Zolpidem in a minimally conscious state.

Abstract

BACKGROUND:

Case reports of the use of zolpidem in Permanent Vegetative States (PVS) have led to interest by the media and court judgements defining treatment with such drugs. It is uncertain whether this paradoxical effect of zolpidem in raising consciousness may be evident in other low awareness states such as Minimally Conscious State (MCS).

CASE STUDY:

This study treated a 44 year old male with MCS some 4 years after his traumatic brain injury with zolpidem for 1 week on and 1 week off treatment. Assessment with a number of tests by blinded therapists showed that his scores were no better on zolpidem and in some cases were worse on treatment.

CONCLUSIONS:

Ideally a series of individuals is required to assess the effect of zolpidem, but in the light of positive spin stories in the media, negative case reports should also be highlighted. It is imperative that medical treatment in all instances and certainly in low awareness states and end of life decisions is always based on firm evidence.

• Authors: Rajiv Singh, Clare McDonald, Kirstin Dawson, Sarah Lewis, Anne-Marie Pringle, Stephen Smith, Brian Pentland
• Journal: Brain injury (Brain Inj) Vol. 22 Issue 1 Pg. 103-6 (Jan 2008) ISSN: 0269-9052 [Print] England
• PMID: 18183514 (Publication Type: Case Reports, Evaluation Study, Journal Article)

Chemical References

• Neurotransmitter Agents
• Pyridines
• Zolpidem

Topics

• Adult
• Brain Injuries (complications, drug therapy)
• Drug Evaluation
• Humans
• Male
• Neurotransmitter Agents (therapeutic use)
• Observer Variation
• Persistent Vegetative State (drug therapy, etiology)
• Pyridines (administration & dosage)
• Treatment Outcome
• Zolpidem