title: Drug induced arousal from the permanent vegetative state.
abstract: BACKGROUND
  Zolpidem is an omega 1 specific indirect GABA agonist that is used for insomnia, but may have efficacy in brain damage. The long term efficacy of zolpidem in the permanent vegetative state is described in three patients.
  
  
  METHODS
  Two motor vehicle accident patients and one near drowning patient, all of them in the permanent vegetative state for at least three years, were rated according to the Glasgow Coma and Rancho Los Amigos scale before and after zolpidem application. Long term response to daily application of this drug was monitored for 3-6 years.
  
  
  RESULTS
  All patients were aroused transiently every morning after zolpidem. Glasgow Coma Scale scores ranged from 6-9/15 before to 10-15/15 after zolpidem. Rancho Los Amigos Cognitive scores ranged from I-II before to V-VII afterward. Drug efficacy did not decrease and there were no long term side effects after 3-6 years daily use.
  
  
  CONCLUSIONS
  Zolpidem appears an effective drug to restore brain function to some patients in the permanent vegetative state.
authors.affiliation: Nuclear Medicine Department, Royal Surrey County Hospital, Guildford, UK. rclauss@royalsurrey.nhs.uk
authors.forename: Ralf
authors.initials: R
authors.lastname: Clauss
authors.forename: Wally
authors.initials: W
authors.lastname: Nel
mesh_terms: D000328:Adult; D001143:Arousal / Q000187:drug effects*; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D018755:GABA Agonists / Q000008:administration & dosage*; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D018458:Persistent Vegetative State / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D011725:Pyridines / Q000008:administration & dosage*; D000077334:Zolpidem
chemical_list: D018755:GABA Agonists; D011725:Pyridines; D000077334:Zolpidem