A paradoxical pill after brain damage

The New York Times has a fascinating article about how brain damaged people in the ‘minimally responsive state’ can become more alert, curiously, after being given a type of sleeping pill.

The drug is called zolpidem and occasional case reports of it increasing alertness in poorly responsive neurological patients have been kicking around for some years. We reported on an early case back in 2006.

It must be said that there is still very research little in this area – some scattered case studies and a trial that recruited just three children, so I’m not sure about the wisdom of the ‘A Drug That Wakes the Near Dead’ headline.

However, the article reports on ongoing research and has a video showing the marked effect on one patient diagnosed with ‘minimally conscious state’ or MCS.

This year, scientists at Moss Rehabilitation Research Institute and at the University of Pennsylvania, both in the Philadelphia area, began the first large-scale clinical study of zolpidem as a treatment for disorders of consciousness. (Amantadine, a drug used to treat Parkinson’s disease, and the anti-anxiety medication Ativan also show promise in increasing awareness in minimally conscious patients.) So far, the evidence suggests that less than 10 percent of brain-injured patients will experience the drug’s paradoxical effects, and that among those, only a few will respond as profoundly as Viljoen did. For families like the Coxes, such odds provide a tortured kind of hope. For doctors, they bring questions. Why does a sleeping pill induce awareness in some patients but not others? And what can these bizarre awakenings tell us about the brain’s ability to heal?

A fascinating article on a curious, if limited, effect. Don’t miss the video.
 

Link to NYT article on zolpidem and brain injury.

2 Comments

  1. The Sleeper Awakens
    Posted December 2, 2011 at 7:29 am | Permalink

    Maybe the “sleeping” damaged brain is caught in a compensatory loop from which it cannot escape until given certain medications. Review the video of TED talk “A Stroke of Insight”. The afflicted neurologist describes incredible pressure to sleep and attributes her mother’s acceptance of this need to her eventual healing. She notes that sleeping in this intense way would not be possible in a hospital.

  2. Joss
    Posted December 16, 2011 at 6:36 pm | Permalink

    I find that very interesting.

    I have ME and find taking Zopiclone improves my alertness and cogntion and reduces a lot of other symptoms as well.

    I can read much more easily when I have taken the sleeping pill.


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