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Drug Found to Aid Vegetative Patients
Posted by
ScuttleMonkey
on Wed May 24, 2006 04:24 AM
from the super-smelling-salts dept.
from the super-smelling-salts dept.
Oxygen99 writes "BBC News is reporting on some amazing effects of a drug called Zolpidem on patients suffering from persistent vegetative state. Apparently the drug, usually used to treat insomnia, activates dormant areas of the brain that can make patients aware of their surroundings and even hold conversations. This raises several interesting points including the diagnosis of PVS and the attendant ethics of the associated life support, as well as the way the brain responds to injury and damage."
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Great! (Score:5, Funny)
Great!!! Finally they found medicine for my boss!!
FP, BTW?
Re:Great! (Score:4, Funny)
Nah, at a guess the drug will only work when the vegatable has a still-functional brain
Gaba stuff (Score:5, Interesting)
Most anti-anxiety medications work by fooling around with how Gaba is handled in the brain. I can't remember whether they inhibit it or make it more effective. Now here you have this thing saying that people in vegitative states have something wrong with their Gaba receptors.
Maybe someone who understands a little bit about brain chemistry (if such a person even exists) can shed some light on this. For instance, does this finding imply that you could induce a vegitative state in someone by stopping the action of Gaba in their brains, only to "restart" them once they're needed again?
Re:Gaba stuff (Score:4, Funny)
Re:Gaba stuff (Score:4, Informative)
GABA is far from the "only thing in our brains". Other neurotransmitters include serotonin (important in depression and hallucinogens), acetylcholine (why people smoke), dopamine (why some drugs are addictive), (nor)?epinephrine, glutamate and aspertate, etc. etc. The descriptions of what these chemicals do, of course, is vastly oversimplified here.
As for what anti-anxiety meds do, they mimic the effect of the naturally occuring GABA neurotransmitter, and have an inhibitory affect on cells with GABA receptors.
You *could* induce a vegitative state in someone by stopping the action of GABA, but it wouldn't exactly be "persistent" - GABA helps control some rather important functions in the brain stem, like breathing and heartbeat - in short, they'd die
Re:Gaba stuff (Score:3, Funny)
Our brain is umami and sweet at the same time? Maybe zombies are just looking for low-calorie Oriental fare.
Perfect for IT (Score:5, Funny)
They will not be able to interact with other people, and will show no responses to sounds or things that happen around them.
But they will show signs of movement, and cycles of sleep and may be able to breathe on their own.
So what would happen if they would start to give these drugs to technical support people and system admins? Would they also start to show responses to their environment, and manage to hold a conversation?
I've always found that... (Score:4, Funny)
*cue cricket cheeps*
What?
just kill me (Score:5, Interesting)
Re:just kill me (Score:5, Insightful)
If my brain has been damaged so much that I can only be roused to awareness of my surroundings by a drug that artificially and temporarily activates bits and pieces of my brain, I just want to die quickly and painlessly. As far as I'm concerned, the biggest crime against me would be to keep me alive.
You say that now, but if it were to actually happen to you I very much doubt that you'd rather die than be dependent on that drug.
It's like all the people that say they'd rather die young, and can't stand the thought of growing old. When it actually happens to you and you're faced with the prospect of death you'll change your mind pretty fast.
Re:just kill me (Score:5, Insightful)
> It's like all the people that say they'd rather die young, and can't stand the thought of growing old. When it actually happens to you and you're faced with the prospect of death you'll change your mind pretty fast.
That's totally true. Having watched my (young) wife go through stroke, I have to say that living wills make very little sense. You cannot predict while you are perfectly healthy and sitting at the kitchen table what choices you'll want when something happens.
As it was, she refused treatment for a while and changed her mind later. Hard choices came day to day. More than once I believed I had made the hardest decisions my life would contain, only to be wrong the next day.
I think the most useful document is a durable power of attorney document. Find someone you trust, who loves you (more important than the other way around). Talk about things some ahead, but tell them to make the best choices they can.
It may mean a mistake. They might act to save your life when they shouldn't. Or they might act to let you go when they shouldn't. But at least they will be making the decisions with the information available then, when it counts. It's better than you can do in a living will.
Re:just kill me (Score:3, Funny)
Eh? Sounds like my morning coffee after a night too much cheer! (not to mak
Re:just kill me (Score:3, Insightful)
That fact bears nothing on the usefulness of this drug though, as it's the lone opinion of yourself. Others may (and probably do) sha
Re:just kill me (Score:4, Interesting)
Judge: "All in favor of waiting a few years of being alive say "Aye""
Doctors, Nurses, Lawyers, and Culture of Lifers at the bedside: "Aye!"
Judge: "All those opposed... Say "Nay!""
Patient: "..."
Judge: "The "Ayes" have it!"
Cool, but... (Score:5, Insightful)
I'm not saying that the decision not to perpetuate the incurably brain dead is the wrong one, nor am I placing blame on the medical community in any way. But you can't expect laypeople to understand the difference, really, and the pain of not knowing if the decision was the right one... Of constantly wondering, down where logic doesn't really help, if there was a chance...
Re:Cool, but... (Score:3, Interesting)
Re:Cool, but... (Score:5, Insightful)
If we develop the technology do bring a truly dead person back to life: to re-animate a day old corpse, will cremation be murder?
Or take the Schiavo case: it may one day be possible to insert new brain cells into someone like that and have them get up and be a person again. But they may not be the same person: the old brain matter that held their memories and personality may be gone. And yet, since we can do that, should we never pull the plug on a brain dead person?
What makes you, you? And what rights do YOU have in determining whether medical science can essentially keep your body alive, forever, no matter what happens to that "you?"
Exciting... but unproven. (Score:4, Insightful)
We understand very little of what causes a person to shutdown and go into PVS. As such, it is EXTREMELY hard to truly diagnosis and pinpoint what is going on. Normally, we wait. If they wake up, it wasn't PVS.
This is like a myriad of other diseases like SIDS that are vaguely defined. Many more incidents are attributed to the issue than are actually caused because we simply don't understand it.
Hyperactivity disorders in children are another perfect example of a rather subjective diagnosis leading to over-prescription and misunderstanding. All that said, hopefully another set of trials over a wider base of patients proves some hope. (insert the obligatory Robin Williams "awakenings" quote here).
It's not news yet (Score:5, Insightful)
Over the years there have been miraculous cures for diseases that didn't pan out because they couldn't be replicated. Reasons for this might be: the study patients weren't really cured, the study patients improved, but didn't have the disease in question, scientific fraud, simple chance. This is the kind of result that has to be looked at skeptically, because if it were true, it would be true it would mean the bulk of what we think we know about the brain and its function is wrong.
It's possible, of course. Such possibilities are part of what makes science and exciting pursuit. It's also possible that the authors didn't do their study correctly. It's your choice as to what is most likely. If I had to bet, it would be the study population was not selected properly (i.e. they were in a coma, but not a PVS).
I checked out the journal in question. It is peer reviewed, but it is not a neuroscience journal per se. It is an interdisciplinary for various disciplines involved around rehab of brain damage patients. Although it's perfectly erspectable to publish in such a journal, the article would have a lot more initial credibility if it had been published in a journal specializing in basic neuroscience research. It would have to convince reviewers who would be forced by the publication to admit that they hold some significant misconceptions. It's a tough standard of truth, and it slows the spread of Truth (if you will), but it slows the spread of Error more.
If this is a legitimate result, the publication activity will be, to borrow a metaphor from Shaw, like the first pea in a handful of peas thrown at a wall: first one hits, then a couple, then a whole mass of them. Afterwards, the state of science will have changed in a fundamental way.
Re:It's not news yet (Score:3, Insightful)
Bah (Score:5, Funny)
What is the matter with me...? (Score:3, Funny)
This might help my daughter - more info? (Score:5, Interesting)
Does anyone have a link to the actual paper, or more info on this? I hesitate to grind up an Ambien and put it in her G-tube, but even the thought of something that might help her brings tears to my eyes as I write this. You have no idea what it is like to watch your child essentially disintegrate right before your eyes -- it's been 18 years of torture.
Thanks in advance for any help.
The medical study, and this isn't the only drug (Score:5, Informative)
The study investigates the effect of zolpidem (CAS 82626-48-0) on brain injuries and cerebellar diaschisis. Four patients with varied brain injuries, three of them with cerebellar diaschisis, were imaged by 99mTc HMPAO Brain SPECT before and after application of zolpidem. The baseline SPECT before zolpidem showed poor tracer uptake in brain injury areas and cerebellar diaschisis. After zolpidem, cerebral perfusion through brain injury areas improved substantially in three patients and the cerebellar diaschisis was reversed. Observations point to a GABA based phenomenon that occurs in brain injury and diaschisis that is reversible by zolpidem.
The problem with this study is a small sample group and no control. You can't make many broad conclusions from that data.
Indications, efficacy and tolerance of drug therapy in view of improving recovery of consciousness following a traumatic brain injury [nih.gov]
All of the drugs described in the above study have dopaminergic function; either indirectly increasing dopamine levels (amantadin, amphetamine, and methylphenidate) or directly agonizing the receptors (bromocriptine). It is interesting that GABA, an inhibitory rather than excitatory neurotransmitter in most cases, shows efficacy here as well.
Important distinction (Score:3, Informative)
Re:Important distinction (Score:3, Interesting)
Re:Important distinction (Score:5, Insightful)
I think you'll find that most patients die of pneumonia brought on by the morphine, and not by starvation. I sat by her bed for 10 days, and I can vouch for the level of comfort provided by the physicians...if her body showed any signs of distress, and we're talking elevated heart rate here, they took steps.
It is only a cruel way to die for the people who have to watch.
Re:Important distinction (Score:5, Interesting)
So can an ant. It doesn't make them human. If the personality is gone
and theres no sign of intellect all you have left is a base functioning
brain.
"It was downright horrible and state approved MURDER."
In your opinion. Perhaps if you'd been her husband you might have a
different opinion. You sanctamonious types are all mouth. I'd love to see
one of have to see your wife be a vegetable for years or even decades
and see if you still have your arrogant self righteous opinions then.
"Ths drug could have helped her have a normal life, but she did not live long enough to ever have the chance to try it!"
And many people in the middle ages died because they couldn't wait 500
years for anti biotics to be invented. So fscking what?
Re:Important distinction (Score:5, Interesting)
Westerners have an irrational fascination with these new drugs and yes, they do prolong life, but quality of life is most of the time in no way shape or form improved. I've seen family members whose bodies have basically failed, but the doctors have kept them physically alive for another couple of years, for nothing, at the cost of between $10,000-100,000 a piece.
I've been a victim of the FDA approved drug bullshit for almost 20 years, and now that I realize that the drugs made me worse over the years, which has been supported by medical studies, I'm off of the drugs, and at least for now, I'm fine, and I feel healthier than I have in over 20 years since before I started taking these things.
I will give western medicine 4 things. 1) Improved success in living for mothers and children during child birth. 2) Physical repair of broken things like hips and joints. 3) Improved quality and longevity of life because of antibiotics. 4) Immunizations for nasty things.
I'm sure that someone will add to the list, and I did not come up with that list via hard hours of research, its just one I've put together over the past few months of thinking about the stuff.
I was labeled as being mentally ill when I was 18, and have taken between 8-10 different maintenance drugs to help me "manage" my condition. Well, between 6-8 of those drugs are documented for making me worse, which is what I said word for word the last time I saw my doctor. So, he gave me another handful of drugs, that I never took and I threw in the trash. I have altered my diet, and am taking quality (read, not Centrum or anything like that) vitamins, herbs, and supplements, and I'm essentially symptom free, and I have had friends and coworkers comment on how much better I seem.
The drugs that were given to me gave me 1) Chronic diarrhea for over 18 months 2) Headaches 3) Vertigo to the point of almost getting in serious car accidents twice. 4) Depression, anxiety, confusion, and mania (what the drugs were supposed to treat) 5) Obsessive thoughts, usually in the form of a cheesy pop song that I could not get one line out of my head. 5) Daily dry heaves. 6) Paranoia 7) Generally a lower state of cognition and well being.
Oh, and if you think all of those things don't affect your personal and professional life, well, in my case they did.
The trend here is for the pharmaceutical companies to make "maintenance medications", not a cure or something that will drastically increase the speed of recovery and then forgo taking the drug. I strongly recommend that nobody take a drug that is prescribed by a doctor that has no time frame for when you are to stop taking the drug. At least, do plenty of research, and get second and third opinions before taking any maintenance drug.
Another thing to look into, is what you are eating. Most of the food in this country is either void of nutrients or has additives or pollutants in it or comes from unhealthy, uncared for animals. This is for another discussion.
Re:Important distinction (Score:3, Insightful)
Re:Important distinction (Score:4, Insightful)
Re:Important distinction (Score:4, Interesting)
I'd have to agree with this. Members of my own family flipped out over the Terry Schiavo thing, calling it murder. And this was after they had pulled the plug on my grandmother for being in a similar state after a stroke. This was back in '91 and she was in PVS for only a couple weeks. All I had to do was remind them and they shut up. Around me, anyways... they'd still go on preaching to others who didn't know they had made the same decision for their own loved ones.
Cheers.
Re:Important distinction (Score:3, Insightful)
The problem with the extreme pro-life position is that they don't really believe their own rhetoric when it comes to ac
Re:Important distinction (Score:3, Interesting)
Did anyone ask the patient in question about it.
So if they are brain dead then it is nothing to worry about and simply allowing the family to finally grieve
If they are not b
Re:Important distinction (Score:3, Insightful)
Re:Important distinction (Score:3, Informative)
Re:Oblig. Terri Schiavo comment. (Score:4, Insightful)
She died years ago.
Re:Oblig. Terri Schiavo comment. (Score:5, Informative)
According to the autopsy [washingtonpost.com], this drug would have had to have done a lot more than described here. Maybe if they'd given it to her when she first fell into a coma (we'll never know) but by the time she died, her brain was irreperable.
Re:Oblig. Terri Schiavo comment. (Score:5, Informative)
Assuming we could fully repair braindeath (ie, restore the brain when higher functions have been lost), what would remain of the original person? Would we have an adult with infantile brain capabilities, a blank slate? How much of a person's identity is hardcoded? And what are the ethics of the situation - do we revive someone knowing that we'd be making them start over from scratch (and maybe not even that - most of early learning is made possible by infantile brain "plasticity", which an adult brain lacks).
It's not an easy question...
Oblig. Brain/Computer Analogy (Score:3, Interesting)
Being comatose is like a computer crashing. It can happen for
Re:Oblig. Terri Schiavo comment. (Score:3, Informative)
A private service by me to all of Slashdot who doesn't understand:
Brain death is defined legally as cessation of all brain activity, with the caveat that it is not due to a reve
Re:Oblig. Terri Schiavo comment. (Score:3, Interesting)
Re:Oblig. Terri Schiavo comment. (Score:5, Informative)
Re:Terri Shivo (Score:5, Insightful)
Re:Terri Shivo (Score:3, Informative)
Re:Terri Shivo (Score:4, Insightful)
No, he couldn't.
Terry was legally incompetent to participaet in divorce (or any other) proceedings. Normally, this wouldn't be a big deal - just have her legal guardian represent her. Problem - her legal guardian was Mark. Mark couldn't try to divorce her - he'd be representing her against himself. It only became an "option" when her parents "offered" to take over her guardianship in a quid pro quo - he relinquishes his responsibility to his wife in return for not contresting a divorce.
Mark was Terry's legal guardian because she CHOSE it before she died, by marrying him. Her parents couldn't (and probably still can't) get that through their heads. They went to desperate lengths to override their daughter's wishes, denying her the very autonomy and choice she had made previously. She chose to leave them and put her care into the hands of another. Mark did the same thing - it's called marriage.
Mark discharged his responsibilities to his wife. Why couldn't her parents accept that?
Starving... (Score:3, Insightful)
Re:Starving... (Score:3, Insightful)
Re:What simple questions? (Score:4, Interesting)
Re:What simple questions? (Score:4, Funny)
Researcher: Hi there, can you see me? Patient: BRAAAAAAIIIIINNNZZZZZZZZ