Abstract
Objective. To study the Zolpidem arousing effect in persistent vegetative state (PVS) patients combining clinical evaluation, autonomic assessment by heart rate variability (HRV), and EEG records. Methods. We studied a group of 8 PVS patients and other 8 healthy control subjects, matched by age and gender. The patients and controls received drug or placebo in two experimental sessions, separated by 10-14 days. The first 30 minutes of the session were considered the basal record, and then Zolpidem was administered. All participants were evaluated clinically, by EEG, and by HRV during the basal record, and for 90 minutes after drug intake. Results. We found in all patients, time-related arousing signs after Zolpidem intake: behavioral (yawns and hiccups), activation of EEG cortical activity, and a vagolytic chronotropic effect without a significant increment of the vasomotor sympathetic tone. Conclusions. We demonstrated time-related arousing signs after Zolpidem intake. We discussed possible mechanisms to explain these patho-physiological findings regarding EEG cortical activation and an autonomic vagolytic drug effect. As this autonomic imbalance might induce cardiocirculatory complications, which we didn’t find in any of our patients, we suggest developing future trials under control of physiological indices by bedside monitoring. However, considering that this arousing Zolpidem effect might be certainly related to brain function improvement, it should be particularly considered for the development of new neuro-rehabilitation programs in PVS cases. According to the literature review, we claim that this is the first report about the vagolitic effect of Zolpidem in PVS cases.
Keywords: Persistent vegetative state, Zolpidem, heart rate variability, autonomic, EEG, arousal.
Current Pharmaceutical Design
Title:Zolpidem Arousing Effect in Persistent Vegetative State Patients: Autonomic, EEG and Behavioral Assessment
Volume: 20 Issue: 26
Author(s): Calixto Machado, Mario Estevez, Rafael Rodriguez, Jesus Perez-Nellar, Mauricio Chinchilla, Philip DeFina, Gerry Leisman, Frederick R. Carrick, Robert Melillo, Adam Schiavi, Joel Gutierrez, Maylen Carballo, Andres Machado, Ana Olivares and Nuvia Perez-Cruz
Affiliation:
Keywords: Persistent vegetative state, Zolpidem, heart rate variability, autonomic, EEG, arousal.
Abstract: Objective. To study the Zolpidem arousing effect in persistent vegetative state (PVS) patients combining clinical evaluation, autonomic assessment by heart rate variability (HRV), and EEG records. Methods. We studied a group of 8 PVS patients and other 8 healthy control subjects, matched by age and gender. The patients and controls received drug or placebo in two experimental sessions, separated by 10-14 days. The first 30 minutes of the session were considered the basal record, and then Zolpidem was administered. All participants were evaluated clinically, by EEG, and by HRV during the basal record, and for 90 minutes after drug intake. Results. We found in all patients, time-related arousing signs after Zolpidem intake: behavioral (yawns and hiccups), activation of EEG cortical activity, and a vagolytic chronotropic effect without a significant increment of the vasomotor sympathetic tone. Conclusions. We demonstrated time-related arousing signs after Zolpidem intake. We discussed possible mechanisms to explain these patho-physiological findings regarding EEG cortical activation and an autonomic vagolytic drug effect. As this autonomic imbalance might induce cardiocirculatory complications, which we didn’t find in any of our patients, we suggest developing future trials under control of physiological indices by bedside monitoring. However, considering that this arousing Zolpidem effect might be certainly related to brain function improvement, it should be particularly considered for the development of new neuro-rehabilitation programs in PVS cases. According to the literature review, we claim that this is the first report about the vagolitic effect of Zolpidem in PVS cases.
Export Options
About this article
Cite this article as:
Machado Calixto, Estevez Mario, Rodriguez Rafael, Perez-Nellar Jesus, Chinchilla Mauricio, DeFina Philip, Leisman Gerry, Carrick R. Frederick, Melillo Robert, Schiavi Adam, Gutierrez Joel, Carballo Maylen, Machado Andres, Olivares Ana and Perez-Cruz Nuvia, Zolpidem Arousing Effect in Persistent Vegetative State Patients: Autonomic, EEG and Behavioral Assessment, Current Pharmaceutical Design 2014; 20 (26) . https://dx.doi.org/10.2174/13816128113196660646
DOI https://dx.doi.org/10.2174/13816128113196660646 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Blood-based biomarkers in large-scale screening for neurodegenerative diseases
Disease biomarkers are necessary tools that can be employ in several clinical context of use (COU), ranging from the (early) diagnosis, prognosis, prediction, to monitor of disease state and/or drug efficacy. Regarding neurodegenerative diseases, in particular Alzheimer’s disease (AD), a battery of well-validated biomarkers are available, such as cerebrospinal fluid ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Diabetes mellitus: advances in diagnosis and treatment driving by precision medicine
Diabetes mellitus (DM) is a chronic degenerative metabolic disease with ever increasing prevalence worldwide which is now an epidemic disease affecting 500 million people worldwide. Insufficient insulin secretion from pancreatic β cells unable to maintain blood glucose homeostasis is the main feature of this disease. Multifactorial and complex nature of ...read more
![](/images/wayfinder.jpg)
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Antifungal Agents in Hematopoietic Stem Cell Transplantation
Current Pharmaceutical Design Pneumonia Due to Methicilin-Resistant Staphylococcus aureus (MRSA): A Review
Current Respiratory Medicine Reviews Recent Trends on the Use of Nanoparticles for Nitric Oxide Delivery in Antimicrobial Applications
Drug Delivery Letters Clinical Evidence of Herb-Drug Interactions: A Systematic Review by the Natural Standard Research Collaboration
Current Drug Metabolism The Activated Endocannabinoid System in Atherosclerosis: Driving Force or Protective Mechanism?
Current Drug Targets Amaranth: A Pseudo-Cereal with Nutraceutical Properties
Current Nutrition & Food Science COXIBs, CINODs and H2S-Releasing NSAIDs: Current Perspectives in the Development of Safer Non Steroidal Anti-Inflammatory Drugs
Current Medicinal Chemistry Fresh Frozen Plasma Administration in the NICU: Evidence-based Guidelines
Current Pediatric Reviews Bivalirudin or Heparin Treatment During Transcatheter Valve Interventions: Where are we Now?
Current Pharmaceutical Design Next Generation Sequencing in the Management of Leptomeningeal Metastases of Non-Small Cell Lung Cancer: A Case Report and Literature Review
Recent Patents on Anti-Cancer Drug Discovery Potential Mechanisms of Failure in the Sudden Infant Death Syndrome
Current Pediatric Reviews Syntheses of Amido-, Carbamido- and Carbamatoalkylnaphthols
Current Organic Synthesis Ras Family Small GTPase-Mediated Neuroprotective Signaling in Stroke
Central Nervous System Agents in Medicinal Chemistry Neuronutrient Amino-Acid Therapy Protects Against Reward Deficiency Syndrome: Dopaminergic Key to Homeostasis and Neuroplasticity
Current Pharmaceutical Design Bioactive Cyclohexenones: A Mini Review
Current Bioactive Compounds Chemical Intuition in Drug Design and Discovery
Current Topics in Medicinal Chemistry Hypertension in the Elderly
Cardiovascular & Hematological Agents in Medicinal Chemistry The Role of Transesophageal Echocardiography in the Intraoperative Period
Current Cardiology Reviews Synaptic Inputs of Neural Afferent Pathways to Vasopressin- and Oxytocin-Secreting Neurons of Supraoptic and Paraventricular Hypothalamic Nuclei
Endocrine, Metabolic & Immune Disorders - Drug Targets Pathophysiology of Sepsis in the Elderly: Clinical Impact and Therapeutic Considerations
Current Drug Targets