Nonsteroidal anti-inflammatory drugIt is difficult to obtain valid estimations of the true incidence of CNS effects associated with nonsteroidal anti-inflammatory drugs NSAIDs from spontaneously reported adverse reactions. This is because the reporting rates of adverse reactions are low and the total number of individual drugs prescribed is not generally documented. In effect case studies, the association has been validated by rechallenge with the NSAID in question. Npnsteroidal with systemic lupus erythematosus are at an increased risk of NSAID-induced aseptic meningitis, steroids in pills for sale the meningitis may be a specific cell-mediated immune response. Evidence for an association between NSAIDs and psychiatric adverse effects is mainly anecdotal and comes from spontaneous central nervous system side effects of nonsteroidal anti inflammatory drugs.
Case reports have identified numerous neurologic sequelae including ataxia, vertigo, dizziness, recurrent falls, nystagmus, headache, encephalopathy, and disorientation. Seizures have also been reported, mostly after overdose ingestions, but even therapeutic doses have occasionally been associated with seizures.
The clinical signs of drug-induced meningitis are similar to those of infectious meningitis and include fever, headache, photophobia, and stiff neck. The laboratory findings are also similar, including cerebrospinal fluid CSF pleocytosis of several hundred or thousand cells, mainly neutrophils, elevated levels of protein, normal or low glucose levels and negative cultures.
Drug-induced meningitis is a transient disorder with an excellent prognosis. Most or all drugs used for the treatment of headache, including NSAIDs, may cause a condition known as medication overuse headache - a refractory chronic daily headache that tends to resolve following discontinuation of the analgesics. The pathogenesis is currently unknown, but commonly the syndrome is preceded by a viral episode, with an intermediate latent period of days. An association with aspirin use is strongly suggested.
Aspirin, the classic and most commonly used NSAID, has a well-documented effect in inhibiting intravascular clotting, thus reducing the occurrence of ischemic strokes and other vascular events.
NSAIDs, however, have a double impact on coagulation. On the one hand, most agents inhibit the synthesis of thromboxane in the platelets, thereby inhibiting coagulation. On the other hand, they also inhibit the production of prostacyclin by endothelial cells, resulting in a prothrombotic state.
Selective inhibition of COX-2 by drugs such as rofecoxib Vioxx and valdecoxib Bextra results in specific inhibition of synthesis of prostaglandins participating in inflammation and was found to lead to vascular complications including an increased risk for stroke. The connection between inflammation and neuronal degeneration is well established. Most studies, including the prospective Rotterdam study, have found an inverse correlation between the use of NSAIDs and the risk for dementia.
However, some large, well designed studies failed to confirm these results, and some even found that NSAID use is associated with cognitive decline.
While some studies showed that chronic NSAID use is protective against PD, other studies could not confirm the existence of a significant relationship. Read Article at publisher's site. How does Europe PMC derive its citations network? CitePeer Related Articles http: Gene Ontology GO Terms.