Editor, – With 12 years of 'statins' under my personal belt I feel able to comment on the medicinal mishap 'Statins and muscle symptoms' (Aust Prescr 2005;28:102), particularly the checklist of muscle symptoms. My observations over many years since I first recognised the connection between my muscle pains and simvastatin, and briefly atorvastatin, lead me to assert that the pain:
- is severe enough to wake you up
- tends to be nocturnal, within 2-8 hours of the last dose, unless the statin is taken in the morning
- is quickly and surprisingly easily relieved by a few contractions of the muscle concerned, or a walk to the bathroom - the ensuite may not be far enough
- recurs in the same area of muscle, which is tender to touch and also on contraction
- is never symmetrical - my right vastus lateralis was originally involved, and lately my left deltoid muscle.
Earlier I could control the symptoms by leaving out my daily dose of 10 mg on two days per week, but relief (that is unbroken sleep) sometimes took 24 hours. I tested this response perhaps dozens of times.
The insouciance of an overseas trip three months ago led me to taking a tablet everyday. The result was persistent pain and weakness in the same muscle, and ultimately wasting, to the point where I was unable to step up with the right leg - a drastic disability in Europe.
After stopping the drug for two months, my thigh is nearly back to normal, but I can still feel the affected area. My lipids are not optimal now, but creatine kinase seems unaffected.
There seems little prospect of these adverse effects being reported to the Adverse Drug Reactions Advisory Committee because both my general practitioner and cardiologist attributed them (not so definitely of late) to my old age. I graduated in medicine 54 years ago. Having experienced both, I find old age much easier to take, so far, than the adverse effects I have experienced with the statins.
Peter J. Stobie
Emeritus ophthalmologist, Women's and Children's Hospital
Adelaide
