11 ms·

Severe brain injury and paralysis temporarily reversed with a sleeping pill

313 points by ptbello 6y ago

PIKAL 6y ago
Mainstream medical doctors have been ignoring this for more than a decade. It’s absolutely shameful.
kneel 6y ago
https://www.youtube.com/watch?v=4kWKvDj3jD4 https://www.youtube.com/watch?v=4kWKvDj3jD4
- pcurve 6y ago
  Update https://www.youtube.com/watch?v=VUnBPOO9Qmw https://www.youtube.com/watch?v=VUnBPOO9Qmw
TedDoesntTalk 6y ago
What happens when the sleeping pill wears off? Does the patient revert to his previous state until administered another dose, or does a single dose permanently change the patient?
- ve55 6y ago
  It would seem they revert back to their previous state, since it mentions 'temporary'
- teej 6y ago
  They revert when it wears off.
- xwdv 6y ago
  Essentially they come back to life for a bit and then slither back to their vegetative state.
  - getlawgdon 6y ago
    You could phrase this much more kindly.
    - toolz 6y ago
      I believe it would be on you to interpret it more charitably. I'm unsure how you've found a way to take offense with words that aren't readily associated with malice.
      - getlawgdon 6y ago
        Your bizarre use of "malice" explains a lot about why you don't see how "slither" and "come back to life" are plainly uncharitable phraseology to associate with people dealing with tbi. If you can't figure that out, buddy, I don't know what to tell ya.
        chairmanwow1 6y ago
        I think you are off base here. OP’s comment isn’t malicious.
        nitrogen 6y ago
        Indeed, to me the comment in question sounds like a subjective description of what the hyporesponsive might be feeling as their lucidity or initiative are taken away after a brief window of activity.
        xwdv 6y ago
        As the author of the original comment, I feel this is the most accurate comprehension. Other comments seem to have taken a more literal read, but that would be incorrect, as clearly the patients are neither dead nor snakes. I would debate that slither isn’t a negative connotation when used in reference to senses, for instance: electrical impulses slither through the synapses of the human nervous system, allowing us to perceive a reality.
- mikeyouse 6y ago
  > After consultation with his family, a single dose of zolpidem (10 mg) was administered by the nursing home physician. This dose is frequently used for patients with persistent hyporesponsive disorders (Bomalaski et al., 2017). Within 20 min, the patient started communicating spontaneously, asking the nurse how his wheelchair was to be operated, and requesting fast food. He managed to walk while being supported by the staff and phoned his father, who had not heard his son's voice for years. Despite evident retrograde amnesia, going back three years before the brain injury, and an apparent hearing deficit, he was cheerful, alert, and showing interest in the people and objects surrounding him. > Two hours after zolpidem administration, he gradually fell back into his diminished motivational state.
  - yellow_lead 6y ago
    It's great that he's able to "come back" for a little while, but it must be so sad for his loved ones to see him revert to the diminished state.
ComputerGuru 6y ago
Zolpidem is famous for this, although it’s raised more questions than answers. This particular phenomenon has been known since the early 2000s; NYT has a good write up about it: https://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-minimally-conscious.html https://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-...
- ianai 6y ago
  After taking it for sleep, I think it should be researched for way more. It’s clearly rewiring things.
  - shakezula 6y ago
    Can you elaborate on your experience with it? I’m super curious about that.
    - agency 6y ago
      Zolpidem is Ambien, which is notorious for its interesting side-effects https://www.healthline.com/health/side-effects-of-taking-ambien#1 https://www.healthline.com/health/side-effects-of-taking-amb...
      - nitrogen 6y ago
        I would never take Ambien myself after someone I know was prescribed it, and instead of sleeping they would black out, blast techno/dance music in their apartment, and scream at the top of their lungs while stomping up and down ("dancing"). Then post about it on social media. All without remembering it, or with only hazy memories.
        deleted 6y ago
        [deleted]
        nineparts 6y ago
        Sounds like it's a gateway drug to demon possession (or at least descriptions of it -- in case of an atheist reading).
madcow00 6y ago
Things like these makes me realize how little we know about the functioning of brain. Manipulating brain digitally would be perhaps one of the biggest technological revolution after industrial revolution.
- numpad0 6y ago
  That’s basically singularity
- monkeydreams 6y ago
  I saw a paper describing a clinical trial of a device which electrically stimulates the median nerve to reduce the severity of tourette's symptoms. This would be game changing to the Tourette's community. It is so much more than just a speech or tic disorder, and to give the worst affected sufferers their lives back (by reducing the impact of disinhibition, etc) is a fucking miracle.
- the_only_law 6y ago
  Sometimes I wish I was smart enough to have gotten involved with things like neuroscience. I watched part of a lecture on certain brain functions a good while back, regarding the mechanics of various mental illnesses, and it was incredibly fascinating. Such a powerful organ that we simply can't understand well enough.
  - crispyporkbites 6y ago
    You probably are smart enough. It’s never to late to learn and contribute.
    - etrautmann 6y ago
      This is true. I pivoted from EE to Neuroscience after several years in industry.
      - the_only_law 6y ago
Nextgrid 6y ago
Sci-Hub link: https://sci-hub.do/10.1016/j.cortex.2020.08.011 https://sci-hub.do/10.1016/j.cortex.2020.08.011
mariopt 6y ago
Zolpidem, I use this pill to sleep and works fantastic for me. My MD told me that regular use could lead to dementia and the risk for addiction is considerable. I've tried antidepressants to sleep but always wake up with a headache, the feeling of it it's not great either. But with this one, never had an issue.
- ed25519FUUU 6y ago
  Dementia as a side effect? Aren’t you scared of that?
  - ianai 6y ago
    It’s a crap calculation but dementia years away is better than a life without proper sleep. You might not make it to those dementia years or skip it through some other process-like not triggering it. I’ve accepted similar trade offs with medication for chronic migraine (as in literally every day sometimes multiples per day). Functioning today definitely matters more than decades down the road if that’s what it truly takes.
  - leetrout 6y ago
    Check this out: Zolpidem may cause serious or possibly life-threatening sleep behaviors. Some people who took zolpidem got out of bed and drove their cars, prepared and ate food, had sex, made phone calls, sleep-walked, or were involved in other activities while not fully awake. After they woke up, these people were unable to remember what they had done. Tell your doctor if you have ever had an unusual sleep behavior while taking zolpidem. Be sure that your family or caregiver are aware that these symptoms are serious and to call your doctor if they occur. Stop taking zolpidem and call your doctor right away if you find out that you have been driving or doing anything else unusual while you were sleeping. https://medlineplus.gov/druginfo/meds/a693025.html https://medlineplus.gov/druginfo/meds/a693025.html
    - casefields 6y ago
      Look up Ambien Walrus for humorous takes on what's a serious issue.
jetrink 6y ago
Reading the HN title, I was immediately reminded of the Oliver Sacks book Awakenings[1]. He discovered that the drug L-DOPA could temporarily awaken encephalitis patients from a coma-like state. I wonder if the article's title "Awakening after a sleeping pill" is a reference to that book. 1. https://en.wikipedia.org/wiki/Awakenings_(book) https://en.wikipedia.org/wiki/Awakenings_(book)
- mdoms 6y ago
  There's a House M.D. episode about this. It's one of my favourite episodes, but if you weren't already following the show it wouldn't be the best one to start on, as it involved Wilson doing a lot of analysis on House's way of thinking which you'd lack context on. https://en.m.wikipedia.org/wiki/Son_of_Coma_Guy https://en.m.wikipedia.org/wiki/Son_of_Coma_Guy
  - bbarnett 6y ago
    https://www.imdb.com/title/tt0099077/ https://www.imdb.com/title/tt0099077/ Two incredible actors, and one very touching movie.
hikerclimb 6y ago
Hopefully this doesn’t work
DoreenMichele 6y ago
Excerpt: A man, 29-year old, with a history of alcohol abuse suffered from hypoxic-ischemic brain injury after choking on a piece of meat. After an initial, though slow neurological recovery, spontaneous movement and speech disappeared. The patient developed such a severe impairment of arousal that he required intensive auditory and tactile stimulation to maintain a wakeful state. No structural lesions were found using a computerized tomography (CT) scan to explain this secondary deterioration, and conventional EEG-recordings showed no evidence of epilepsy. After a stay in the ICU and neurology department, the patient was transferred to a nursing home without a formal diagnosis explaining his hyporesponsive state. A structural MRI at follow-up showed signs of diffuse atrophy without hydrocephalus. Eight years passed without any further improvement and neurological follow-up. Eventually, a new nursing home physician with experience in hyporesponsive disorders took over the patient's treatment and performed a new neurological examination to find directions to improve his care. Upon clinical assessment, the now 37-year old patient seemed awake, but showed a complete lack of voluntary movement (akinesia) and absence of speech (mutism). More specifically, the patient showed no affective reactions, initiation of eating or drinking, and remained incontinent. Although the patient showed no signs of spontaneous speech or vocalization on request, he was able to respond to questions or commands with movements with a significant delay (usually a couple of seconds) and with evident ataxia and muscle rigidity. Despite his intact awareness, the patient's initiative was so severely impaired that he remained wheelchair-bound and entirely dependent on nursing care for all daily activities, including the need for enteral tube feeding. It's incredible how little we still know about some things. They couldn't pin down a cause and this is apparently a significant detail as to why this patient was basically warehoused in a nursing home with no real treatment for literally years until they tried this new thing, which had some short-lived effects.
- centimeter 6y ago
  Several years ago I experienced a (thankfully temporary) severe reduction in brain function, for several weeks. I was shocked by the truly abysmal diagnostic capability of modern neuromedicine for anything less than large-scale physical trauma. In my case, they couldn't pin down a cause at all, except to say that the symptoms were consistent with a viral infection of the CNS. What virus? Who knows, we can only test for a handful of them.
canada_dry 6y ago
This reminded me of the treatment of Encephalitis lethargica [i] and the temporary effect of L-dopa (as made famous in the movie Awakenings). [i] https://en.wikipedia.org/wiki/Encephalitis_lethargica https://en.wikipedia.org/wiki/Encephalitis_lethargica
tedd4u 6y ago
Ah, the video at the bottom of the paper is really emotional! I hope they can figure out how to prolong the effects. Still, an hour of lucidity and verbal communication and a stroll every few weeks and a visit with the family is infinitely better than nothing at all.
- casefields 6y ago
  I'm glad you pointed that out. It was great to see video of him.
  - Nextgrid 6y ago
    I wonder how does he feel when he's not under zolpidem. We can clearly see him being slow and mostly non-responsive, but I wonder what the experience for him is like - is it like sleep where he doesn't feel/remember anything about it (notice how once under zolpidem he does not think he has health problems), does he feel normal, and if so what is he thinking about, etc?
    - mattlondon 6y ago
      Totally agreed. I wonder what the ethical side of this is... Give someone a pill and they suddenly "unlocked" from locked-in syndrome. How can you not want to give these people these drugs all the time and let them have at least a partially normal existence.
      - Nextgrid 6y ago
        The problem seems to be that their body builds tolerance to it so that even if you give them this medication constantly it gradually stops being effective. However I do agree that these drugs should be available and it's up to the carers to work out a dose that maximizes the amount of time the person is "unlocked".
  - GordonS 6y ago
    Same here, I don't expect to find videos attached to papers, so would never think to look. It's absolutely incredible! You can read as much in the paper of course, but seeing it with your own eyes is somehow very different.
demostanes 6y ago
Living through TBI is hell. Thankfully I found a legit brand of CBD whose creators made me a custom blend. Now I'm fully recovered: www.Jampha.com
bxtt 6y ago
I’ve been taking Zolpidem for about 13 years now and suffer from addiction. I’ve sought treatment for this but it doesn’t work as now I cannot sleep without taking something. If you haven’t taken Z-type sleeping aids, I would definitely suggest not to start, as from experience the consequences outweigh the benefits. I’ve lost a considerable amount of friends/reputation/etc. from the abuse. Every experience that you hear about from sleeping aids, I’ve been through it (from the loopy fun to binge eating to weird sex to psychosis to crashing my car)
- grecy 6y ago
  (Genuinely curious and not trying to downplay the seriousness at all) What would happen if you took a month off work and all your obligations and stayed home and didn't take anything for a whole month? My understanding is the human body can't go more than about 10 days without sleep [1]. So I assume at that point you would fall asleep, and then over the coming ~20 days hopefully you could normalize it and get back to some kind of unassisted "regular" sleeping.... ? [1] https://www.healthline.com/health/healthy-sleep/how-long-can-you-go-without-sleep https://www.healthline.com/health/healthy-sleep/how-long-can...
  - Pfhreak 6y ago
    According to Wikipedia, withdrawal symptoms can be severe including seizures, vomiting, etc. To do nothing of the discomfort from a lack of sleep. It would take incredible will power to overcome something like that. It also sounds like there are some treatments that can help fight an auction, including other medications that bind to some of the same receptors. Or very slowly weaning someone off (but then you have to figure out something else for the insomnia.)
  - bxtt 6y ago
    I've actually decided to take some time off work because of my addiction issues. It's more so the cycle. I'll stop taking Zolpidem/Zopiclone for several weeks/month (the first several days -- terrible shakes, chills, nightmares, several days without sleeping etc. Zopiclone/Benzo withdrawal is far worse) After a while, I'll eventually adjust but I have insomnia/poor sleep so I'll eventually cave in due to sleep deprivation then I'll pick back up. For the past year, I would roughly take 90mg of either Zolpidem/Zopiclone in a single night. On average, I roughly go through 100 pills a week (I have pharmacies that sell to me...I know sketch). It wasn't always like this, when I first started taking medication after going to Stanford Sleep Clinic, I would just take a pill or two a night and have fantastic sleep. It was like this for several years but eventually my tolerance increased and my work stress/insomnia got worse with age. I want to reiterate that I've destroyed/damaged every meaningful relationship in my life. I state this all out because I've realized that people have a strange fascination with Ambien.
jb775 6y ago
My sister suffered severe TBI from a car accident for 15 years before she eventually passed last year. It was pretty shocking to witness the lack of knowledge in regards to how the human brain works, and more specifically lacking in how to heal/treat an injured brain. Immediately following the accident, we saw other patients in the same condition as her and tracked their progress for comparison sake. The common theme was that patients either made significant progress (with motor skills, talking, etc) within the first 0-3 weeks, or not really at all. It seemed like once scar-tissue started forming in the brain, critical brain connectivity began to get blocked (not necessarily broken). If we can better understand the underlying mechanism behind the "signal blocking" vs "signal un-blocking" aspect seen using this drug in TBI patients, it would be a huge win for all brain related conditions.
- cblconfederate 6y ago
  The underlying mechanism is well known: it activates GABA (inhibitory) receptors causing cells to hyperpolarize. We have all kinds of receptor activators/deactivator drugs, the problem is the brain is complex and we don't know where/when/how to use them to achieve desired effects.
AllegedAlec 6y ago
Trapped inside this Octavarium...
apatheticonion 6y ago
Found out promethazine (over the counter antihistamine) can make me sleepy after trying to use it to help with virtual reality sickness. I've recently started taking it a few times a month to help out when I am having poor sleep, in an attempt to kick me back into a decent rhythm. Reading the experiences in this thread of people using Seroquel or Zolpidem and their negative reactions - I am feeling a little sketchy about my crutch.
- opiate_addict 6y ago
  Careful with antihistamines. I've abused diphenhydramine in the past. Like crazy amounts each night. And I know at least 2 other addicts who have as well - one even claimed they shot it lol... so it can be addictive (and slightly physically addictive hard to get sleep until after 'withdrawals' end). it helps 'slow down my thinking' and just kind of nod out to nothingness when taken alone. and combining with other drugs/alcohol amplifies I feel like it has permanently worsened my memory. For sure brain fog is definitely noticeable for weeks after stopping. There are also a few scary articles I've read linking to alzheimer's/dementia. It kind of makes sense from my limited wikipedia understanding of brain chemistry that blocking Acetylcholine would have long term effects. amped up version of this action is used to kill people vx seren etc im sober from everything now. but every once and a blue moon i'll take diphenhydramine if i'm having serious insomnia. one night feels restful. after that it just exasperates & continues the cycle. It also is hard to take just one, I literally have to buy a travel pack, take one, throw the rest away or i will keep taking them until they are gone. annnnd now i want one to zone out. don't abuse drugs kids!
tyingq 6y ago
Different drug and underlying affliction, but the film "Awakenings" is worth watching if this story piques your interest. It's a true (though highly dramatized) story. https://www.imdb.com/title/tt0099077/ https://www.imdb.com/title/tt0099077/
- copperx 6y ago
  The book (Awakenings by Oliver Sacks) might be a better resource if you're interested in specifics and don't care for dramatization.
layoutIfNeeded 6y ago
So at least some people who have been declared “brain-dead” and had their organs harvested could have been brought back (albeit temporarily) with a shot of Ambien? That’s... disturbing.
neuronic 6y ago
Out of curiosity, I brought this up to a professor in 2009. Examples were circulating online back then regarding Ambien and lock-in syndrome with similar temporary reversal effect. Got basically told off with denial and laughs. Experts often get stuck on this point where their ego supercedes any notion of new science, exploration and potentially disruptive information.
artur_makly 6y ago
sleeping pills are going to be our next pandemic. these drugs need to be reclassified as “fucking dangerous” here is just a list of shit to be prepared for when you take them for more than a few short weeks: https://youtu.be/IKNzL-eU650 https://youtu.be/IKNzL-eU650 please be VERY careful. ive been on then for years and it is a nasty and very long detox process.
- copperx 6y ago
  They can be a lifesaver for an informed patient, though. I suffer from occasional insomnia (about once a month -- if working too late, got too emotionally invested in something, or if accidentally drank too much coffee), and Ambien has been incredibly helpful. I wouldn't dare take it on even a weekly basis, though. Even though I haven't had any side effects, I still hide my car keys before taking it after having read stories of people driving while asleep on Ambien.
loceng 6y ago
A really fascinating book is just waiting to be written taking into account the brain wave pattern understanding from research that's occurred over the last few years.
cobolcowboy 6y ago
To the people in this thread advocating antipsychotic medication for anything other than treating psychosis and as an adjunct for severe depression, don't. These medications are serious things for serious situations and can have unexpected effects on you mentally. I went on them in my early twenties due to a nervous breakdown, and while they stopped the endless loops of thought and insomnia (I ended up sleeping ten hours a night without breaking a sweat), they reduced my libido, made me gain weight, and worst of all, robbed me of my natural sharpness and creativity. It was as if my brain had been wrapped in a layer of bubble wrap, and my ability to come up with those sparks of inspiration that you need to do intellectual work was almost extinguished. I'm 100% now, fully recovered, but it took me about 3-4 years to get back where I was before it all happened. If your doctor thinks you're right for them, go for it, but only as a last resort. They do work, but they're the last tool in the box that you only want to use when everything else has failed.
- costcopizza 6y ago
  What helped you in your 3-4 year recovery?
  - cobolcowboy 6y ago
    Honestly, learning to program. I was listless when I got into university, and couldn't cope with the fact I wasn't the smartest person I knew anymore. That hit me a lot harder than I expected, and cascaded into a complete loss of confidence. Learning a skill from the ground up I couldn't bullshit from random esoterica I'd picked up from high school forced me to confront my lifelong hubris and put aside my ego. Eventually I got decent enough at it that it became my career. It was a slow, grinding, painful process, but it taught me a lot about humility and the value of incremental progress.
- kayodelycaon 6y ago
  Agree with this. I’m on antipsychotic medication due to psychosis and insomnia. Works great but there are a lot of side effects, which I take additional medication to correct.
- 6y ago
someperson 6y ago
Here's a human-interest story on this same medication: https://www.youtube.com/watch?v=i9XeeVSRlYs https://www.youtube.com/watch?v=i9XeeVSRlYs
foxhop 6y ago
My guess is the damage was primarily on the conscious parts of the head, my guess is the sleeping pill (I'd wager canibus may also work) allows the more unconscious "dream-like" side of the brian to temporarily fill-in on executive functions.
therealbilly 6y ago
So sad knowing the patient will always revert back to his original state.

313 points by ptbello 6y ago

PIKAL 6y ago

Mainstream medical doctors have been ignoring this for more than a decade. It’s absolutely shameful.

kneel 6y ago

https://www.youtube.com/watch?v=4kWKvDj3jD4 https://www.youtube.com/watch?v=4kWKvDj3jD4

pcurve 6y ago
Update https://www.youtube.com/watch?v=VUnBPOO9Qmw https://www.youtube.com/watch?v=VUnBPOO9Qmw

TedDoesntTalk 6y ago

What happens when the sleeping pill wears off? Does the patient revert to his previous state until administered another dose, or does a single dose permanently change the patient?

ve55 6y ago
It would seem they revert back to their previous state, since it mentions 'temporary'
teej 6y ago
They revert when it wears off.
xwdv 6y ago
Essentially they come back to life for a bit and then slither back to their vegetative state.
- getlawgdon 6y ago
  You could phrase this much more kindly.
  - toolz 6y ago
    I believe it would be on you to interpret it more charitably. I'm unsure how you've found a way to take offense with words that aren't readily associated with malice.
    - getlawgdon 6y ago
      Your bizarre use of "malice" explains a lot about why you don't see how "slither" and "come back to life" are plainly uncharitable phraseology to associate with people dealing with tbi. If you can't figure that out, buddy, I don't know what to tell ya.
      - chairmanwow1 6y ago
        I think you are off base here. OP’s comment isn’t malicious.
        nitrogen 6y ago
        Indeed, to me the comment in question sounds like a subjective description of what the hyporesponsive might be feeling as their lucidity or initiative are taken away after a brief window of activity.
        xwdv 6y ago
        As the author of the original comment, I feel this is the most accurate comprehension. Other comments seem to have taken a more literal read, but that would be incorrect, as clearly the patients are neither dead nor snakes. I would debate that slither isn’t a negative connotation when used in reference to senses, for instance: electrical impulses slither through the synapses of the human nervous system, allowing us to perceive a reality.
mikeyouse 6y ago
> After consultation with his family, a single dose of zolpidem (10 mg) was administered by the nursing home physician. This dose is frequently used for patients with persistent hyporesponsive disorders (Bomalaski et al., 2017). Within 20 min, the patient started communicating spontaneously, asking the nurse how his wheelchair was to be operated, and requesting fast food. He managed to walk while being supported by the staff and phoned his father, who had not heard his son's voice for years. Despite evident retrograde amnesia, going back three years before the brain injury, and an apparent hearing deficit, he was cheerful, alert, and showing interest in the people and objects surrounding him. > Two hours after zolpidem administration, he gradually fell back into his diminished motivational state.
- yellow_lead 6y ago
  It's great that he's able to "come back" for a little while, but it must be so sad for his loved ones to see him revert to the diminished state.

ComputerGuru 6y ago

Zolpidem is famous for this, although it’s raised more questions than answers. This particular phenomenon has been known since the early 2000s; NYT has a good write up about it: https://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-minimally-conscious.html https://www.nytimes.com/2011/12/04/magazine/can-ambien-wake-...

ianai 6y ago
After taking it for sleep, I think it should be researched for way more. It’s clearly rewiring things.
- shakezula 6y ago
  Can you elaborate on your experience with it? I’m super curious about that.
  - agency 6y ago
    Zolpidem is Ambien, which is notorious for its interesting side-effects https://www.healthline.com/health/side-effects-of-taking-ambien#1 https://www.healthline.com/health/side-effects-of-taking-amb...
    - nitrogen 6y ago
      I would never take Ambien myself after someone I know was prescribed it, and instead of sleeping they would black out, blast techno/dance music in their apartment, and scream at the top of their lungs while stomping up and down ("dancing"). Then post about it on social media. All without remembering it, or with only hazy memories.
      - deleted 6y ago
        [deleted]
      - nineparts 6y ago
        Sounds like it's a gateway drug to demon possession (or at least descriptions of it -- in case of an atheist reading).

madcow00 6y ago

Things like these makes me realize how little we know about the functioning of brain. Manipulating brain digitally would be perhaps one of the biggest technological revolution after industrial revolution.

numpad0 6y ago
That’s basically singularity
monkeydreams 6y ago
I saw a paper describing a clinical trial of a device which electrically stimulates the median nerve to reduce the severity of tourette's symptoms. This would be game changing to the Tourette's community. It is so much more than just a speech or tic disorder, and to give the worst affected sufferers their lives back (by reducing the impact of disinhibition, etc) is a fucking miracle.
the_only_law 6y ago
Sometimes I wish I was smart enough to have gotten involved with things like neuroscience. I watched part of a lecture on certain brain functions a good while back, regarding the mechanics of various mental illnesses, and it was incredibly fascinating. Such a powerful organ that we simply can't understand well enough.
- crispyporkbites 6y ago
  You probably are smart enough. It’s never to late to learn and contribute.
  - etrautmann 6y ago
    This is true. I pivoted from EE to Neuroscience after several years in industry.
    - the_only_law 6y ago

Nextgrid 6y ago

Sci-Hub link: https://sci-hub.do/10.1016/j.cortex.2020.08.011 https://sci-hub.do/10.1016/j.cortex.2020.08.011

mariopt 6y ago

Zolpidem, I use this pill to sleep and works fantastic for me. My MD told me that regular use could lead to dementia and the risk for addiction is considerable. I've tried antidepressants to sleep but always wake up with a headache, the feeling of it it's not great either. But with this one, never had an issue.

ed25519FUUU 6y ago
Dementia as a side effect? Aren’t you scared of that?
- ianai 6y ago
  It’s a crap calculation but dementia years away is better than a life without proper sleep. You might not make it to those dementia years or skip it through some other process-like not triggering it. I’ve accepted similar trade offs with medication for chronic migraine (as in literally every day sometimes multiples per day). Functioning today definitely matters more than decades down the road if that’s what it truly takes.
- leetrout 6y ago
  Check this out: Zolpidem may cause serious or possibly life-threatening sleep behaviors. Some people who took zolpidem got out of bed and drove their cars, prepared and ate food, had sex, made phone calls, sleep-walked, or were involved in other activities while not fully awake. After they woke up, these people were unable to remember what they had done. Tell your doctor if you have ever had an unusual sleep behavior while taking zolpidem. Be sure that your family or caregiver are aware that these symptoms are serious and to call your doctor if they occur. Stop taking zolpidem and call your doctor right away if you find out that you have been driving or doing anything else unusual while you were sleeping. https://medlineplus.gov/druginfo/meds/a693025.html https://medlineplus.gov/druginfo/meds/a693025.html
  - casefields 6y ago
    Look up Ambien Walrus for humorous takes on what's a serious issue.

jetrink 6y ago

Reading the HN title, I was immediately reminded of the Oliver Sacks book Awakenings[1]. He discovered that the drug L-DOPA could temporarily awaken encephalitis patients from a coma-like state. I wonder if the article's title "Awakening after a sleeping pill" is a reference to that book. 1. https://en.wikipedia.org/wiki/Awakenings_(book) https://en.wikipedia.org/wiki/Awakenings_(book)

mdoms 6y ago
There's a House M.D. episode about this. It's one of my favourite episodes, but if you weren't already following the show it wouldn't be the best one to start on, as it involved Wilson doing a lot of analysis on House's way of thinking which you'd lack context on. https://en.m.wikipedia.org/wiki/Son_of_Coma_Guy https://en.m.wikipedia.org/wiki/Son_of_Coma_Guy
- bbarnett 6y ago
  https://www.imdb.com/title/tt0099077/ https://www.imdb.com/title/tt0099077/ Two incredible actors, and one very touching movie.

hikerclimb 6y ago

Hopefully this doesn’t work

DoreenMichele 6y ago

Excerpt: A man, 29-year old, with a history of alcohol abuse suffered from hypoxic-ischemic brain injury after choking on a piece of meat. After an initial, though slow neurological recovery, spontaneous movement and speech disappeared. The patient developed such a severe impairment of arousal that he required intensive auditory and tactile stimulation to maintain a wakeful state. No structural lesions were found using a computerized tomography (CT) scan to explain this secondary deterioration, and conventional EEG-recordings showed no evidence of epilepsy. After a stay in the ICU and neurology department, the patient was transferred to a nursing home without a formal diagnosis explaining his hyporesponsive state. A structural MRI at follow-up showed signs of diffuse atrophy without hydrocephalus. Eight years passed without any further improvement and neurological follow-up. Eventually, a new nursing home physician with experience in hyporesponsive disorders took over the patient's treatment and performed a new neurological examination to find directions to improve his care. Upon clinical assessment, the now 37-year old patient seemed awake, but showed a complete lack of voluntary movement (akinesia) and absence of speech (mutism). More specifically, the patient showed no affective reactions, initiation of eating or drinking, and remained incontinent. Although the patient showed no signs of spontaneous speech or vocalization on request, he was able to respond to questions or commands with movements with a significant delay (usually a couple of seconds) and with evident ataxia and muscle rigidity. Despite his intact awareness, the patient's initiative was so severely impaired that he remained wheelchair-bound and entirely dependent on nursing care for all daily activities, including the need for enteral tube feeding. It's incredible how little we still know about some things. They couldn't pin down a cause and this is apparently a significant detail as to why this patient was basically warehoused in a nursing home with no real treatment for literally years until they tried this new thing, which had some short-lived effects.

centimeter 6y ago
Several years ago I experienced a (thankfully temporary) severe reduction in brain function, for several weeks. I was shocked by the truly abysmal diagnostic capability of modern neuromedicine for anything less than large-scale physical trauma. In my case, they couldn't pin down a cause at all, except to say that the symptoms were consistent with a viral infection of the CNS. What virus? Who knows, we can only test for a handful of them.

canada_dry 6y ago

This reminded me of the treatment of Encephalitis lethargica [i] and the temporary effect of L-dopa (as made famous in the movie Awakenings). [i] https://en.wikipedia.org/wiki/Encephalitis_lethargica https://en.wikipedia.org/wiki/Encephalitis_lethargica

tedd4u 6y ago

Ah, the video at the bottom of the paper is really emotional! I hope they can figure out how to prolong the effects. Still, an hour of lucidity and verbal communication and a stroll every few weeks and a visit with the family is infinitely better than nothing at all.

casefields 6y ago
I'm glad you pointed that out. It was great to see video of him.
- Nextgrid 6y ago
  I wonder how does he feel when he's not under zolpidem. We can clearly see him being slow and mostly non-responsive, but I wonder what the experience for him is like - is it like sleep where he doesn't feel/remember anything about it (notice how once under zolpidem he does not think he has health problems), does he feel normal, and if so what is he thinking about, etc?
  - mattlondon 6y ago
    Totally agreed. I wonder what the ethical side of this is... Give someone a pill and they suddenly "unlocked" from locked-in syndrome. How can you not want to give these people these drugs all the time and let them have at least a partially normal existence.
    - Nextgrid 6y ago
      The problem seems to be that their body builds tolerance to it so that even if you give them this medication constantly it gradually stops being effective. However I do agree that these drugs should be available and it's up to the carers to work out a dose that maximizes the amount of time the person is "unlocked".
- GordonS 6y ago
  Same here, I don't expect to find videos attached to papers, so would never think to look. It's absolutely incredible! You can read as much in the paper of course, but seeing it with your own eyes is somehow very different.

demostanes 6y ago

Living through TBI is hell. Thankfully I found a legit brand of CBD whose creators made me a custom blend. Now I'm fully recovered: www.Jampha.com

bxtt 6y ago

I’ve been taking Zolpidem for about 13 years now and suffer from addiction. I’ve sought treatment for this but it doesn’t work as now I cannot sleep without taking something. If you haven’t taken Z-type sleeping aids, I would definitely suggest not to start, as from experience the consequences outweigh the benefits. I’ve lost a considerable amount of friends/reputation/etc. from the abuse. Every experience that you hear about from sleeping aids, I’ve been through it (from the loopy fun to binge eating to weird sex to psychosis to crashing my car)

grecy 6y ago
(Genuinely curious and not trying to downplay the seriousness at all) What would happen if you took a month off work and all your obligations and stayed home and didn't take anything for a whole month? My understanding is the human body can't go more than about 10 days without sleep [1]. So I assume at that point you would fall asleep, and then over the coming ~20 days hopefully you could normalize it and get back to some kind of unassisted "regular" sleeping.... ? [1] https://www.healthline.com/health/healthy-sleep/how-long-can-you-go-without-sleep https://www.healthline.com/health/healthy-sleep/how-long-can...
- Pfhreak 6y ago
  According to Wikipedia, withdrawal symptoms can be severe including seizures, vomiting, etc. To do nothing of the discomfort from a lack of sleep. It would take incredible will power to overcome something like that. It also sounds like there are some treatments that can help fight an auction, including other medications that bind to some of the same receptors. Or very slowly weaning someone off (but then you have to figure out something else for the insomnia.)
- bxtt 6y ago
  I've actually decided to take some time off work because of my addiction issues. It's more so the cycle. I'll stop taking Zolpidem/Zopiclone for several weeks/month (the first several days -- terrible shakes, chills, nightmares, several days without sleeping etc. Zopiclone/Benzo withdrawal is far worse) After a while, I'll eventually adjust but I have insomnia/poor sleep so I'll eventually cave in due to sleep deprivation then I'll pick back up. For the past year, I would roughly take 90mg of either Zolpidem/Zopiclone in a single night. On average, I roughly go through 100 pills a week (I have pharmacies that sell to me...I know sketch). It wasn't always like this, when I first started taking medication after going to Stanford Sleep Clinic, I would just take a pill or two a night and have fantastic sleep. It was like this for several years but eventually my tolerance increased and my work stress/insomnia got worse with age. I want to reiterate that I've destroyed/damaged every meaningful relationship in my life. I state this all out because I've realized that people have a strange fascination with Ambien.

jb775 6y ago

My sister suffered severe TBI from a car accident for 15 years before she eventually passed last year. It was pretty shocking to witness the lack of knowledge in regards to how the human brain works, and more specifically lacking in how to heal/treat an injured brain. Immediately following the accident, we saw other patients in the same condition as her and tracked their progress for comparison sake. The common theme was that patients either made significant progress (with motor skills, talking, etc) within the first 0-3 weeks, or not really at all. It seemed like once scar-tissue started forming in the brain, critical brain connectivity began to get blocked (not necessarily broken). If we can better understand the underlying mechanism behind the "signal blocking" vs "signal un-blocking" aspect seen using this drug in TBI patients, it would be a huge win for all brain related conditions.

cblconfederate 6y ago
The underlying mechanism is well known: it activates GABA (inhibitory) receptors causing cells to hyperpolarize. We have all kinds of receptor activators/deactivator drugs, the problem is the brain is complex and we don't know where/when/how to use them to achieve desired effects.

AllegedAlec 6y ago

Trapped inside this Octavarium...

apatheticonion 6y ago

Found out promethazine (over the counter antihistamine) can make me sleepy after trying to use it to help with virtual reality sickness. I've recently started taking it a few times a month to help out when I am having poor sleep, in an attempt to kick me back into a decent rhythm. Reading the experiences in this thread of people using Seroquel or Zolpidem and their negative reactions - I am feeling a little sketchy about my crutch.

opiate_addict 6y ago
Careful with antihistamines. I've abused diphenhydramine in the past. Like crazy amounts each night. And I know at least 2 other addicts who have as well - one even claimed they shot it lol... so it can be addictive (and slightly physically addictive hard to get sleep until after 'withdrawals' end). it helps 'slow down my thinking' and just kind of nod out to nothingness when taken alone. and combining with other drugs/alcohol amplifies I feel like it has permanently worsened my memory. For sure brain fog is definitely noticeable for weeks after stopping. There are also a few scary articles I've read linking to alzheimer's/dementia. It kind of makes sense from my limited wikipedia understanding of brain chemistry that blocking Acetylcholine would have long term effects. amped up version of this action is used to kill people vx seren etc im sober from everything now. but every once and a blue moon i'll take diphenhydramine if i'm having serious insomnia. one night feels restful. after that it just exasperates & continues the cycle. It also is hard to take just one, I literally have to buy a travel pack, take one, throw the rest away or i will keep taking them until they are gone. annnnd now i want one to zone out. don't abuse drugs kids!

tyingq 6y ago

Different drug and underlying affliction, but the film "Awakenings" is worth watching if this story piques your interest. It's a true (though highly dramatized) story. https://www.imdb.com/title/tt0099077/ https://www.imdb.com/title/tt0099077/

copperx 6y ago
The book (Awakenings by Oliver Sacks) might be a better resource if you're interested in specifics and don't care for dramatization.

layoutIfNeeded 6y ago

So at least some people who have been declared “brain-dead” and had their organs harvested could have been brought back (albeit temporarily) with a shot of Ambien? That’s... disturbing.

neuronic 6y ago

Out of curiosity, I brought this up to a professor in 2009. Examples were circulating online back then regarding Ambien and lock-in syndrome with similar temporary reversal effect. Got basically told off with denial and laughs. Experts often get stuck on this point where their ego supercedes any notion of new science, exploration and potentially disruptive information.

artur_makly 6y ago

sleeping pills are going to be our next pandemic. these drugs need to be reclassified as “fucking dangerous” here is just a list of shit to be prepared for when you take them for more than a few short weeks: https://youtu.be/IKNzL-eU650 https://youtu.be/IKNzL-eU650 please be VERY careful. ive been on then for years and it is a nasty and very long detox process.

copperx 6y ago
They can be a lifesaver for an informed patient, though. I suffer from occasional insomnia (about once a month -- if working too late, got too emotionally invested in something, or if accidentally drank too much coffee), and Ambien has been incredibly helpful. I wouldn't dare take it on even a weekly basis, though. Even though I haven't had any side effects, I still hide my car keys before taking it after having read stories of people driving while asleep on Ambien.

loceng 6y ago

A really fascinating book is just waiting to be written taking into account the brain wave pattern understanding from research that's occurred over the last few years.

cobolcowboy 6y ago

To the people in this thread advocating antipsychotic medication for anything other than treating psychosis and as an adjunct for severe depression, don't. These medications are serious things for serious situations and can have unexpected effects on you mentally. I went on them in my early twenties due to a nervous breakdown, and while they stopped the endless loops of thought and insomnia (I ended up sleeping ten hours a night without breaking a sweat), they reduced my libido, made me gain weight, and worst of all, robbed me of my natural sharpness and creativity. It was as if my brain had been wrapped in a layer of bubble wrap, and my ability to come up with those sparks of inspiration that you need to do intellectual work was almost extinguished. I'm 100% now, fully recovered, but it took me about 3-4 years to get back where I was before it all happened. If your doctor thinks you're right for them, go for it, but only as a last resort. They do work, but they're the last tool in the box that you only want to use when everything else has failed.

costcopizza 6y ago
What helped you in your 3-4 year recovery?
- cobolcowboy 6y ago
  Honestly, learning to program. I was listless when I got into university, and couldn't cope with the fact I wasn't the smartest person I knew anymore. That hit me a lot harder than I expected, and cascaded into a complete loss of confidence. Learning a skill from the ground up I couldn't bullshit from random esoterica I'd picked up from high school forced me to confront my lifelong hubris and put aside my ego. Eventually I got decent enough at it that it became my career. It was a slow, grinding, painful process, but it taught me a lot about humility and the value of incremental progress.
kayodelycaon 6y ago
Agree with this. I’m on antipsychotic medication due to psychosis and insomnia. Works great but there are a lot of side effects, which I take additional medication to correct.
6y ago

someperson 6y ago

Here's a human-interest story on this same medication: https://www.youtube.com/watch?v=i9XeeVSRlYs https://www.youtube.com/watch?v=i9XeeVSRlYs

foxhop 6y ago

My guess is the damage was primarily on the conscious parts of the head, my guess is the sleeping pill (I'd wager canibus may also work) allows the more unconscious "dream-like" side of the brian to temporarily fill-in on executive functions.

therealbilly 6y ago

So sad knowing the patient will always revert back to his original state.