Low serum cholesterol and violence or suicide - Tips from Other Journals

Date: June, 1992

Several studies that have shown a decrease in deaths due to coronary artery disease in patients receiving lipid-lowering therapy have also shown an increase in suicides and violent deaths in these patients. This observation has lead several authors to recommend a more cautious approach to lipid-lowering therapy (i.e., considering this therapy only in high-risk patients). Engelberg correlated the results of studies of lipid-lowering therapy with observations on cerebral metabolism in suicide victims and serum cholesterol levels in patients with antisocial or violent behavior. He has developed a possible explanation for the apparent connection between low cholesterol levels and violent behavior.

The ratio of cholesterol of phospholipids in brain cell membranes is the major determinant of many membrane functions, including transport processes. When the cholesterol content is high, the increased viscosity of brain cell membranes leads to increased uptake of serotonin. Serotonin has been demonstrated in animal and human studies to play an essential role in impulse control. This suggests that lowering serum cholesterol could decrease the uptake of serotonin. Thus, lowering serum cholesterol could lead to violent behavior in susceptible individuals.

This article is one of a growing number in the European literature that call for a more sophisticated approach to recommendations for universal lowering of serum cholesterol levels. The author cautions that further research is needed on the noncardiac consequences of changes in serum lipid levels. (Lancet, March 21, 1992, vol. 339, p. 727.)

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