Sleeping Pill May Reverse Comatose Patients, Study Says

By Dawn Rizzoni | July 7, 2008 | 8:22 PM EDT

( - Scientific researchers have revealed in the medical journal NeuroRehabilitation that a commonly-used sleeping pill, zolpidem (brand name Ambien), can be used to temporarily awaken patients in a persistent vegetative state (PVS), coma, or other brain-injured state.

The discovery has attracted the interest of The Terri Schindler-Schiavo Foundation for Health Care Ethics. The Foundation was named in memory of the brain-damaged Florida woman who died in March 2005 after her husband Michael Schiavo won a long legal battle to cut off her off from all nutrition.

In light of the medical breakthrough, The Schindler-Schiavo Foundation has called for a moratorium of "ordinary care removal for persons diagnosed in a PVS condition." Terri's parents and siblings do not believe Michael Schiavo would have allowed her to be administered the Ambien even if it had been suggested.

"Sadly, we will never know if any of these drugs or treatments that were available would have improved Terri's condition," the Schindler family stated in their press release. "Terri's family pleaded for years with Terri's guardian, Michael Schiavo, and the courts to try and use different treatments of medicine that could possibly help improve Terri's condition, but were denied."

Doctors R.P. Clauss and W.H. Nel reported that the stimulation effects of zolpidem reverse the damaging effects in brain injured patients, to the point that they are able to wake up and interact with their environment. The benefits were maintained as long as the drug stayed in a patient's system, according to Clauss and Nel.

The drug was given daily to patients in the study which lasted six years. Each patient had been in a PVS for at least three years.

The discovery that zolpidem had such promising effects came about when Dr. Clauss gave a PVS patient the drug for restlessness. The drug, which normally induces sleepiness, also has an arousing effect on certain areas of the brain, the Clauss/Nel report indicates.

After being given zolpidem, the patients in the study could "interact, make jokes, and speak on the phone," Clauss stated in the journal, and one patient even played catch with his family.

Stephen Drake, research analyst for the pro-disabilities group Not Dead Yet, said it's not that zolpidem helped PVS patients, but that "misdiagnosis is the real issue."

"We put out a moratorium (on removal of ordinary care in PVS patients) a year ago," Drake said. "Persistent Vegetative State should really be called Persistent Non-Responsive State because that's all we can tell from the outside. There's no way to really know at the present time" whether someone is truly PVS or temporarily non-responsive.

"There's so much evidence that we're making mistakes" in these PVS diagnoses, Drake said. "So to us, (the zolpidem news) is interesting, but it doesn't change anything."

The Schindler family members also touched on the misdiagnosis issue in their press release.

"A report released by the British Medical Journal in 1996 found that 43 percent of the diagnosed cases of PVS they studied were in fact misdiagnosed," the statement reads. "We at the Foundation are seeing that the PVS diagnosis is being commonly misdiagnosed. Consequently, it has become very obvious we don't know enough about this so-called diagnosis, and common sense dictates that the removal of food and water based on this misclassification must end until further studies can be conducted."

Bobby Schindler, Terri's brother, told Cybercast News Service that he believes "the PVS diagnosis is a very subjective diagnosis."

"It is now being used in most states as one of the criteria to allow doctors to recommend terminating life. We are seeing a growing amount of evidence that suggests that the PVS diagnosis is often being misdiagnosed. And now there are certain drugs that could provide help to persons that are being labeled as PVS," Schindler said.

Other drugs have been successfully used in the past to help PVS patients. In December 2000, Patricia White Bull awoke after 16 years of what doctors called a persistent vegetative state, after being given the drug Amantadine. The drug is commonly used to stimulate individuals with Parkinson's disease and brain damage.

The pharmaceutical group NeuroHealing was just granted "orphan drug status" by the Food and Drug Administration (FDA) on a drug labeled NH001 that worked much like Ambien in PVS and comatose patients, but with longer-lasting effects, according to the company's president, Daniel Katzman.

"With the growing amount of uncertainly regarding this diagnosis, and drugs that could potentially help, it is only common sense we stop using it, particularly when the decision to terminate life can't be undone," Bobby Schindler said.

Michael Schiavo's political group TerriPAC did not respond to requests for comment, nor did the pro-euthanasia group Death With Dignity.

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