Statins withdrawal, vascular complications, rebound effect and similitude.
Hahnemann considered the secondary action of medicines to be a law of nature and reviewed the conditions under which it occurs. It is closely related to the rebound effects observed with many modern drugs. I review the evidence of the rebound effect of statins that support the similitude principle. In view of their indications in primary and secondary prevention of cardiovascular diseases, statins are widely prescribed. Besides reducing cholesterol biosynthesis, they provide vasculoprotective effects (pleiotropic effects), including improvement of endothelial function, increased nitric oxide bioavailability, antioxidant properties, inhibition of inflammatory and thrombogenic responses, stabilisation of atherosclerotic plaques, and others. Recent studies suggest that suspension of statin treatment leads to a rebound imparing of vascular function, and increasing morbidity and mortality in patients with vascular diseases. Similarly to other classes of modern palliative drugs, this rebound effect is the same as a secondary action or vital reaction described by Samuel Hahnemann, and used in homeopathy in a therapeutic sense.
Department of Internal Medicine, Universidade de São Paulo, Brazil. marcus@homeozulian.med.br
Marcus Zulian
MZ
Teixeira
D003324:Coronary Artery Disease / Q000209:etiology / Q000517:prevention & control; D004305:Dose-Response Relationship, Drug; D004727:Endothelium / Q000187:drug effects; D019317:Evidence-Based Medicine; D006705:Homeopathy / Q000379:methods*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D006937:Hypercholesterolemia / Q000517:prevention & control; D000960:Hypolipidemic Agents / Q000008:administration & dosage*; D008419:Materia Medica / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000209:etiology; D009569:Nitric Oxide / Q000378:metabolism; D012307:Risk Factors; D020521:Stroke / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000401:mortality / Q000517:prevention & control*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D008419:Materia Medica; D009569:Nitric Oxide