[lit-ideas] Now THIS is interesting!

  • From: JimKandJulieB@xxxxxxx
  • To: lit-ideas@xxxxxxxxxxxxx
  • Date: Sat, 3 Jun 2006 12:11:17 EDT


Sleeping  pill may rouse coma patients
12:39 24 May 2006 
NewScientist.com news  service 
Roxanne Khamsi 

A drug used to treat insomnia has  paradoxically helped temporarily rouse 
three men who were each in a vegetative  state following motor accidents, 
researchers claim. They believe that zolpidem  (marketed as Ambien) activates 
cells in the brain. 
But experts  caution that the patients may not have been in a permanent 
vegetative state  (PVS), and that the men may simply have shown signs of 
The  initial discovery that zolpidem could benefit patients of severe brain 
trauma  came about accidentally, according to Ralf Clauss, who led the study at 
the  Royal Surrey County Hospital in Guildford, UK. He and colleagues 
reported in  2000 that the drug seemed to help restore partial consciousness, 
least  temporarily.
Their new study details the effects of the drug in three  patients, all of 
whom have been in a PVS for at least three years. People in  this state may 
regular sleep cycles but do not show detectable awareness.  The men received 
daily doses of zolpidem for up to 6 years.

Before  treatment with the drug, Patient L did not respond to any commands 
and showed no  signs of language comprehension. According to Clauss, after 
taking his first, 10  milligram dose of zolpidem the patient could meaningfully 
interact with family,  friends and strangers. He could name his favourite rugby 
player and make simple  calculations.
The effects of the drug seemed to last for approximately 4  hours, after 
which Patient L would relapse into the vegetative state.
Patient  N, who had been in a vegetative state for three years following a 
motor vehicle  accident, showed no signs of language comprehension and was 
constantly  screaming. With the drug he stopped screaming and appeared to react 
appropriately to scenes on television, laughing at funny moments.
Before  taking zolpidem, Patient N scored 6 out of a possible 15 points on 
the Glasgow  Coma Scale, a measure of responsiveness. With the medication, his 
score improved  to 10. A coma score of 13 or higher correlates with mild brain 
injury while a  score of 8 or less is generally considered severe brain injury.
The third  man, Patient G, showed no response to language prior to drug 
treatment but could  count to five after receiving the medication, the 
write. His score  on the Glasgow Coma Scale improved temporarily from 9 to 14 
All three  patients have received daily doses of the drug since the study  

Clauss and his colleagues have applied for a usage patent of  zolpidem in 
brain damage. He says that drugs such as zolpidem, manufactured by  
Sanofi-Aventis, activate receptors for the neurotransmitter gamma aminobutyric  
acid (GABA) 
in the brain. 
According to the researchers, brain injury may  alter GABA receptors, causing 
regions of the brain to remain dormant. They  speculate that zolpidem could 
possibly, temporarily, reverse this  change.
Other experts stress, however, that people are sometimes misdiagnosed  as 
being in a permanent vegetative state. Mike Barnes, professor of neurological  
rehabilitation at the Hunters Moor centre in Newcastle, told the BBC: "A  
diagnosis of PVS means the patient should not wake up and respond." 
An  article published in the British Medical Journal in 1996 (vol 313, p 13) 
found  that 43% of 40 patients were considered misdiagnosed with the 
condition. Only  13% of the patients remained vegetative, the study reported. 
Journal  reference: NeuroRehabilitation (vol 21, p 23)  

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  • » [lit-ideas] Now THIS is interesting!