Long-Term NSAID Use Linked to Lower Dementia Risk

Be aware of these problems:

What are symptoms of too much ibuprofen long-term?
Long-term effects:

impaired hearing. kidney and liver damage. bleeding in the stomach and bowels. increased risk of heart attack. 

The main types of NSAIDs include:

• ibuprofen.
• naproxen.
• diclofenac.
• celecoxib.
• mefenamic acid.
• etoricoxib.
• indomethacin.
• aspirin for pain relief (low-dose aspirin is not normally considered to be an NSAID)

Long-Term NSAID Use Linked to Lower Dementia Risk

Summary: A new study finds that long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a lower risk of developing dementia. Researchers followed 11,745 adults over 14.5 years and found that those who used NSAIDs long-term had a 12% reduced dementia risk.

However, short- and intermediate-term NSAID use did not provide the same benefit, nor was the total cumulative dose linked to risk reduction. These findings suggest that sustained anti-inflammatory effects may play a role in protecting against dementia.

Key Facts

• Long-Term NSAID Use: Associated with a 12% lower risk of dementia.
• Short-Term Use: No significant protective effect was observed.
• Anti-Inflammatory Role: Findings support inflammation’s role in dementia progression.

Source: Wiley

Past research has suggested that inflammation may contribute to the development and progression of dementia and that non-steroidal anti-inflammatory (NSAID) medications may help protect against dementia due to their anti-inflammatory effects.

Long-term NSAID use was associated with a 12% reduced risk of developing dementia. Short- and intermediate-term use did not provide benefits. Credit: Neuroscience News

A new large prospective study published in the Journal of the American Geriatrics Society provides additional evidence, showing that long-term NSAID use is linked to a decreased risk of developing dementia.

In the population-based study of 11,745 adults with an average follow-up of 14.5 years, 9,520 participants had used NSAIDs at any given time, and 2,091 participants developed dementia. Long-term NSAID use was associated with a 12% reduced risk of developing dementia. Short- and intermediate-term use did not provide benefits.

Also, the cumulative dose of NSAIDs was not associated with decreased dementia risk.

The findings suggest that prolonged, rather than intensive, use of anti-inflammatory medications may help protect against dementia.

“Our study provides evidence on possible preventive effects of anti-inflammatory medication against the dementia process.

“There is a need for more studies to further consolidate this evidence and possibly develop preventive strategies,” said corresponding author M. Arfan Ikram, MSc, MD, PhD, of Erasmus MC University Medical Center Rotterdam, in the Netherlands.

About this neuropharmacology and dementia research news

Author: Sara Henning-Stout
Source: Wiley
Contact: Sara Henning-Stout – Wiley
Image: The image is credited to Neuroscience News

Original Research: The findings will appear in Journal of the American Geriatrics Society

Ibuprofen-based advanced therapeutics: breaking the inflammatory link in cancer, neurodegeneration, and diseases

Nothing here is proven without side effects so don't start taking ibuprofen in hopes of preventing dementia.  Ask your doctor to reconcile these differing results.

The Common Painkiller That Prevents Alzheimer’s Disease - Ibuprofen April 2018 

The latest here.

Ibuprofen-based advanced therapeutics: breaking the inflammatory link in cancer, neurodegeneration, and diseases

Arun Upadhyay, Ayeman Amanullah, Vibhuti Joshi, Rohan Dhiman, Vijay Kumar Prajapati, Krishna Mohan Poluri & show all

Received 01 Feb 2021, Accepted 10 Mar 2021, Published online: 05 Apr 2021

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• https://doi.org/10.1080/03602532.2021.1903488
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Abstract

Ibuprofen is a classical nonsteroidal anti-inflammatory drug (NSAID) highly prescribed to reduce acute pain and inflammation under an array of conditions, including rheumatoid arthritis, osteoarthritis, dysmenorrhea, and gout. Ibuprofen acts as a potential inhibitor for cyclooxygenase enzymes (COX-1 and COX-2). In the past few decades, research on this small molecule has led to identifying other possible therapeutic benefits. Anti-tumorigenic and neuroprotective functions of Ibuprofen are majorly recognized in recent literature and need further consideration. Additionally, several other roles of this anti-inflammatory molecule have been discovered and subjected to experimental assessment in various diseases. However, the major challenge faced by Ibuprofen and other drugs of similar classes is their side effects, and tendency to cause gastrointestinal injury, generate cardiovascular risks, modulate hepatic and acute kidney diseases. Future research should also be conducted to deduce new methods and approaches of suppressing the unwanted toxic changes mediated by these drugs and develop new therapeutic avenues so that these small molecules continue to serve the purposes. This article primarily aims to develop a comprehensive and better understanding of Ibuprofen, its pharmacological features, therapeutic benefits, and possible but less understood medicinal properties apart from major challenges in its future application.

• KEY POINTS

• Ibuprofen, an NSAID, is a classical anti-inflammatory therapeutic agent.

• Pro-apoptotic roles of NSAIDs have been explored in detail in the past, holding the key in anti-cancer therapies.

• Excessive and continuous use of NSAIDs may have several side effects and multiple organ damage.

• Hyperactivated Inflammation initiates multifold detrimental changes in multiple pathological conditions.

• Targeting inflammatory pathways hold the key to several therapeutic strategies against many diseases, including cancer, microbial infections, multiple sclerosis, and many other brain diseases.

 

Can aspirin treat Alzheimer's?

But what about this from April, 2018? Demand your doctor find out which one is better. You do expect your doctor to know this medical stuff down cold, don't you? Or are you giving them a pass just like you gave them a pass on not getting you 100% recovered?

Can You Take Aspirin and Ibuprofen Together? - Healthline

A dangerous combination. Both aspirin and ibuprofen belong to a drug class called nonsteroidal anti-inflammatory drugs (NSAIDs). They have similar side effects, and taking them together increases your risk of these side effects. Aspirin and ibuprofen can cause stomach bleeding, especially if you take too much.

The Common Painkiller That Prevents Alzheimer’s Disease - Ibuprofen April 2018

Can aspirin treat Alzheimer's?

A regimen of low-dose aspirin potentially may reduce plaques in the brain, which will reduce Alzheimer's disease pathology and protect memory, according to neurological researchers at Rush University Medical Center, who published the results of their study today in the July issue of The Journal of Neuroscience.

"The results of our study identifies a possible new role for one of the most widely used, common, over-the-counter medications in the world," said Kalipada Pahan, Ph.D., the study's senior author and lead research investigator, who also is the Floyd A. Davis, MD, Endowed Chair of Neurology and professor of neurological sciences, biochemistry and pharmacology in Rush Medical College.
Alzheimer's disease is a fatal form of dementia that affects up to 1 in 10 Americans age 65 or older. To date, the FDA has approved very few drugs for the treatment of Alzheimer's disease-related dementia and the medications that exist can only provide limited symptomatic relief.
The exact cause of Alzheimer's disease progression is unknown; however, poor disposal of the toxic protein amyloid beta in the brain is a leading mechanism in dementia and memory loss.
Activating the cellular machinery responsible for removing waste from the brain therefore has emerged as a promising strategy for slowing Alzheimer's disease.
Amyloid beta forms clumps called amyloid plaques, which harm connections between nerve cells and are one of the major signs of Alzheimer's disease. Building on previous studies demonstrating a link between aspirin and reduced risk and prevalence of Alzheimer's disease,
Pahan and his colleagues were able to show that aspirin decreases amyloid plaque pathology in mice by stimulating lysosomes—the component of animal cells that help clear cellular debris.

Aspirin treatment reduces amyloid beta burden in the hippocampus of 5XFAD mouse model of AD. Credit: Chandra et al., JNeurosci (2018)

"Understanding how plaques are cleared is important to developing effective drugs that stop the progression of Alzheimer's disease," said Pahan.
A protein called TFEB is considered the master regulator of waste removal. The researchers gave aspirin orally for a month to genetically modified mice with Alzheimer's pathology, then evaluated the amount of amyloid plaque in the parts of the brain affected most by Alzheimer's disease.
They found that the aspirin medications augmented TFEB, stimulated lysosomes and decreased amyloid plaque pathology in the mice.
"This research study adds another potential benefit to aspirin's already established uses for pain relief and for the treatment of cardiovascular diseases," said Pahan. "More research needs to be completed, but the findings of our study has major potential implications for the therapeutic use of aspirin in AD and other dementia-related illnesses."

Explore further: New tools could uncover important answers for Alzheimer's researchers

More information: Sujyoti Chandra et al, Aspirin induces Lysosomal biogenesis and attenuates Amyloid plaque pathology in a mouse model of Alzheimer's disease via PPARα, The Journal of Neuroscience (2018). DOI: 10.1523/JNEUROSCI.0054-18.2018 , dx.doi.org/10.1523/JNEUROSCI.0054-18.2018

Journal reference: Journal of Neuroscience
Provided by: Rush University Medical Center

 

The Common Painkiller That Prevents Alzheimer’s Disease

The previous post on this did not mention the diet needed.
Not to be done for 50 years when all the interactions are known. You likely are taking aspirin already. Ask your doctor what SPECIFIC interventions you need to do to prevent Alzheimers.

Can You Take Aspirin and Ibuprofen Together? - Healthline

A dangerous combination. Both aspirin and ibuprofen belong to a drug class called nonsteroidal anti-inflammatory drugs (NSAIDs). They have similar side effects, and taking them together increases your risk of these side effects. Aspirin and ibuprofen can cause stomach bleeding, especially if you take too much.

The Common Painkiller That Prevents Alzheimer’s Disease

A simple daily regimen of the common painkiller ibuprofen along with dietary adjustments could prevent the onset of Alzheimer’s disease, new research concludes.

Ibuprofen is a widely available nonsteroidal anti-inflammatory that does not require a prescription.

The drug, along with adopting the Mediterranean diet and a healthy intake of antioxidants, could stop the disease in its tracks.

Until recently the problem has been identifying the disease early enough to take action.

Alzheimer’s is thought to begin around 10 years before any cognitive symptoms are noticeable.

The author of the new research, Dr Patrick McGeer (and colleagues), have developed a simple saliva test that can predict the onset of Alzheimer’s.

Dr Patrick McGeer, study co-author, explained:

“Knowing that the prevalence of clinical Alzheimer’s Disease commences at age 65, we recommend that people get tested ten years before, at age 55, when the onset of Alzheimer’s would typically begin.

If they exhibit elevated Abeta 42 levels then, that is the time to begin taking daily ibuprofen to ward off the disease.

Abeta 42 refers to a protein secreted in the saliva that is elevated in people at risk of developing Alzheimer’s.

It could provide the vital clue to start treatment early, Dr McGeer said:

“Unfortunately, most clinical trials to date have focused on patients whose cognitive deficits are already mild to severe, and when the therapeutic opportunities in this late stage of the disease are minimal.

Consequently, every therapeutic trial has failed to arrest the disease’s progression.

Our discovery is a game changer.

We now have a simple test that can indicate if a person is fated to develop Alzheimer’s disease long before it begins to develop. Individuals can prevent that from happening through a simple solution that requires no prescription or visit to a doctor.

This is a true breakthrough since it points in a direction where AD can eventually be eliminated.”

Neuroscientists say daily ibuprofen can prevent Alzheimer's disease

Not to be done for 50 years when all the interactions are known. You likely are taking aspirin already. Ask your doctor what SPECIFIC interventions you need to do to prevent Alzheimers.

Can You Take Aspirin and Ibuprofen Together? - Healthline

A dangerous combination. Both aspirin and ibuprofen belong to a drug class called nonsteroidal anti-inflammatory drugs (NSAIDs). They have similar side effects, and taking them together increases your risk of these side effects. Aspirin and ibuprofen can cause stomach bleeding, especially if you take too much.

https://medicalxpress.com/news/2018-03-neuroscientists-daily-ibuprofen-alzheimer-disease.html

A Vancouver-based research team led by Canada's most cited neuroscientist, Dr. Patrick McGeer, has successfully carried out studies suggesting that, if started early enough, a daily regimen of the non-prescription NSAID (nonsteroidal anti-inflammatory drug) ibuprofen can prevent the onset of Alzheimer's disease. This means that by taking an over-the-counter medication, people can ward off a disease that, according to Alzheimer's Disease International's World Alzheimer Report 2016, affects an estimated 47 million people worldwide, costs health care systems worldwide more than US$818 billion per year and is the fifth leading cause of death in those aged 65 or older.

The Alzheimer's Association estimates that there are more than 5 million cases in the United States alone, with a new case being identified every 66 seconds. The annual cost to the country in 2017 is estimated have been $259 billion, with that figure predicted to potentially rise to $1.1 trillion by 2050.

Dr. McGeer, who is President and CEO of Vancouver-based Aurin Biotech, and his wife, Dr. Edith McGeer, are among the most cited neuroscientists in the world. Their laboratory is world-renowned for their 30 years of work in neuroinflammation and neurodegenerative diseases, particularly Alzheimer's disease. A paper detailing Dr. McGeer's most recent discoveries were published Friday in the prestigious Journal of Alzheimer's Disease.

In 2016, Dr. McGeer and his team announced that they had developed a simple saliva test that can diagnose Alzheimer's disease, as well as predict its future onset. The test is based on measuring the concentration of the peptide amyloid beta protein 42 (Abeta42) secreted in saliva. In most individuals, the rate of Abeta 42 production is almost exactly the same regardless of sex or age. However, if that rate of production is two to three times higher, those individuals are destined to develop Alzheimer's disease. That is because Abeta42 is a relatively insoluble material, and although it is made everywhere in the body, deposits of it occur only in the brain, causing neuroinflammation, which destroys neurons in the brains of people with Alzheimer's disease.

Contrary to the widely held belief that Abeta 42 is made only in the brain, Dr. McGeer's team demonstrated that the peptide is made in all organs of the body and is secreted in saliva from the submandibular gland. As a result, with as little as one teaspoon of saliva, it is possible to predict whether an individual is destined to develop Alzheimer's disease. This gives them an opportunity to begin taking early preventive measures such as consuming non-prescription non-steroidal drugs (NSAIDs) such as ibuprofen.

"What we've learned through our research is that people who are at risk of developing Alzheimer's exhibit the same elevated Abeta 42 levels as people who already have it; moreover, they exhibit those elevated levels throughout their lifetime so, theoretically, they could get tested anytime," says Dr. McGeer. "Knowing that the prevalence of clinical Alzheimer's Disease commences at age 65, we recommend that people get tested ten years before, at age 55, when the onset of Alzheimer's would typically begin. If they exhibit elevated Abeta 42 levels then, that is the time to begin taking daily ibuprofen to ward off the disease.

"Unfortunately, most clinical trials to date have focused on patients whose cognitive deficits are already mild to severe, and when the therapeutic opportunities in this late stage of the disease are minimal. Consequently, every therapeutic trial has failed to arrest the disease's progression. Our discovery is a game changer. We now have a simple test that can indicate if a person is fated to develop Alzheimer's disease long before it begins to develop. Individuals can prevent that from happening through a simple solution that requires no prescription or visit to a doctor. This is a true breakthrough since it points in a direction where AD can eventually be eliminated."

Explore further: Personality changes during transition to developing mild cognitive impairment

More information: Patrick L. McGeer et al, Conquering Alzheimer's Disease by Self Treatment, Journal of Alzheimer's Disease (2018). DOI: 10.3233/JAD-179913

Journal reference: Journal of Alzheimer's Disease

NSAIDs: A Risky Addition to Post-MI Antithrombotics

Ok, a very very serious question for your doctor. What should be done about NSAIDs post stroke? Since they might be helpful for recovery.
Common Medicine Helps Repair Brain After Stroke, Study in Rats Suggests - Ibuprofen

NSAIDs: A Risky Addition to Post-MI Antithrombotics

Over-The-Counter Drug Used To Cure Cold And Fever Could Hold Key To A Longer Life - Ibuprofen

I sure you don't really want to trust that the effect in worms translates to humans without a bunch of testing.
These other uses of ibuprofen make for interesting consideration by your doctor.

Nasal NSAIDs for Alzheimer's Disease

FDA revisits heart risks with NSAIDs

High-Dose NSAIDs Hike Risk of Heart Attack and Stroke

Common Medicine Helps Repair Brain After Stroke, Study in Rats Suggests

 

 Over-The-Counter Drug Used To Cure Cold And Fever Could Hold Key To A Longer Life - Ibuprofen

 

 

How To Live Longer: Regular Low Doses Of Ibuprofen Found To Extend The Lives Of Animals By 15 Percent

Do not do this. Only in animals.
http://www.medicaldaily.com/how-live-longer-regular-low-doses-ibuprofen-found-extend-lives-animals-15-percent-314876
What’s orange, may be able to extend your life, and is probably already in the back of your medicine cabinet? Ibuprofen. A recent study found that regular small doses of the pill extended the lives of animal subjects by up to 15 percent. Not only did the animals live longer, but they also lived healthier, and scientists believe the same effect could be seen in humans.
In the study, scientists gave a number of species doses of ibuprofen that would be comparable to the recommended human dose. They first began their tests on baker’s yeast, but then moved on to worms and flies. Results showed that over time this extended the test subjects’ lives by 15 percent, which when translated into human life is about an extra dozen years of life.
"We are not sure why this works, but it's worth exploring further," explained Dr. Michael Polymenis, one of the collaborating researchers who had taken part on the study, in a press release.
Ibuprofen interferes with the ability of yeast cells to pick a universal amino acid called tryptophan. This molecule is essential for human life, and ibuprofen’s effect on it results in longer healthier lives.  
While the findings are exciting, Polymenis explained to Medical Daily in an email that he did not recommend anyone take ibuprofen regularly without first consulting a physician.
“We just need more research to examine and understand these properties,” Polymenis said.
This study was the first to show that relatively safe drugs are capable of extending lifespans, and according to Polymenis, ibuprofen may not be the only drug with this unique capability.
“This study was a proof of principle to show that common, relatively safe drugs in humans can extend the lifespan of very diverse organisms. Therefore, it should be possible to find others like ibuprofen with even better ability to extend lifespan, with the aim of adding healthy years of life in people," Polymenis said.
Ibuprofen is a nonsteroidal anti-inflammatory drug. It was first created in England in the 1960s and is listed on the World Health Organization’s “list of essential medication.” The drug is used to reduce fever and treat pain or inflammation. It’s commonly used as a quick and easy treatment for minor ailments such as headaches, toothaches, back pain, arthritis, and menstrual cramps.
“Our institute is interested in finding out why people get sick when they get old. We think that by understanding those processes, we can intervene and find ways to extend human health span, keeping people healthier longer and slowing down aging. That's our ultimate goal," concluded Dr. Brian Kennedy, CEO of the Buck Institute, in the press release.

Nasal NSAIDs for Alzheimer's Disease

This could just be a continuation of your stroke therapy.
Common Medicine Helps Repair Brain After Stroke, Study in Rats Suggests
If your competent? doctor has any understanding of research and is willing to try something to save your neurons from dying. 

Nasal NSAIDs for Alzheimer's Disease

1. Steven Lehrer, MD1⇑

1. ¹Fermata Pharma, Inc, New York, NY, USA

1. Steven Lehrer, MD, Fermata Pharma, Inc, 30 West 60th Street, New York, New York 10023, USA. Email: steven@fermatapharma.com

Abstract

Alzheimer’s disease may result from low-grade inflammation of the brain, and the characteristic amyloid β may be a protective response. Epidemiological observation indicates that long-term oral administration of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to patients having rheumatoid arthritis results in reduced risk and delayed onset of Alzheimer's disease. However, oral ibuprofen, flurbiprofen, and other NSAIDs are not an effective treatment. The NSAIDs may work as an Alzheimer’s preventive but not a treatment because the oral dose to the brain is too small, 1% to 2% of the total plasma concentration. The NSAID brain dose could be significantly increased by delivering the drug intranasally. Flurbiprofen would be preferable to ibuprofen because flurbiprofen has 12½ times the potency of ibuprofen. The smaller nasal dose of flurbiprofen than ibuprofen could significantly increase patient compliance. Alzheimer’s disease starts in the entorhinal cortex, which is closely connected to the olfactory nerves, and spreads anatomically in a defined pattern. Therefore, a nasal NSAID would readily reach the region of the brain where it is most likely to be therapeutic.

FDA revisits heart risks with NSAIDs

Ibuprofen is one of them. What does your doctor think of using them for immediate therapy after the stroke compared to these identified problems.  Of course this is in rats so your doctor can just dismiss it out of hand. Don't follow my ideas, I however will be insisting I get this. I plan on saving as many neurons as possible even if my doctor knows nothing about how to do that.

Common Medicine Helps Repair Brain After Stroke, Study in Rats Suggests

My list of 31 things I will insist I get after my next stroke

http://www.clinicaladvisor.com/fda-revisits-heart-risks-with-nsaids/article/333458/?

Reducing fever after a stroke with acetoaminophen

Interesting idea, who is going to compare this to giving ibuprofen  immediately after a stroke?  I bet no one will thus leaving more neurons to die.
http://www.tele-management.ca/2013/08/reducing-fever-after-a-stroke/
Giving acetoaminophen after a stroke lowers body temperature and this may improve the outcome.
Previous research has suggested that patients who develop a fever after stroke may suffer more brain damage. So it may be that reducing fever, with medication, could improve the outcome.

Rest at link.

High-Dose NSAIDs Hike Risk of Heart Attack and Stroke

Be careful out there.
http://www.medpagetoday.com/PainManagement/PainManagement/39457?
High doses of some commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) increased the risk of major vascular events by about a third, according to a new meta-analysis of clinical trials.
The increase -- mainly driven by a higher risk of myocardial infarction -- is similar to that seen with selective COX-2 inhibitors, or coxibs, according to Colin Baigent, MD, of the University of Oxford, and colleagues.
But the analysis suggests the size of the risk can be predicted, which could assist doctors and patients in making clinical decisions, the researchers reported online in The Lancet.
High-dose NSAIDs, widely used to manage pain in inflammatory disorders, have been linked previously with an increased risk of gastrointestinal complications.
The coxibs -- a newer generation of NSAIDs -- were developed to reduce gastrointestinal side effects, but were found to increase the risk of heart attacks and death.
But the vascular effects of the traditional NSAIDs -- diclofenac, ibuprofen, and naproxen at respective doses of 150, 2,400, and 1,000 mg daily -- has not been clear.
To help fill the gap, Baigent and colleagues in the Coxib and traditional NSAID Trialists' Collaboration undertook a meta-analysis of 639 trials of coxibs and traditional NSAIDs compared with each other or with placebo. The coxibs under study were mainly mainly celecoxib (Celebrex), rofecoxib (Vioxx), etoricoxib (Arcoxia), and lumiracoxib (Prexige).
The main outcomes were major vascular events, including non-fatal MI, non-fatal stroke, or vascular death, as well as major coronary events, stroke, mortality, heart failure, and upper gastrointestinal complications.
All told, the trials included more than 353,000 participants with patient-level data available for many of the studies.
The analysis showed:

• Major vascular events were increased by about a third by a coxib, where the rate ratio was 1.37 (95% CI 1.14-1.66, P=0.0009).
• The same was true for diclofenac: the rate ratio was 1.41 (95% CI 1.12-1.78, P=0.003).
• The increases were chiefly due to more major coronary events. The rate ratio for such events for coxibs was 1.76 (P=0.0001), while the ratio for diclofenac was 1.70 (P=0.003).
• Ibuprofen significantly increased major coronary events -- the rate ratio was 2.22 (95% CI 1.10 to 4.48, P=0.0253) -- but not major vascular events.
• Naproxen did not significantly increase major vascular events or vascular deaths.

Heart failure risk was roughly doubled by all NSAIDs and all NSAID regimens increased upper GI complications, with rate ratios of 1.81 for coxibs, 1.89 for diclofenac, 3.97 for ibuprofen, and 4.22 for naproxen.
Compared with placebo, Baigent and colleagues reported, the effect of coxibs or diclofenac was to slightly increase the risk of vascular events. For every 1,000 patients treated with either, rather than a placebo, there were three extra major vascular events, one of which was fatal.
On the positive side, high-dose naproxen seemed to be associated with less hazard, although it's "unclear" if that's true of the lower doses most commonly used in clinical practice, they reported.
"Whilst NSAIDs increase vascular and gastrointestinal risks to a varying extent," Baigent said in a statement, "our analyses indicate that the effects of different regimens in particular patients can be predicted, which may help physicians choosing between alternative NSAID regimens to weigh up which type of NSAID is safest in different patients."
Indeed, the analysis "offers considerable certainty" about the risks of high doses of commonly used NSAIDS, commented Marie Griffin, MD, of Vanderbilt University Medical Center in Nashville.
But in an accompanying commentary, Griffin argued that the study has some major gaps -- the risks associated with lower doses, longer durations of use, and residual effects after stopping treatment.
Clinical trials are not the whole story, she noted, and information to help fill those gaps might be found in observational studies.
But the bottom line, Griffin wrote, is that "identification of safe and effective strategies for chronic pain is sorely needed."
Until those are worked out, she concluded, "long-term use of high-dose NSAIDs should be reserved for those who receive considerable symptomatic benefit from the treatment and understand the risks."

Arthritis painkillers raise stroke, heart attack risk by more than a third, landmark study suggests

So ask your doctor which of these risk reduction ideas will counteract the use of these painkillers. You do expect your doctor to know this, don't you?
http://life.nationalpost.com/2013/05/30/arthritis-painkillers-raise-stroke-heart-attack-risk-by-more-than-a-third-landmark-study-suggests/
Millions of arthritis sufferers could be increasing their risk of a heart attack or stroke by more than a third by taking large doses of drugs such as ibuprofen, according to one of the largest studies into painkillers.
The study of more than 350,000 patients taking prescription doses of such medications found the chance of a heart attack or stroke rose by almost 40%.
The research found that the greater risk of cardiac side-effects from ibuprofen was similar to those of another arthritis drug, Vioxx, which was withdrawn from the market almost a decade ago when research suggested it might double the risk of heart attacks.

The painkillers were also found to double the risk of heart failure and bleeding ulcers when taken in high quantities

The painkillers, which are known as non-steroidal anti-inflammatory drugs (NSAIDs) and taken by millions of arthritis sufferers each day, were also found to double the risk of heart failure and complications such as bleeding ulcers when taken in high quantities.
The authors of the University of Oxford study said that their findings showed that prolonged use of such medicines was “risky”, but added that patients needed to weigh up the benefits against the potential dangers.
More than seven million people in Britain suffer from rheumatoid arthritis and osteoarthritis, and many rely on high doses of NSAIDs, which are also sold in lower quantities over the counter for common ailments.
The study, published in The Lancet, found that for every 1,000 people with a moderate risk of heart disease, about eight would normally have a heart attack or stroke each year.
When similar patients were given a year of treatment with a high dose of ibuprofen (2,400 milligrams daily) or another NSAID called diclofenac (150mg daily), that risk rose, with 11 patients suffering major cardiac events.
One in three of the extra heart attacks was fatal, the study found.
The same dosage, which is the maximum normally prescribed and twice the amount allowed over the counter, more than doubled the risk of heart failure from three cases in 1,000 to seven, and more than doubled the risks of complications such as bleeding ulcers.
If all seven million people with arthritis took the highest dosage of drugs, it would equate to an estimated 21,000 more heart attacks in sufferers, the study suggested.

‘We are trying to say yes, these drugs are risky, but it may be worth it’

Researchers said the study, funded by the Medical Research Council and the British Heart Foundation and led by the council’s unit at Oxford, had looked at the risks from common painkillers in “unprecedented detail.”
The lead author, Colin Baigent from the University of Oxford, said: “The research shows that, when used in high doses, diclofenac and ibuprofen increase the risk of cardiovascular disease, on average causing about three extra heart attacks a year in every 1,000 patients treated, one of which would be fatal.”
He added: “For many people who take these drugs for severe arthritis they make the difference between being able to go about their daily life or not. We are trying to say yes, they are risky, but it may be worth it.”
The findings, from an analysis of 639 randomized trials, found that a third drug, called naproxen, did not increase the risk of heart attacks or strokes when a high dose of 1,000mg a day was taken.
The study found that it was the most likely of the medications to cause bleeding from the stomach, but researchers said such problems were normally less serious.
Researchers said the cardiac risks from ibuprofen and diclofenac were “mainly relevant” to people with arthritis who were prescribed high doses or long periods. “A short course of lower dose tablets purchased without a prescription, for example, for a muscle sprain, is not likely to be hazardous,” said Prof Baigent.
Last year almost 17 million prescriptions were written by doctors in England for NSAIDs. About a third were for ibuprofen, a third for diclofenac and about a sixth for naproxen.
Alan Silman, the medical director of Arthritis Research UK, urged arthritis sufferers not to be “unduly concerned,” but said family doctors were turning increasingly to naproxen because of the potential cardiac risks of the other medications. He said: “There is an urgent need to find alternatives that are as effective, but safer.”
Dr. Shannon Amoils, research advisor at the BHF, said: “People should take the lowest effective dose of these drugs for the shortest time necessary.”

What I am going to insist I get after my next stroke

This is totally not to be followed. Your doctors advice needs to be followed even though they are doing nothing to stop the neuronal cascade of death. Assisting by inaction in the death of your neurons. None of these have any human clinical trial proof so  don't expect an easy time getting your doctor to listen to you.  I want the kitchen sink thrown at saving my neurons.

Your doctor better have something similar planned and you need to demand the protocol now.  Winging it is not appropriate medical practice.

Better yet, Ask your doctor what they would do in the first week to save neurons for their stroke, if they don't have anything to say, get rid of them as a doctor.

I'm going to have to get a medic alert bracelet with this URL engraved.

0. Ambulance ride - hypothermia applied

  Have them stop at that frozen lake and dunk you in it.

Study of Brain Cooling and Clot-Busting Drug Therapy for Stroke Receives FDA OK to Expand 

February 2013

0.1  blood pressure cuffs in the ambulance ride

http://oc1dean.Can Blood-Pressure Cuffs Work? Novel Ways to Limit Stroke Damage 

December 2012

1. Statins.

tested in rats from 2003

http://Statins induce angiogenesis, neurogenesis, and synaptogenesis after stroke Statins induce angiogenesis, neurogenesis, and synaptogenesis after stroke  

Simvastatin Attenuates Stroke-induced Splenic Atrophy and Lung Susceptibility to Spontaneous Bacterial Infection in Mice

Or,

Simvastatin attenuates axonal injury after experimental traumatic brain injury and promotes neurite outgrowth of primary cortical neurons 

October 2012

tested in humans, March, 2011

http://www.medwirenews.com/39/91658/Stroke/Acute_statin_therapy_improves_survival_after_ischemic_stroke.html

And now lost even to the Wayback Machine

So I think this below is the actual research;

Association Between Acute Statin Therapy, Survival, and Improved Functional Outcome After Ischemic Stroke April 2011

 

2. Fish oil.

     either by injection

Fish oil ‘may help stroke patients’

March 2013

     or a feeding tube

Fish oil for brain injuries - TBI 

October 2012

3.  Leg compressions

Leg compressions may enhance stroke recovery 

August 2012

4. anti-depressants -  real ones

Scottish News Stroke study into antidepressants

December 2012

5. music listening

music listening and stroke rehab 

March 2011

6. Sensation overload

   the human equivalent of rat whisker stimulation.

Mild Sensory Stimulation Completely Protects the Adult Rodent Cortex from Ischemic Stroke 

May 2012

7. Coffee - I want many cups a day, where is 24 hour a day coffee station?

Coffee may help perk up your blood vessels

    reduce my dementia chances

delay my Alzheimers chances

reduce my Parkinsons risk

8. CerAxon

Introducing CerAxon®, the First & Only Oral Solution Medical Food for Dietary Management of Brain Ischemia in Patients With Partially Impaired Swallow

October 2011

Bobs' use of it from Pink House on the Corner.

CerAxon: The Verdict is In

9.  Peptide application

Tarix Pharmaceuticals' Peptide Technology Stimulates Revascularization Following Ischemia 

March 2013

10. Action observation

 Videos of everything from walking, running, jumping to finger ballet, baseball throwing, piano playing, eating. Every minute of the day not spent in traditional rehab should be watching videos, including during meals, that would work on multitasking.

a.  Clinical Relevance of Action Observation in Upper-Limb Stroke Rehabilitation 

May 2012

b.  Action observation and mirror neuron network: a tool for motor stroke rehabilitation

April 2012

c.  The Impressionable Brain and mirror neurons

May 2011

d.  Action observation of walking/running 

May 2012

11.  bFGF administered intravenously

Potential Usefulness of Basic Fibroblast Growth Factor as a Treatment for Stroke

March 2013

12. Viagra - Ladies, I don't know how you're going to convince your doctor why you need this, maybe say its for your spouse and you want to make sure your lady parts are still working. Only tested in rats.

viagra and stroke rehab 

March 2011

13.  Training in lucid dreaming.

Scientists Measure Dream Content for the First Time: Dreams Activate the Brain in a Similar Way to Real Actions 

July 2012

14.  Eptifibatide

Study of the Combination Therapy of Rt-PA and Eptifibatide to Treat Acute Ischemic Stroke (CLEAR-ER)

February 2013

15.  dietary olive leaf extract

Effect of dietary olive leaf extract on brain cholesterol, cholesterol ester and triglyceride levels and of brain edema in rat stroke model

January 2013

16. ebselen - neuroprotective treatment? within 48 hours

ebselen - neuroprotective treatment? 

December 2012

17.  diabetes drug linagliptin

Diabetes drug may reduce brain damage after stroke

December 2012

18. Etazolate, an α-secretase activator

Etazolate, an α-secretase activator, reduces neuroinflammation and offers persistent neuroprotection following traumatic brain injury in mice 

November 2012

19.  Glibenclamide - administered intravenously 6, 12, and 24 hours after reperfusion

Glibenclamide enhances neurogenesis and improves long-term functional recovery after transient focal cerebral ischemia 

November 2012

20.   Paeoniflorin (PF) - PF treatment for 14 days

Paeoniflorin Protects against Ischemia-Induced Brain Damages in Rats via Inhibiting MAPKs/NF-κB-Mediated Inflammatory Responses 

November 2012

21.  administration of nontoxic carbon particles 

Halting Brain Injury

October 2012

22.  Ibuprofen

Common Medicine Helps Repair Brain After Stroke, Study in Rats Suggests 

October 2012

23.  Ceria nanoparticles

Ceria nanoparticles could lessen the damage from ischemic strokes

September 2012

24.  Head-of-Bed Optimization of Elevation

HOBOE (Head-of-Bed Optimization of Elevation) Study: association of higher angle with reduced cerebral blood flow velocity in acute ischemic stroke

May 2012

25.   antibiotic minocycline

Antibiotic may be new stroke treatment 

May 2012

26.   neurotransmitter precursor levodopa

Early Promise For Stroke Patients Given - levodopa

May 2012

27.   Inhalation of nitric oxide

Inhalation of nitric oxide could help improve blood flow to ischemic brain 

March 2012

28.  old flu drug amantadine

Study: Old flu drug speeds brain injury recovery 

February 2012

29.  Melatonin 

Melatonin ameliorates neural function by promoting endogenous neurogenesis through MT2 melatonin receptor in ischemic stroke mice

February 2012

and

Melatonin improves neuroplasticity by upregulating the growth-associated protein 43 (GAP-43) and NMDAR-post-synaptic density-95 (PSD95) proteins in cultured neurons exposed to glutamate excitotoxicity and in rats subjected to transient focal cerebral ischemia even during a long-term recovery period 

December 2013

30.   opiate antagonists — Effects of exogenous antagonists and dynorphin 1–13  - damn this war on drugs

Treatment of stroke with opiate antagonists — Effects of exogenous antagonists and dynorphin 1–13 

January 2012

I don't give a damn if this is considered practicing medicine, anything else is criminally negligent.

I challenge anyone at the Joint Commission/WSO to come up with something better. Anyone willing to take up that challenge? I will post an unedited reply.