CNS effects of indomethacin, should patients be cautioned about decreased mental alertness and motor coordination?
Hegeman, Judith × van den Bemt, Bart Weerdesteyn, Vivian Nienhuis, Bart van Limbeek, Jacques Duysens, Jaak #
Blackwell Scientific Publications
British journal of clinical pharmacology vol:75 issue:3 pages:814-21
AIM.: In many European countries as well as in the USA, the leaflet or even the packaging of indomethacin contains a specific warning to refrain from activities requiring mental alertness and motor coordination, such as driving a car. In this placebo-controlled randomized study with cross-over design we attempted to find evidence for that warning. METHODS.: Indomethacin 75mg slow-release or a visually identical placebo with similar flavor was taken in orally twice daily for 2.5 days. It was suggested that indomethacin affects the motor coordination required to successfully avoid obstacles during walking and that this effect will be even stronger when simultaneously performing a cognitive task puts mental alertness to the test. Nineteen healthy middle-aged individuals (60±4.7years, 8 female) performed an obstacle avoidance task on a treadmill), combined with a cognitive secondary task. Biceps femoris (BF) muscle response times, obstacle avoidance failure rates and composite scores ((100xaccuracy)/verbal response time) were used to evaluate the data. RESULTS.: No differences between indomethacin and placebo were found on the outcome measures regarding motor coordination, avoidance failure rates (p=0.81) and BF response times (p=0.47), nor on the performance on the secondary cognitive task (p=0.12). CONCLUSIONS.: Even though surrogate methods were used, the current study provides evidence to suggest that there might be no need to caution patients who experience CNS side effects after indomethacin use to avoid activities requiring quick and adequate reactions, such walking under challenging circumstances and maybe also driving a car.