Dose-dependent effects of diclofenac sodium on the nervous system

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are prostaglandin inhibitors used for the alleviation of pain, inflammation, myocardial infarction and stroke. Prostaglandins are also important chemical mediators in the human body, being involved in both normal and abnormal functioning of organs and systems. Diclofenac sodium (DS) is reported to cross from the human placenta to the foetus during the first and second trimesters. The drug crosses the placental barrier to prevent the biosynthesis of prostanoids and passes into the foetal circulation, where it causes significant side-effects and sometimes malformations in newborns. Experiments have suggested that exposure to DS during the prenatal period produces teratogenic effects on the CNS and neuroanatomical anomalies in animal models. However, it has also been suggested that used in low doses, DS may produce beneficial effects on neurological systems, especially in terms of prenatal development. The aim of this chapter is to fill this knowledge gap by means of quantitative and qualitative analysis in order to identify the probable neuroprotective/neurotoxic effect on the nervous system of DS administration in differing doses. Another aim is to report potential results regarding its use during the prenatal period. The chapter will also add further information to the existing literature regarding the effects of DS on the spinal cord, brain, cerebellum and peripheral nerves.