Statins and epilepsy: preclinical studies, clinical trials and statin-anticonvulsant drug interactions

3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase inhibitors (statins) are potent cholesterol- lowering drugs which also possess beneficial antioxidant, antiinflammatory, immunomodulatory, and antiexcitotoxic effects. In addition, statins have proven neuroprotective effects in several neurological diseases: stroke, cerebral ischemia, Alzheimer’s and Parkinson’s disease, multiple sclerosis and traumatic brain injury. Relatively few studies have investigated the potential anti-seizure properties of statins in epilepsy and the possible underlying protective mechanisms that may be involved. This review summarizes the currently available data concerning statin effects in modulating seizure activity (sometimes adversely) and epileptogenesis in different experimental models as well as in clinical studies. Furthermore, we analyze the consequences of some of the more commonly reported statin–anticonvulsant drug interactions in the literature, discuss some of the adverse effects of statins encountered in clinical practice and comment on the potential future usefulness of statins in epilepsy therapy.