Not ready for prime time
An accompanying editorial says doctors should "absolutely not" begin prescribing ibuprofen for patients with Parkinson's disease. Why? Because it may be that ibuprofen protects against the "initial insult" that leads to Parkinson's but is useless once symptoms appear, or it may be it's not ibuprofen at all but some separate characteristic of ibuprofen users that actually protects against the condition, explains the lead editorialist, James H. Bower, M.D., associate professor of neurology at the Mayo Clinic in Rochester, Minn. Meanwhile, he says, long-term ibuprofen use comes with the risk of serious side effects. These include irritation and stomach bleeding and increased risk of heart and kidney problems.
In his editorial, Bower compares the findings on ibuprofen to similar observational findings on smoking, caffeine consumption and high blood levels of uric acid, all of which have been associated with lower risk of Parkinson's. Rather than suggest people try these approaches, he says, scientists have incorporated them into research that tests their effect in a safe form and controlled environment.
Mya Schiess, M.D., director of movement disorders and neurodegenerative diseases at the University of Texas Medical School at Houston, says she has followed research on the issue closely, and does recommend ibuprofen for patients who have a sharply increased risk of developing Parkinson's — for example, those with a rare and disruptive problem called rapid eye movement (REM) sleep behavior disorder, in which they act out their dreams.
Schiess says although she screens patients for problems that could make ibuprofen riskier, and watches them for side effects, the amount linked to reduced risk for Parkinson's is generally not dangerous. "This study is based on whether people use ibuprofen a minimum of two times a week, and that's not an excessive amount of medicine," she says. "It's not a daily, scheduled amount of medicine. I would think that that has to be strongly taken into consideration."
Katharine Greider lives in New York and writes about health issues.