Does rosuvastatin (Crestor) cause forgetfulness?

Rosuvastatin and Cognitive Function

Rosuvastatin does not cause forgetfulness based on high-quality evidence from multiple guidelines, although rare reports of reversible cognitive effects exist in post-marketing surveillance.

Evidence on Cognitive Effects of Statins

Current high-quality evidence from multiple guidelines consistently indicates that statins, including rosuvastatin, do not cause significant cognitive impairment:

• The American Diabetes Association states that concerns about statins causing cognitive dysfunction or dementia are not supported by evidence 1.
• The USPSTF found no clear evidence of decreased cognitive function associated with statin use 2.
• Three large randomized controlled trials specifically examining cognitive function found no differences between statin and placebo groups 1.

FDA Label Information

The FDA label for rosuvastatin does acknowledge:

• Rare postmarketing reports of cognitive impairment (including memory loss, forgetfulness, amnesia) associated with statins 3.
• These reports are generally nonserious and reversible upon statin discontinuation.
• Symptoms typically resolve with a median time of 3 weeks after stopping the medication.
• Onset of symptoms can vary from 1 day to years after starting therapy 3.

Clinical Implications

What to Consider

• The cardiovascular benefits of rosuvastatin significantly outweigh the potential cognitive risks.
• A meta-analysis of 13 randomized statin trials showed that for every 255 patients treated with statins for 4 years:
  • 5.4 vascular events were prevented
  • Only 1 additional case of diabetes occurred 2

Management Approach

If a patient reports cognitive symptoms while on rosuvastatin:

1. Consider temporary discontinuation to assess if symptoms resolve
2. If symptoms improve after discontinuation, consider:
   • Switching to a different statin
   • Using a lower dose
   • Weighing cardiovascular benefits against cognitive effects

Case Report Context

While there is one published case report of short-term memory loss associated with rosuvastatin 4, this represents an isolated report rather than a consistent pattern in controlled trials. In fact, some research suggests statins may have neuroprotective effects, with rosuvastatin showing improvement in cognitive functions in certain experimental models 5.

Bottom Line

The current consensus from multiple high-quality guidelines is that rosuvastatin and other statins do not cause significant cognitive impairment in most patients. The rare reports of cognitive effects are generally reversible upon discontinuation. The cardiovascular benefits of rosuvastatin therapy outweigh the potential risk of cognitive side effects for patients with appropriate indications for statin therapy.