Sleeping pills offer wake-up call to vegetative patients Drug could overcome brain shutdown...

news@nature.com ^ | 23 May 2006 | Michael Hopkin

[A CA Guy]

That is great news.

Will it work for Senate Republicans?

[billorites]

Posting this article isn't a crime.

But, it oughta be...

[tacticalogic]

It says "comatose", not "inchordate".

[Ichneumon]

He says that there is no reason why the drug cannot be provided as a slow-release formula, allowing patients to remain permanently aware. But the long-term effects of such a treatment are completely unknown.

Cautionary tale: The movie "Awakenings" was based on true events which took place in 1969. A doctor discovered that a new (at the time) drug, L-Dopa, would wake patients who had been catatonic for years. They were fully conscious and could carry on conversations, etc. The drug was horrendously expensive, but because it worked miracles, the hospital found ways to fund the doses.

Then they started noticing that as time went by it took more and more of the drug to be effective...

Eventually, no safe dosage of the drug would work any longer, and the patients tragically faded back into catatonic states, for the rest of their lives.

[Revel]

It would have been great to give this drug to Terri Schindler Schiavo.

[MotleyGirl70]

That is great news.

Will it work for Senate Republicans?

I'll BUMP to that.

[GOPJ]

Thanks for the ping.

[syriacus]

Very interesting article! Thanks for the ping!

[syriacus]

Sleeping pill wakes men in vegetative state Sarah Boseley, health editor Tuesday May 23, 2006 The Guardian

Patient N "was constantly uttering random screams". After he was given the drug, the screaming stopped, and he started watching television and reacting to his family.

[steve-b]

Drug could overcome brain shutdown

Somebody put some of this stuff in the Capitol water coolers, stat.

[GOPJ]

Will it work for Senate Republicans?

Good one.

[supercat]

Eventually, no safe dosage of the drug would work any longer, and the patients tragically faded back into catatonic states, for the rest of their lives.

That a drug appears to impart awareness to a person who would otherwise appear to be PVS does not mean that it should necessarily be used to continuously impart conciousness. At minimum, however, I would think short-term use of the drug could be very useful in diagnosing a person's condition.

It may well be that a person's condition is such that there is no known therapy that would provide long-term improvement. On the other hand, if a drug provides short-term improvement, that would suggest that the prognosis for long-term improvement should be excellent (since it implies that the necessary parts of the brain are in "operable" condition and will work if properly stimulated, even if the proper means of stimulation are not yet known).

[Coleus]

CAN UNCONSCIOUS PATIENTS WAKE UP?

In the wake of the discovery (reported in last week's BioEdge) that a brain-damaged woman in the UK in a persistent vegetative state was responding to stimuli, other stories about recoveries from irreversible comas are emerging in the press. While many doctors are sceptical, the possibility that some therapies may restore some consciousness in some cases threatens to overthrow a consensus on how to deal with patients languishing in hospitals and nursing homes.

Bioethicist Joseph Fins, of Cornell's Weill Medical College, says that ever since the Karen Ann Quinlan case in the US in the 1970s, doctors have been abandoning brain-damaged patients too readily. As a result, fewer patients improve and the statistics get worse. Then families and doctors give up and researchers stop pursing new treatments. It becomes a vicious circle which Fins dubs therapeutic nihilism. "We've spent a long time allowing people to die," he says. Maybe they deserve more intellectual, diagnostic and therapeutic engagement than we have acknowledged."   One simple therapy which has produced remarkable results comes from South Africa: a sleeping pill. A family doctor near Johannesburg discovered that when some severely brain-damaged patients are given zolpidem they emerge from their comas and begin to communicate. No one understands why, but it appears that the damaged brain cells are not dead, in some cases at least, but only hibernating. The drug may wake them up.

A journalist for the UK Guardian met several patients who emerge from a persistent vegetative state after taking zolpidem. The degree of recovery varies, and lasts only about two and a quarter hours, but some of the recoveries appear remarkable. Papers describing what happens have been published in the journals NeuroRehabilitation and the New England Journal of Medicine and a British company, ReGen Therapeutics, is carrying out clinical trials.   Another therapy is electrical stimulation of the brain. An American doctor, Edwin Cooper, claims that people given electrical stimulation emerge from comas more quickly and regain functions more quickly than if they are given only traditional treatment. His work has not attracted much attention in the US ­ and was even denounced by the recently deceased expert witness in the Terri Schiavo case, Ronald Cranford, as "junk science".

However, in Japan, electrical stimulation is far more common. Doctors there implant electrodes directly into the spine. The results are not spectacular, but they are significant. About 40% of patients move from a persistent vegetative state to a minimally conscious state. Small as this may seem, relatives regard it as a blessing.   Even if these treatments are only experimental, if they can be verified, their implications for end-of-life treatment are enormous. If a persistent vegetative state is no longer a hopeless and irreversible condition, it will become more difficult to justify withdrawing life support from patients. ~ Wired, Sept 6; Guardian, Sept 12   

[jwalsh07]

Pretty amazing stuff. A hit of ambien and voila!

[8mmMauser]

Pinged from Terri SEPTEMBER Dailies

8mm

[The Wizard]

bttt

[The Wizard]

bttt

[Apple Blossom]

Ping.

[bmwcyle]

LOL