderated]
1

Austin and Jordan

I have someone close to me who has recently had blood work performed that found elevated total cholesterol and LDL values prompting his physician prescribing Lipitor and upon discussion with this person discovered some of his hesitations with the medication regarding muscle pain and weakness. These beliefs came from a friend of his who took this medication ~10 years ago that resulted in marked weakness and muscle pains that left them with difficulty performing ADLs.

I felt comfortable doing a literature review on my own and discovered a significant nocebo effect with Statin drugs that found increased reports of muscle aches and pains when the patient believe this would occur. (I’m sure you already know this, just adding background, apologies if repeating). I’m not asking for medical advice and I am not planning on giving my family member medical advice. However, I was wondering if there was a way to educate him on this nocebo effect. My questions for you guys are:
(1) Would it be appropriate for me to present to him this information regarding the nocebo effect and educating that the data shows no difference in reports of muscle aches and pains when subjects are blinded? (2) Or is this something I should report to him to follow up with his physician about?
(3) Could providing education about the nocebo effect in turn make the nocebo (muscle aches/pains) worse?

2

  1. This is hard to answer without knowing more about the individual in question, as it assumes their ability to interpret and understand this information (or at least your ability to effectively convey it). I do not see a problem with presenting the concepts, however.

  2. His physician may be unaware of these issues.

  3. Probably not, although this depends on his current beliefs and interpretation of the symptoms.