Man with rare brain disorder briefly cured by Ambien sleeping pill

A drug that makes most people sleep has been shown to boost recovery in mute patients, in an unexpected breakthrough researchers call “spectacular.”

Years ago, a Dutch man, identified only as Richard in the report, suffered a brain injury caused by oxygen deprivation after choking on food, according to IFLScience. After the accident, which happened when he was 29 years old, he never fully recovered his motor functions, leaving him unable to speak, move or eat on his own.

Richard, wheelchair-bound, required a feeding tube and round-the-clock caretakers. Nevertheless, he was undeniably awake and conscious.

Dr. Hisse Arnts, a neurosurgical resident at Amsterdam UMC, diagnosed his condition as akinetic mutism, a condition in which a person cannot move consciously or talk.

“These patients have an intact level of consciousness but present with the inability to speak or move spontaneously,” Arnts, who co-authored the study, told IFLScience. “The patient constantly is in a wakeful state of profound apathy, seemingly indifferent to pain, thirst, hunger and shows no emotions.”

Dr. Willemijn van Erp, elderly care physician and researcher at Radboud University, co-authored the study, which was published in the journal Cortex.

“It was clear that Richard saw and heard us,” said van Erp, as reported by Radbound University for MedicalXpress.com, “but because of his brain injury, he was barely able to respond to us.”

Van Erp, who was still in training for her role when she met now-37-year-old Richard, had been aware of an experimental treatment for paralytic patients: the common sleep-aid zolpidem. The sedative is sold over-the-counter as many brands, including Ambien and Intermezzo.

Richard had been barely responsive for eight years at that point, and his family was ready to try anything.

“Because Richard’s situation seemed hopeless, the family and I decided to administer this medication to Richard,” said van Erp.

In only 20 minutes after a single 10-milligram dose, Richard began to talk — promptly asking for someone to fetch him fast food.

“Against all expectations, zolpidem had remarkable effects. After taking the sleep pill, Richard started talking, wanted to call his father, and started recognizing his brothers again,” said van Erp. “With some help, he could even get up from his wheelchair and walk short distances.”

Unfortunately, the remarkable effects lasted only about two hours, upon which Richard returned to his mute state.

Richard’s brain scans illustrated the zolpidem’s effects, Arnts explained to IFLScience.

“If you could compare the function of the brain, as it were, to a large string orchestra. In our patient, the first violins play so loud that they drown out the other members of the string orchestra and people can no longer hear each other. Zolpidem ensures that these first violins play more ‘pianissimo,’ so that everyone plays back within time. That’s really the beautiful part of our study,” he said.

However, the doctors have yet to fully understand the relationship between the akinetic mutism and zolpidem, or why its success is only temporary, in what they called a “paradoxical phenomenon” in the report.

Richard’s dosage was quickly increased to three doses per day. Unfortunately, the positive effects began to subside with increased use after several days.

Arnts and van Erp hope to apply their findings to a more long-term solution for patients with mutism caused by severe brain injuries, according to the university and will continue to work with Richard.