Just nod if you can hear me... is there anyone home?

[Robert F]

Zolpidem (Ambien), a widely prescribed sleep aid has been found to elicit positive effects in the semi-conscious and even the comatose, by way of its interactions on GABA receptors, which scientists believe to have a huge role in brain injury. This being said, I would like to supplement the following information to perhaps inspire evidence based practice amongst fellow practitioners.

How Zolpidem Works
YouTube - Sleep Aid: Ambien


Official Research

Clauss

Drug induced arousal from the permanent vegetative...[NeuroRehabilitation. 2006] - PubMed Result

http://www.ncbi.nlm.nih.gov/pubmed/10721397?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.P ubmed_Discovery_RA&linkpos=1&log$=relatedarticles& logdbfrom=pubmed



In The Media

Sleeping pill may rouse coma patients - health - 24 May 2006 - New Scientist

Sleeping pill Zolpidem awakens girl from coma - Telegraph

I am trying to get the medical school to allow me to put together a research team to present before the ethics board of the hospital a proposal to begin our own longitudinal study of this occurence within our NeuroScience unit, led by our NeuroSurgeons and Scientists of course. We would further like to incorporate Zolpidem with TMS to demonstrate or disprove the efficacy of these therapies in brain injury.

[Medicality]

Hello,
I think trying zolpidem (Ambien) in head injury or stroke patients is the right thing to do because Ambien is a known safe drug whilst the recoveries that we have seen from PVS and severe strokes can be dramatic. The risks involved in trying such a well known medication are extremely small, so that the risk-benefit is highly in favour of patients having a trial. However, we do not yet know the proportion of responders and some responses have been very subtle and so are quite easily masked by the sedative effect, so it is difficult to be optimistic for all patients.
I write to offer you a summary of all the known published reports and the safety aspects in case it would help you make your applications to the IRB etc. Please let me know if it would be useful or if there is anything else I can do.

I must let you know that I am the medic that has been helping the discoverers of this phenomenon to develop it partly because I worked with the company that has the rights to this new usage. I discovered your blog through a Google alert on zolpidem brain damage.

I wish you and your patients good luck
Andrew Sutton MD

[Robert F]

Dr. Sutton,

I am very aware of your work as a consultant for re-gen and your role in the patenting process of this study in South Africa. Moreover, I am honored to have your support, as I move forward in pursuing this research. At the moment, I have two research studies, one is on Transcranial Magnetic Stimulation, the other on N-methyl-D-aspartate antagonists and neural plasticity in the brain injury model. I am hoping to integrate all three studies into a single trial at some point.

It wasn't until I was about half-way through my B.S. NeuroScience that I came to the conclusion that brain injury and coma are not going to be corrected through a single solution or treatment, rather a variety of treatments working in synergy to achieve a common goal. Of course there will be patients who see little to no benefit from these therapies, I am not naive enough to presume that brain injury is a one size fits all cut and dry etiology. However, if this study can help just one person or help another practitioner in furthering his/her research into the topic leading to development of a working therapy, then my expirement, can be considered a success in my eyes.

At the moment my clinical intuition is telling me that post-injury free radicals might play a larger role in brain damage than is currently known.

I would love to hear the opinion of my fellow nurses. What do you think?