We read with interest the excellent article on "Cholesterol and Violent Behavior" by Santiago and Dalen1 that critically reviews the existing literature on this important issue.
The authors start their conclusion with the statement: "There is certainly enough evidence to warrant further investigation and to formulate several hypotheses rather than a single, unitary explanation of the relationship between cholesterol level, serotonin, and violent behavior."1 Later on, they comment that "The current literature does not support a relationship between low or lowered cholesterol levels and violent behavior."1
In our opinion, there is evidence only for the second conclusion. From the data reviewed by the authors, it remains questionable whether a change in the total mortality may be expected at all in small short-term trials intended only to demonstrate that lowering cholesterol will reduce the incidence of coronary heart disease and of coronary death. Furthermore, it should be kept
Schwandt P, Richter WO, Sönnichsen AC. Lowering High Plasma Cholesterol Levels Is Not Dangerous. Arch Intern Med. 1995;155(9):985. doi:10.1001/archinte.1995.00430090137014