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Atorvastatin/simvastatin Ataxia: 2 case reports A 52-year-old man and a 64-year-old woman, who both had bipolar disorder, developed ataxia after receiving atorvastatin and simvastatin, respectively [therapeutic indications not stated]. The man presented with hypomania and depression in 1999 and had been on treatment with lamotrigine and topiramate since 2000 for bipolar disorder. The dosage of lamotrigine was reduced after a follow-up in 2008 when he reported new-onset ataxia. He was also taking atorvastatin 20mg [frequency and duration of therapy not stated] as part of his chronic regimen. Atorvastatin was subsequently discontinued. At 6-month follow-up, his ataxia had completely resolved. The woman presented in 2008 with subacute onset of gait and writing ataxia. She had been receiving zolpidem, carbamazepine and lamotrigine. Simvastatin [dosage not stated] had been added to her treatment regimen 2 years earlier and her husband had observed progressive cognitive slowing since. Simvastatin was discontinued. Four weeks later, her ataxia and cognitive complaints had resolved. Author comment: "I suggest the hypothesis, conceptually consistent with the concept that statins may act as unmasking agents for latent neuromuscular disorders, that neuropsychiatric statin intolerance suggests preexisting CNS metabolic disorder." Berner JE. Statins can produce ataxia in bipolar disorder: Two case reports. Journal of Clinical Psychiatry 71: 359, No. 3, Mar 2010. Available from: URL: http:// 803013946 dx.doi.org/10.4088/jcp.09l05412yel - USA

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Reactions 22 May 2010 No. 1302