Unbelievable: Could a Sleep Disorder Drug Soon Wake Coma Patients?

It sounds like the most paradoxical claim imaginable: a drug that is used to treat insomnia and thus helps people fall asleep could also be used to enhance awareness and potentially wake patients who are in a coma and defined as 'vegetative'.

However, in the world of pharmaceuticals, such paradoxical claims are not dismissed lightly. After all, there is a common example of a drug that works in a similarly counterintuitive way: Ritalin is essentially a stimulant, but in people with attention disorders, it actually has a calming and soothing effect.

The drug in question this time is Zolpidem, a common medication for insomnia (sold under names like Ambien, Stilnox, Zodorm, among others). A comprehensive analysis of studies published by researchers from the University of Michigan determined that this drug has dramatic effects when given to patients suffering from neurological issues affecting awareness or movement. The Zolpidem was tested on patients including those with Parkinson's and dystonia (movement disorders), patients in a coma and those defined as 'vegetative', dementia sufferers, and those who have suffered a stroke or brain trauma.

It should be emphasized: at this stage, the medication has only achieved temporary improvements lasting between one to four hours. But considering the severe condition of the patients, the effect was dramatic. Patients in a coma moved to a minimally conscious state, and some even attempted to speak with their families – sometimes for the first time in years. Other patients showed temporary improvement in motor and verbal abilities.

"This is one of those strange paradoxes where the effect of a sleep disorder medication seems reversed in patients with neurological disorders," says Dr. Mark Peterson, one of the review's authors.

The challenge for the authors of the review was not simple. Even though many doctors have tried to give the medication to patients in the past or conducted small-scale studies, a large-scale clinical trial has yet to be conducted. But by reviewing the medical literature and filtering the best existing studies, they managed to find a total of 551 test subjects. Data analysis showed there was no magic here: although the drug helped 24 percent of patients with neurological movement problems, in cases of awareness issues (such as coma), the response rate was only five to seven percent. However, considering what it can achieve in that small percentage, researchers believe it is definitely worth further exploration of the drug's performance beyond its sedative abilities.

"We wrote the secret of the report that raises more questions than the number it answers," says Peterson. "But what we found can definitely guide us in conducting a larger medical trial." Among other things, researchers intend to investigate whether the difference in response rates among different brain injuries depends on the part of the brain where the injury occurred.