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Drug induced arousal from the permanent vegetative state

Article type: Research Article

Authors: Clauss, Ralfa; * | Nel, Wallyb

Affiliations: [a] Nuclear Medicine Department, Royal Surrey County Hospital, Guildford, UK | [b] Family Practice, Pollack Park, Springs, South Africa

Correspondence: [*] Address for correspondence: R.P. Clauss, Nuclear Medicine Department, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, UK. Tel.: +44 1483 571122; Fax: +44 1483 406702; E-mail: rclauss@royalsurrey.nhs.uk

Keywords: Diaschisis, GABA, dormancy, brain injury, permanent vegetative state

DOI: 10.3233/NRE-2006-21104

Journal: NeuroRehabilitation, vol. 21, no. 1, pp. 23-28, 2006

Published: 9 May 2006
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Abstract

Background:

Zolpidem is an omega 1 specific indirect GABA agonist that is used for insomnia, but may have efficacy in brain damage. The long term efficacy of zolpidem in the permanent vegetative state is described in three patients.

Method:

Two motor vehicle accident patients and one near drowning patient, all of them in the permanent vegetative state for at least three years, were rated according to the Glasgow Coma and Rancho Los Amigos scale before and after zolpidem application. Long term response to daily application of this drug was monitored for 3–6 years.

Results:

All patients were aroused transiently every morning after zolpidem. Glasgow Coma Scale scores ranged from 6–9/15 before to 10–15/15 after zolpidem. Rancho Los Amigos Cognitive scores ranged from I–II before to V–VII afterward. Drug efficacy did not decrease and there were no long term side effects after 3–6 years daily use.

Conclusion:

Zolpidem appears an effective drug to restore brain function to some patients in the permanent vegetative state.

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