Research Reports - Zolpidem arouses patients in vegetative state after brain injury

Am J Med Sci. 2013 Mar 4

Du B, Shan A, Zhang Y, Zhong X, Chen D, Cai K

BACKGROUND:: To investigate the efficacy and indications of zolpidem, a
nonbenzodiazepine hypnotic, inducing arousal in vegetative state patients after
brain injury. METHODS:: One hundred sixty-five patients were divided into 4
groups, according to area of brain damage and injury mechanism. All patients'
brains were imaged by Tc-ECD single-photon emission computerized tomography
(SPECT), before and 1 hour after treatment with 10 mg of zolpidem.
Simultaneously, 3 quantitative indicators of brain function and damage were
obtained using cerebral state monitor. Thirty-eight patients withdrew from the
study after the first zolpidem dose. The remaining 127 patients received a daily
dose of 10 mg of zolpidem for 1 week and were monitored again at the end of this
week. RESULTS:: One hour after treatment with zolpidem, cerebral state index was
increased and burst suppression reduced in both brain contrecoup contusion and
space-occupying brain compression groups (P < 0.05). SPECT showed, 1 hour after
medication, that cerebral perfusion was improved in both brain contrecoup
contusion and space-occupying brain compression groups, but no changes were seen
in primary and secondary brain stem injury groups. In the 127 patients' group,
after 1 week of zolpidem treatment, all parameters obtained from cerebral state
monitor were not statistically different compared with those after the initial
medication (P > 0.05). CONCLUSIONS:: Zolpidem is an effective medicine to restore
brain function in patients in vegetative state after brain injury, especially for
those whose brain injuries are mainly in non-brain-stem areas. Improvement of
brain function is sudden rather than gradual.

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