NSAIDs for Alzheimer's? Never Mind

Clinical Trial: No Better Mental Function With Naproxen, Celebrex

From the WebMD Archives

May 12, 2008 -- Remember all those studies suggesting NSAID painkillers cut Alzheimer's risk? Forget about it.

Despite accumulating circumstantial evidence that people who take NSAID drugs have a lower risk of Alzheimer's disease, a clinical trial shows neither naproxen nor Celebrex preserves mental function.

NSAIDs -- nonsteroidal anti-inflammatory drugs -- include ibuprofen (brands include Advil and Motrin), naproxen (brands include Aleve), and Celebrex. Studies that compare people with Alzheimer's disease to people who don't have Alzheimer's disease often (but not always) find that those without Alzheimer's are more likely to be long-term NSAID users.

Just this month, one such study suggested that ibuprofen might cut Alzheimer's risk.

But researchers always warn that only clinical trials can show whether a drug really helps. Now such a trial shows that taking naproxen or Celebrex for up to four years doesn't slow age-related decline in mental function. In fact, the study offers weak evidence that naproxen may very slightly decrease mental function.

"For now, we suggest that naproxen and [Celebrex] should not be used for the prevention of Alzheimer's disease," conclude Johns Hopkins researcher Barbara K. Martin, PhD, and fellow members of the Alzheimer's Disease Anti-Inflammatory Prevention Trial (ADAPT) research group.

Martin and colleagues note that naproxen and Celebrex are not among the NSAIDs that fight Alzheimer's-like plaque in mouse studies. Ibuprofen does -- and ibuprofen is more commonly used than other NSAIDs.

But as Boston University researcher Steven Vlad, MD, told WebMD earlier this week, "I would not advise patients to start taking an NSAID to prevent Alzheimer's. There are too many known risks associated with this class of medications, and we would need a lot more research to figure out the risk-benefit ratio."

Martin and colleagues report their findings in the May 12 issue of Archives of Neurology.