In the last 12 months, several articles have come out that have forced neurologists to seriously reconsider their basic understanding of vegetative states and coma.

From the March 2007 issue of Annals of Neurology, we have yet another article detailing the little understood yet dramatic effects Zolpidem (Ambien) can have on patients with severe hypoxic-ischemic brain injury (i.e., as is typically seen in cardiac arrest when there is a lack of blood flow and oxygen to the brain).

From the EurekAlert:

…researchers conducted a study of a 48 year-old woman who developed akinetic mutism due to oxygen deprivation to her brain following an attempted suicide by hanging. The patient was totally dependent, unable to speak or walk, and was using a feeding tube for nourishment, although she was able to understand single words. Two years after the suicide attempt, she was given zolpidem for a bout of insomnia; 20 minutes later, she was able to communicate to her family, eat by herself, and move. These effects lasted for up to three hours.

Ironically, Zolpidem (Ambien) is a widely prescribed sleeping pill.

The near-miraculous effects this drug can have on patients with severe brain injury were discussed in this earlier Smarkit article.

Reference: "Clinical and Imaging Evidence of Zolpidem Effect in Hypoxic
Encephalopathy," Christine Brefel-Courbon, Pierre Payoux, Fabienne Ory,
Agnes Sommet, Tarik Slaoui, Gaelle Raboyeau, Beatrice Lemesle, Michele Puel, Jean Louis Montastruc, Jean-Francois Demonet, Dominique Cardebat, Annals of Neurology, March 2007

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A number of case reports have cropped up recently documenting an absolutely shocking discovery:

Zolpidem, a common sleeping pill, can miraculously awaken some patients from a Persistent Vegetative State or “semi-coma”.

“Across three continents, brain-damaged patients are reporting remarkable improvements after taking a pill that should make them fall asleep but that, instead, appears to be waking up cells in their brains that were thought to have been dead”.The remarkable story of this rather common pill can be found here.

From an article SA Fam Pract 2005;47(3):49-50 “There is increasing evidence for an important role of zolpidem in the treatment of the sequelae of a wide range of brain pathology, based on its reversal of dormant neural tissue after brain damage. A number of brain injured patients may benefit from this treatment”.

From an article published in the journal Neurorehabilitation (2006): Zolpidem appears an effective drug to restore brain function to some patients in the permanent vegetative state.

This is a stunning development in the field of neurology. Chances are most neurologists aren’t familiar with these new developments. If you have family members or friends that have suffered severe brain injury, you may want to bring this to your doctor’s attention.

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