Hoppmann R A, Peden J G, Ober S K
Department of Medicine, East Carolina University, School of Medicine, Greenville, NC.
Arch Intern Med. 1991 Jul;151(7):1309-13.
A review of the literature regarding central nervous system side effects of the nonsteroidal anti-inflammatory drugs (NSAIDs) revealed three general categories: aseptic meningitis, psychosis, and cognitive dysfunction. Aseptic meningitis is found most commonly in patients with lupus treated with ibuprofen, but it should be considered in any patient with meningitis if the patient has used NSAIDs. Psychosis, although infrequently reported with NSAIDs, should be suspected in an elderly patient started on a regimen of indomethacin who acutely develops disorientation, paranoia, or hallucinations. Finally, there appears to be some potential for memory dysfunction and attention deficits in elderly patients treated with NSAIDs. Until further studies are available on the incidence and severity of these cognitive changes, physicians should use low doses of NSAIDs in the elderly and remain alert to the possibility of such adverse side effects.
一项关于非甾体抗炎药（NSAIDs）中枢神经系统副作用的文献综述揭示了三大类情况：无菌性脑膜炎、精神病和认知功能障碍。无菌性脑膜炎最常见于使用布洛芬治疗的狼疮患者，但如果患者使用过NSAIDs，任何脑膜炎患者都应考虑这种情况。精神病虽然较少有NSAIDs相关报道，但对于开始使用吲哚美辛治疗方案后急性出现定向障碍、偏执或幻觉的老年患者应怀疑有精神病。最后，在使用NSAIDs治疗的老年患者中似乎存在一定的记忆功能障碍和注意力缺陷的可能性。在获得关于这些认知变化的发生率和严重程度的进一步研究之前，医生应在老年患者中使用低剂量的NSAIDs，并对这种不良副作用的可能性保持警惕。
