As no doubt a few of you have, I’ve experienced an Ambien hallucination or seven. The first time I took it, I was typing on my computer, waiting for it to kick in, when suddenly I realized that my computer was actually the deck of the Starship Enterprise. Next gen, for the record.
Ambien is some interesting stuff when it comes to knocking you into a metaphorical coma and making the dragons really show up to the party. But even more interesting is the absurdity that happens when you give it to someone in an actual fucking coma.
Today’s Moment of Science… What layer of Inception is a coma patient on Ambien?
Paradoxical reactions to medications are well documented. In some cases, we tap into those reactions. Amphetamines are useful for keeping you awake and wired as a highly anxious squirrel. They tend to have an almost sedating, calming effect on some people, typically those with ADHD.
Some paradoxical effects go completely awry. Antidepressants can do wonderful things to balance out neurotransmitters, but a well-documented side effect is worsening depression for some. Benzodiazepines, muscle-relaxants that typically mellow people the fuck out, every once in a while cause aggression and violent behavior. Marinol, i.e. government approved THC, is prescribed specifically for nausea caused by chemotherapy. But in some people, cannabis use can cause severe nausea and vomiting, the only treatment for which is quitting cannabis.
So, Ambien, comas, and persistent vegetative states.
Ambien is a sedative-hypnotic indicated for the short term treatment of a variety of sleep disturbances. It works brilliantly for helping people fall asleep and stay asleep, but it also can make you do some interesting things while sleeping. Like sleep walking, sleep driving, and sleep raiding the fridge for cheese.
Then there’s what happens when you give it to someone who’s already out cold.
Like, literally comatose out cold.
They wake the fuck up.
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In 1994 in South Africa, Louis Viljoen was hit by a truck, never to regain consciousness on his own again. Years passed and not a flicker behind his eyes. In 1999, long past when any spontaneous recovery would have been expected, they noticed his arm was spasming. After some discussion with his doctor, they thought perhaps a sedative would help keep him comfortable. So his doctor prescribed Stilnox (the brand name for Ambien in South Africa).
His Mom crushed up and administered the medication. Viljoen perked up and said “hello, Mummy.” Like he hadn’t just spent five goddamn years in sleep mode.
Viljoen’s doctor, Dr. Wally Nel, has continued to prescribe Stilnox, reporting success in treating 150 patients since then with cognitive improvement in over half of them. Though his accidental discovery has been shown to work time and again, the success rate is highly variable from one patient to the next.
Over the last two decades, Ambien’s off-label success has been well documented, albeit in a low percent of patients. In a review study, it was found that less than 10% of patients with consciousness disorders and about 25% of patients with movement disorders (such as Parkinson’s or dystonia) responded to the drug. Of course, some of the patients didn’t get the paradoxical effects. They just got to meet the Ambien dragons. To be fair, you’re not gonna get your shit treated, you deserve a decent hallucination.
The transient nature of its ability to lift someone out of a vegetative state means that even when it’s a success, someone has a taxing road to recovery ahead. Viljoen and patients like him who are successfully treated with Ambien take it multiple times a day for years. But looking at a breakthrough for its shortcomings is, at best, unhelpful. A low success rate is infinitely higher one than we had before, and the questions it raises that we’d never thought to ask might lead to new answers about the brain’s delicate on and off switches.
This has been your daily Moment of Science, still a little sad that I missed the era when doctors handed out quaaludes like goddamn m&ms.
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I’m reminded of encephalitis lethargica and the brief success levodopa. Comatose, Parkinsonism and odd symptoms across the map had a brief recovery while taking levodopa, whose effect gradually waned. Some theorized excitotoxicity, but we have trouble proving that today, let alone in the 1960’s.
never got to experience a quaalude. doubt i’ll correct this deficiency.
Same. Man, our parents’ generation had some fun drugs.