A new large-scale UK study suggests that some widely used medications, including common painkillers, may not only alleviate physical symptoms but could also influence brain performance. Conducted by researchers at University College London (UCL), the study analysed data from over half a million individuals and found that ibuprofen could support cognitive function, with improvements in memory and reaction times.

Anti-Inflammatories and Cognitive Function

Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) used to treat pain, fever, and inflammation, was associated with enhanced reaction speed and cognitive performance. Researchers noted that the effect size of ibuprofen and cognitive function was comparable to the benefits of managing high blood pressure – already known to support brain health.

Other pain-relieving medications including aspirin, codeine, and diclofenac were also associated with improved scores on tests of memory, reasoning, and problem-solving. Additionally, drugs such as omega-3 triglycerides (used in cardiovascular care), glucosamine (for osteoarthritis), atorvastatin (for cholesterol), and proton pump inhibitors like omeprazole and lansoprazole showed positive links to cognition.

Cognitive Risks: Paracetamol and Antidepressants

In contrast, paracetamol (acetaminophen) and fluoxetine (an SSRI antidepressant) were linked with poorer cognitive test performance. This is significant given their widespread and long-term use.

Amitriptyline, a tricyclic antidepressant prescribed for migraines and chronic pain, was associated with the most substantial negative impact on cognition among the drugs analysed.

Study Design and Limitations

The study, published in Brain and Behaviour, is observational and does not establish causality. Researchers analysed medical and prescription data from over 540,000 adults up to age 73, comparing cognitive performance in users and non-users of common drugs. Tests assessed reaction time, memory, reasoning, and problem-solving.

While the associations between ibuprofen and cognitive function are intriguing, the authors urge caution. Cognitive outcomes are influenced by age, comorbidities, and polypharmacy. Many drugs studied are more often prescribed to older patients, making it difficult to separate drug effects from age-related decline.

Why Include Cognitive Assessments in Drug Trials?

The findings highlight the importance of including cognitive outcomes in clinical trials of widely used medications. Lead author Dr Martin Rossor emphasised that cognitive side-effects – both positive and negative – should be considered in clinical decision-making:

“Medications are widely employed, and many have adverse cognitive effects. Consideration should be given to a routine assessment of cognition in trials,” Rossor noted.

Clinical Implications of Ibuprofen and Cognitive Function

For clinicians, the study is a reminder to:

  • Monitor cognitive symptoms in patients on long-term medications

  • Factor cognitive impacts into benefit-risk assessments

  • Stay updated on emerging evidence around drug-cognition interactions, particularly in ageing populations

With nearly half of dementia cases considered preventable through modifiable risk factors, the relationship between ibuprofen and cognitive function offers a promising avenue for future research.

For more on drug-related impacts on brain health, see the Alzheimer’s Society.

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