7 replies to this topic

[medievil]

First of all, zolpidem certainly isnt a nootropic in the traditional sense, nor a normal supplement, so no idea what section would be the most apropiate to discuss this, nonetheless zolpidem seems to have some interesting potential in cases of brain injury wich i tought was worth discussing.

Wikipedia:

Brain injury
A case study performed at the Toulouse University Hospital using PET showed zolpidem repeatably improves brain function and mobility of a patient immobilized by akinetic mutism caused by hypoxia.[19]
Recently, zolpidem has been cited in various medical reports mainly in the United Kingdom as waking persistent vegetative state (PVS) patients, and dramatically improving the conditions of people with brain injuries.[20][21][22][23][24] Results from phase IIa trials were expected in June 2007. The trials are being conducted by Regen Therapeutics of the UK, who have a patent pending on this new use for Zolpidem.[25][26]
[edit]Coma
Zolpidem has recently been very strongly related to certain instances of patients in a minimally conscious state being brought to a fully conscious state. While it was initially given to these patients to put them to sleep, it actually brought them to a fully conscious state in which they were capable of communicating and interacting for the first time in years. SPECT and PET scans have shown that the use of the drug actually does dramatically increase the activity in areas of the brain in some patients in a minimally conscious state. Large-scale studies are currently being done to see whether it has the same universal effect on all or most patients in a minimally conscious state.[27] It may be that zolpidem's ability to stimulate the brain, particularly in the semi-comatose, may be related to one of its side-effects, which sometimes causes sleepwalking and other activity while asleep, that appears to observers to be fully conscious activity.

Clinical and imaging evidence of zolpidem effect in hypoxic encephalopathy.
Brefel-Courbon C, Payoux P, Ory F, Sommet A, Slaoui T, Raboyeau G, Lemesle B, Puel M, Montastruc JL, Demonet JF, Cardebat D.

Department of Pharmacology and Centre Midi-Pyrenees de Pharmacovigilance, de Pharmacoepidemiologie et d'Informations sur le Medicament, Faculty of Medecine, University Toulouse, 37 allées Jules Guesde, 31000 Toulouse, France. brefel@cict.fr
Comment in:

Ann Neurol. 2007 Jul;62(1):5-7.
Ann Neurol. 2008 Oct;64(4):477-8.
Abstract
We conducted a randomized, double-blind, placebo-controlled, single-patient (N = 1) trial to evaluate the efficacy of zolpidem in a 48-year-old woman with an akinetic mutism. Motor and cognitive examinations and functional imaging were performed. Acute administration of zolpidem markedly improved motor performance and neuropsychological status. Cerebral metabolism ((18)F-fluorodeoxyglucose positron emission tomography) increased in postrolandic territories and in frontal cortex. Using the H(2) (15)O positron emission tomography, we found a drug-induced activation in the anterior cingulate and orbitofrontal cortices. Zolpidem induced a transient improvement in motor and cognitive performances. This paradoxical effect could result from an activation of limbic loops modulating motivational processes.

S Afr Med J. 2000 Jan;90(1):68-72.
Extraordinary arousal from semi-comatose state on zolpidem. A case report.
Clauss RP, Güldenpfennig WM, Nel HW, Sathekge MM, Venkannagari RR.

Department of Nuclear Medicine, Medical University of Southern Africa, Medunsa.
Abstract
A young semi-comatose male patient was investigated using 99mTc hexamethyl-propylene amine oxime (99mTc HMPAO) brain single photon emission computed tomography (SPECT) before and after administration of the gamma-aminobutyric acid (GABA) agonist zolpidem. It was observed that 15 minutes after application of the drug the patient awoke from his semi-comatose condition and remained awake for the next 3-4 hours. When drug action subsided he returned to his semi-comatose state. Brain SPECT before drug application showed large hypo-active areas in certain parts of the brain. Brain SPECT after drug application showed a generalised cortical activation relative to the cerebellum and a marked and amplified activation of the areas that were hypo-active before drug application.

And a few articles:
http://news.bbc.co.u...lth/5008744.stm
http://www.guardian....lthandwellbeing
http://www.guardian....lth.humanrights
http://abcnews.go.co...=2947406&page=1

I quickly took all those links and abstracts from wikipedia, i'm not sure wheter any new evidence has showed up, or more information about its mechanism of action, i was pretty impressed by those findings, will take a look on pubmed one of the days for some more data.

Edited by medievil, 02 September 2010 - 11:27 PM.

[niner]

It would be interesting to know just how conscious these people are on zolpidem. Is it just an artifact, or are they lucid? It might be hard to tell if they've been akinetic for a very long time; they might have minimal capacity for movement due to muscle atrophy, for example. This is another example of a compound that never would have been tested for such an application if it wasn't for it's other more common pharmacological effect. It makes me wonder how many compounds are out there that have really amazing activities that we're simply unaware of. Probably a lot. The question is how to find them...

[Animal]

I hate Zolpiderm, it's what was used to sedate me when I was psychotic and trying to gouge peoples eyes out.

[familypast]

I've used Zolpidem for over 10 years for insomnia. This past April, I was diagnosed with sleep apnea (even though I rarely snore). I had 24 events an hour, some causing hypoxia. Most of the events were hypopneas (breathing reduced by 50% or more) and the full blown apneas were a combination of obstructive and central. Central apneas occur when the base of the brain forgets to tell you to breathe.

Interestingly, zolpidem is also used to treat central apneas. I didn't realize that it could also treat the damage caused by the hypoxia.

[John Barleycorn]

Interestingly, zolpidem is also used to treat central apneas. I didn't realize that it could also treat the damage caused by the hypoxia.

Interesting, as most sleep aids tend to increase snoring. Any idea how it compares to ondansetron?

[chilp]

Apparently, Zolpidem may increase memory consolidation:

Abstract
Zolpidem is an imidazopyridine hypnotic with preferential binding affinity for the omega1-benzodiazepine (BZD) receptor. The present double-blind, placebo-controlled study evaluated the effects of orally administered zolpidem (15mg/70kg) on specific memory functions in 16 healthy volunteers using a battery of word and picture memory tasks. Relative to placebo, zolpidem significantly impaired memory for material presented after drug administration when memory was assessed directly by referring subjects back to the prior study episode (explicit memory: recall and recognition) but not when memory was assessed indirectly by evaluating subjects' ability to identify degraded versions of studied stimuli (implicit memory: fragment completion). Zolpidem did not impair explicit memory for material presented before drug administration or memory for previously acquired knowledge (semantic memory: categorization). There was evidence suggesting that zolpidem enhanced explicit and implicit memory for material presented before drug administration and that zolpidem produced a specific deficit in the acquisition of contextual information about material presented after drug administration. Despite zolpidem's unique pharmacological profile, the observed selectivity of zolpidem's memory-impairing effects for particular functions appears qualitatively similar to the selectivity observed with classic BZDs in previous studies.

ion

I took it the other evening, prior to an exam the next morning, can't say it consolidated the information I had memoized but I remembered everything during the exam.

[medievil]

^^ Interesting study

[familypast]

John: I've never heard of Ondansetron...will check it out.

I can attest to the post-drug memory deficit. I've had conversations and raided the refrigerator without any memory of it the next day. I once woke up and discovered that I finished a statistical analysis for work -- and did it right!

I have since "trained" myself to remember many of these incidents (particularly, the sleep eating). It turns out that I'm aware of what I am doing as I am doing it, even if I don't remember the next day. Unfortunately, knowing what I'm doing doesn't always stop the sleep eating. It's as if the ambien turns off my inner censor.