Which NSAID may cause an increase in nervousness?

Tolmetin is an NSAID that carries a unique side effect profile among the options. While NSAIDs primarily work by inhibiting cyclooxygenase (COX) enzymes to reduce inflammation and pain, they can also have central nervous system (CNS) effects due to their impact on various neurochemical pathways. In some cases, especially with certain individuals or at higher dosages, tolmetin has been associated with increased nervousness or anxiety.

The specific chemical structure and pharmacology of tolmetin may influence these CNS effects differently than other NSAIDs, which typically have a minimal impact on mental states. This is important when considering a patient's overall health and how they may respond to pain management therapies. Understanding the side effects of medications like tolmetin can guide clinicians in making informed decisions tailored to individual patient needs.

In contrast, while ibuprofen, ketorolac, and naproxen are effective NSAIDs, they are less commonly related to increases in nervousness, as their side effect profiles focus more on gastrointestinal issues or renal function.