Peripheral nerve system and nonsteroidal anti-inflammatory drugs: molecular, morphological, and clinical approaches

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) show its action by inhibiting the enzyme cyclooxygenase (COX); reduce pain and fever and stop inflammation at higher doses. Often, they may show cardiotoxic and renal side effects, notably on gastrointestinal system. Beside of them, it has also neurotoxic effects on the central and peripheral nervous system. Diclofenac sodium (DS), an NSAID drug, is a non-selective COX inhibitor. Experimental studies have pointed out various antioxidants against DS-based neurotoxicity occurring in the central and peripheral nervous system. Although the side effects of these drugs, they are often preferred for the treatment of peripheral neuropathic pain. Recent studies suggest that combinations with other types of drugs would be more effective in the treatment of neuropathic pain. In addition, current studies tend to explore the role of new herbal-derived pharmaceutical molecules in the treatment of neuropathic pain. In this regard, there are no enough clinical and experimental studies that are controversial on the effectiveness and safety of herbal-based treatments. In this chapter, it was aimed to discuss the effect of NSAIDs on the neuropathic pain and sciatic nerve morphology in terms of molecular, experimental, and clinical approaches, considering the pharmacological properties and side effects of NSAIDs.