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Could Ambien Sleep Drug Help 'Awaken' Those With Brain Damage?

"it's doing something crazy with our neurons."

For most people, the drug Ambien puts them out like a light. For others, specifically those in a vegetative or minimally conscious state, the drug does the exact opposite: it wakes them up -- at least to an extent.

Over the years, there have been several accounts of Ambien helping patients with severe brain damage make improvements in focus and cognitive abilities. The New York Times Magazine reports that while research on the drug for this use isn't new -- accounts of using Ambien and similar drugs to "wake" vegetative or minimally conscious patients have been seen throughout the 2000s -- the first large-scale study of drug and its generic version zolpidem began this year and hopes to answer several questions of how exactly it does this and what it means for healing the brain.

The Times features the story of Chris Cox, who became permanently brain damaged in 2008 from lack of oxygen to the brain after taking too many pain killers. He was resuscitated and unconscious for four days. When he awoke he was considered vegetative. But after some time and seeing some small improvements, Chris was deemed minimally conscious and his parents -- Judy and Wayne -- eventually decided to enter him into a study using Ambien and were amazed when it "woke" him up:

Chris was 26. He had not been well. An A.T.V. accident the previous August left him with debilitating back pain that physical therapy did nothing to alleviate. His doctor had recently prescribed Oxycontin. His parents learned later that he had taken too much.

[...]

Convinced that the son they know and love is still “in there,” Chris’s parents have spent the past three years searching for a way to bring him back out. So far, their best hope has come from an unlikely source: Ambien. A growing body of case reports suggests that the popular sleep aid can have a profound — and paradoxical — effect on patients like Chris.

Watch the Times video about Chris' story here.

There are several accounts of Ambien or zolpidem helping to focus awake but otherwise vegetative patients, but the Times reports that less than 10 percent of brain-injured patients will experience the drug’s effects. Even still, the Moss Rehabilitation Research Institute and at the University of Pennsylvania began a study this year to gain understanding about zolpidem as a treatment for such debilitation. The Times describes the drug's success thus far and upcoming research as sort of a "tortured kind of hope" for the Cox family.

So far, John Whyte, director of the Moss Institute and head of the zolpidem trial, and his team of researchers are in the process of testing 80 patients, including Chris, in both a non-medicated and medicated state. From there, they will analyze the data to see what differences in the brain, if any:

[...] maybe a specific brain region that lights up unexpectedly, or a pattern of neuronal firing common to one group but not the other. Any such discovery could light a path not only through the labyrinths of Chris’s fractured mind but to a better understanding of consciousness itself.

The Times reports that according to several studies, 40 percent of those declared vegetative are actually minimally conscious, and the research is looking at both these types of patients to see if the drug provides different results. Results in the cases, which are still very preliminary, are mixed, varying on an individual basis, according to the Times. Of those who do show response to the drug, Whyte said it is looking like some can take it daily without becoming conditioned to it, while others -- perhaps a more common occurrence -- seem to gain a tolerance to the drug and "awakenings" become less and less with continued use.

As for the unusual effects the drug seems to have in these cases, the Times reports that even in patients who take the drug for its intended purpose as a sleep aid can experience unusual side effects, including "sleepwalking, even sleep driving." Gizmodo reports that some people who take the drug and purposefully try to stay awake can experience hallucinations.

It is clear, as Gizmodo sums it up, that this drug is "doing something crazy with our neurons." Hopefully, upcoming research will be able to tell us more.

One last thing…
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