Aspirin: a neuroprotective agent at high doses?

Aspirin, acetylsalicylic acid, is routinely used in clinics as an analgesic, antipyretic and in the secondary prevention of stroke. These effects are caused by low doses of the drug (0.3-3.6 g/day) through the inhibition of cyclo-oxygenase, the enzyme responsible for prostaglandin synthesis. Higher doses of aspirin (4-6 g/day) are used in the treatment of inflammatory conditions such as rheumatoid arthritis and recent laboratory findings suggest that it could play a role in neuroprotection against glutamate excitotoxicity. This article reviews the possible mechanisms of action of high-dose aspirin in neuroprotection.