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Zolpidem Might Assist Patients With Akinetic Mutism

with both zolpidem and a placebo in a randomized, double-blind study.

The results showed that after receiving zolpidem, the patient was able to stand up and walk, repeat words and sentences, read words, and name objects, although she was not able to speak spontaneously. Administration of the drug increased brain metabolism, and PET scans also showed improvement in cerebral areas involved in motivational processing.

Although previous studies have shown the positive effect of zolpidem on catatonic conditions, the authors state, "To our knowledge, this is the first study assessing the impact of zolpidem of post-anoxic brain injury using the modern methodological standards of clinical pharmacology."

The authors demonstrated increased brain activity in the frontal cortex, which is associated with higher cognitive performances, with zolpidem. They suggest that the mechanism may be due to an activation of neural circuits in the brain that control movement and verbal expression, but that the lesions that occurred due to oxygen deprivation may have been too severe to allow spontaneous speech. They conclude that single patient trials can be a logical approach to identifying potentially beneficial drugs, especially in the case of rare or orphan diseases.

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