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Zolpidem Anoxic Brain

Camille Chatelle, Aurore Thibaut, Olivia Gosseries, Marie-Aurélie Bruno, Athena Demertzi, Claire Bernard, Roland Hustinx, Luaba Tshibanda, Mohamed A Bahri, Steven Laureys
BACKGROUND: Zolpidem, a short-acting non-benzodiazepine GABA agonist hypnotic, has been shown to induce paradoxical responses in some patients with disorders of consciousness (DOC), leading to recovery of arousal and cognitive abilities. We here assessed zolpidem-induced changes in regional brain metabolism in three patients with known zolpidem response in chronic post-anoxic minimally conscious state (MCS). METHODS: [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) and standardized clinical assessments using the Coma Recovery Scale-Revised were performed after administration of 10 mg zolpidem or placebo in a randomized double blind 2-day protocol...
2014: Frontiers in Human Neuroscience
Jeffrey L Shames, Haim Ring
Zolpidem is a unique nonbenzodiazepine sedative hypnotic drug that selectively binds to omega-1 gamma-aminobutyric acid receptors in the brain. Although used for years in Israel and abroad for insomnia, there have been periodic reports of unusual or remarkable neurologic effects in patients with various brain pathologies. Here, we report on a 50-year-old woman 18 months after severe anoxic brain injury in a minimally conscious state. Residual deficits included mutism, athetoid movements of the extremities, and complete dependence for all personal care...
February 2008: Archives of Physical Medicine and Rehabilitation
Sara I Cohen, Thao T Duong
A 35-yr-old man sustained an anoxic brain injury resulting from cardiac arrest, with subsequent extreme lethargy and lack of response to stimuli. The patient's lethargy was unresponsive to trials of several medications in attempts to increase arousal. Administration of twice-daily zolpidem 8 mos after injury resulted in a dramatic increase in the level of alertness, including improved speech and gait. When the patient was not able to receive zolpidem for a brief period, the patient's lethargy returned, and he became bedbound until the medication was resumed...
March 2008: American Journal of Physical Medicine & Rehabilitation
Farhad F Shadan, J Steven Poceta, Lawrence E Kline
A 28-year-old male sustained anoxic brain damage following aborted cardiac arrest, and subsequently developed severe muscular rigidity and spasticity involving all extremities. The spasticity was refractory to the standard regimens used for spastic hypertonia. Zolpidem dramatically inhibited muscular rigidity, spasticity, and dystonic posturing in a dose-dependent manner, resulting in a sustained improvement of his global performance over four years. The authors postulate a central mechanism of action by selective inhibition of GABAergic inhibitory neurons, and suggest a controlled clinical study to investigate the potential efficacy of zolpidem in relieving spasticity related to postanoxic brain injury...
August 2004: Southern Medical Journal
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