Severe brain injury and paralysis temporarily reversed with a sleeping pill
sciencedirect.com
sciencedirect.com
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...
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.)
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.
Holy crap. The typical dose is 5 mg or 10 mg. I’ve taken 10 before and I’m out.
90 mg?!?
But more fascinating still is what functionality in the brain even enables that.
Do we have free will when sleeping? No. There goes a large part of our life.
How about when zoned out? No.
Do we ever have free will? Atheists looking at the scientific evidence argue that we never have free will.
This isn’t really an option anymore as a father of young kids
Also (from wikipedia) on Seroquel / Quetiapine: "Despite being widely used as a sleep aid due its sedating effect, the benefits of such use do not appear to generally outweigh the side effects."
https://pdfs.semanticscholar.org/8812/afd4bc713c03435b68f2bb...
Personally I would only take antipsychotics when absolutley necessary. Nasty stuff.
Moreover, if you're severely addicted to Z-drugs like OP, the benefits probably do outweigh the side-effects. Not every person is the same, and the cost benefit analysis differs accordingly.
I'm really sorry, that sucks. There is some new medication that is supposed to treat it (I think I saw an ad on TV for it).
I gained about 40 pounds on it, developed dyskinesia after about 6-8 months and ended up cold turkeying off of it, but 5 years later, the movement problems still stay... Unfortunately it also destroyed my executive function too; I can barely even string together coherent thoughts and perform programming work without being overly medicated on ADHD drugs.
I know there's valbenazine and other Parkinson's drugs (selegiline works decently enough on a daily dose, but MAOIs can become dangerous in certain circumstances), but they don't solve the root problem.
Now I can barely even control my hands, legs or face and it's mildly disfiguring, but it's not like I care anymore...
I’ve never had any meaningful side effects. No sleep walking, binge eating, or anything.
I am certainly, in the clinical sense, addicted - eg if I miss a dose I certainly notice, and there is some degree of tolerance, but I’m still better off than before I went on it.
I believe the correct term is "dependent".
There is a lot of misinformation and stigma out there, so I think it's really important to distinguish between addiction (e.g. insatiable cravings), medical dependence (e.g. someone taking anti-psychotics because they will otherwise have psychotic episodes, or someone taking antidepressants because they otherwise have manic depressive episodes), and physiological dependence, where your body's receptors have up/down-regulated to adjust to a "new normal", and withdrawal symptoms may occur if treatment is stopped.
Yes, it can be used as an anti-psychotic. However, in most of the cases I've heard, it's used as a sleep aid.
This was the case for me, too. I was on it for 10 years and ultimately went off because I grew out of my chronic insomnia. Aside from a muted personality and nightmares (the latter controlled by another medication), it was pretty fool proof and had very little consequence in my particular case.
As always, it depends on the person, but the blanket statement you quoted doesn't seem fair.
I've never taken anti-psychotics. I've asked my doctor for anti-depressants a few times (usually during relationship issues) and they are not my thing.
You're not a medical doctor, right? Obviously, or you wouldn't be giving out such frivolous advice. Dude... it's an anti-psychotic drug.
Edit: I just wanted to acknowledge that there are probably a lot of beautiful people who find this drug helpful. I didn't mean to get down on you, I struggle too. I'm sorry if I jumped the gun with my statement.
https://bnf.nice.org.uk/drug/quetiapine.html
https://www.nami.org/About-Mental-Illness/Treatments/Mental-...
> Quetiapine is a medication that works in the brain to treat schizophrenia. It is also known as a second generation antipsychotic (SGA) or atypical antipsychotic.
If doctors are prescribing seroquel for sleep problems i) that's pretty scary and ii) it's an off label use.
EDIT: here's the FA information showing that seroquel is an antipsychotic and is not licensed to treat sleep problems. https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/02...
There is a nice brief summary of this in Stahl's Essential Psychopharmacology.
To be clear, I am very much against prescribing anti-psychotics as sleeping aids. But I don't think there is a strong case for calling quetiapine anti-psychotic in low doses.
That's a rather common mistake and I'd guess many doctors do it as well. Treatment risk depends only on alternatives. A pill that gives your a 0.01% chance of sudden death is an absolute no-go for genpop, but may be heaven-sent for a particular patient.
This guy drove away his friends, crashed his car and had psychotic episodes. During a 13 year addiction to the zolpidem. That's way past the "there may be some side effects" phase.
Back when I used zolpidem, I found that it is best to use it as a reset button, not as a daily crutch.
I do take 300mcg melatonin but I found it has no diminishing returns and in fact it has a negative feedback -- after 3 days of melatonin, I don't need it for at least another week. I keep the zolpidem for "recreational" usage, but I don't want to use it with my wife and daughter in the house in the remote possibility I get sleepwalking(never actually happened, I just get amazing auditory hallucinations before I fall asleep).
Benzodiazepines on the other hand I've had no issues with (no desire/need to increase the dose, no withdrawal even when I've been taking them for prolonged periods, no side effects), but I don't find them as effective. I have seen the destructive effects they can have though - a family member had to taper off them over six months, and at the end she was cutting the smallest dose tablets into quarters as she still couldn't quite get off them.
I googled around and found that walruses sleep in some pretty weird positions. Is that what you're referring to?
Super curious.
https://en.wikipedia.org/wiki/I_Am_the_Walrus
Edit, just kidding, it's this: https://knowyourmeme.com/memes/ambien-walrus
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.
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.
No consent given or asked for, let alone informed consent. You are told "take this".
This is not in circumstances of hospitalization, let alone involuntary hospitalization, but regular outpatient treatment.
People who are in a bad place generally don't research meds, and if they are not extremely uncooperative, or paranoid, will take them and the doctors' words at face value.
Consequences are severe and long-lasting.
Absolutely shameful and despicable. These doctors should be shamed by the scientific community for [almost] using prehistoric notions of "hysteria" to mistreat ilness by basically showing "see, he's not crying anymore! PROGRESS!" while pointing to a barely awake, sedated patient.
Any and all progress is usually SSRIs and psychotherapy, if available. Why do they give these antiquated meds that are not appropriate for the situation (i.e. CPZ) is beyond me. These are not psychoses, this is Episodium depressivum, gradus moderati .
Sorry, had to get that out. This is from personal experience.
The dose makes the poison. A small dose e.g. of seroquel, for a few days, has a great risk:reward profile for panic disorder
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.
We just have a few pieces of a puzzle and no idea what the overall image actually is. Neuroplasticity and adaptivity make this even harder because often you can't just take a part away like in a car and pinpoint issues due to the absence or disturbance of these parts.
If you knockout an area and a patient loses smell, will you say that you found the "center" of smell? We are still poking at the brain and figuring out its responses.
There's a lab at UCSF[1] that actually specializes in doing genome sequencing of cerebrospinal fluid specifically for cases like this. They're talked about pretty extensively in Adam Savage's "Still Untitled" podcast[2] and all the crazy weird things they managed to diagnose this way.
We all have the impression that medicine is a solved problem, but we've still got a way to go. We're still making progress though.
[1] https://nextgendiagnostics.ucsf.edu/
[2] https://www.tested.com/podcasts/adam-savage-project/854328-s...
https://en.wikipedia.org/wiki/Loa
Combine with parts of https://en.wikipedia.org/wiki/Simulation_hypothesis as you see fit, for instance some bored coder looking into why some parts of code suddenly fail, and putting you into debug mode :)
edit: also https://en.wikipedia.org/wiki/Jinn
Are you seriously suggesting that demonic possession is real and that a drug could lead to it?
treatment effective in the short term, but only in a small proportion of cases (estimated at around 5%)
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.
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.
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.
I was very lucky, but also had already received a BE and an MS, then worked for two years in industry before applying to PhD programs.
My goal is to develop better neural interface technologies to both learn about how the brain works, and also to deliver therapies for patients with conditions like paralysis or psychiatric disorders.
happy to chat - feel free to email me: etrautmann at gmail dot com
New cell types or pathways to become cell types are observed more often than you would think and it feels like we are still at the very foundation of understanding <insert field of biology>. It's scary how much we don't know while publically acting as if we figured out 99.98% of biology.
Explaining allergies and their origin is a good example here. It's just people throwing guesses around.
Two incredible actors, and one very touching movie.
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.
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.
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!
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.
There is no positive attribute to describe something as “slithering”. Not only does it carry negative connotations, it also poor fits the patients behavior.
So Purposeful use of negative phraseology. Incorrect usage of negative phraseology highlighting the willful choice of such words.
Perhaps the OP is a poor English speaker, if that’s the case, He should not be defended, this negative reaction is a social teaching aid.
There are many meanings to the phrase "come back to life". For example, my car "coughs into life" when I start it, and "comes alive" when I floor it, though nobody would infer it is actually alive. If someone "steps lively" that doesn't mean they are otherwise dead. A "live wire" isn't expected to be living, and also a person can be called a "live wire" meaning they're very engaging.
To "come back to life" in this context appears to mean simply that the person becomes animated and responsive to his surroundings. It's a phrase that would never occur to me to be offended by.
"Slither" can reasonably be associated with snakes, for which allusions are aplenty. The choice of word demonstrates a deliberate creativity that invited 6 the reader to consider whether there's deliberate underlying intent in the creative choice.
The "to life" comment takes an opinioated stance on the essence of what it means to be a living being, a controversial and deeply divisive topic for centuries.
Did you intend to inspire these interpretations? I doubt it. But is it reasonable to conclude you might have? Absolutely
No blame warranted, either way. Communication is flakey. ::shrug::
As for your other points, I highly doubt such a simple comment intended to touch on the complexities of what it means to be alive - any interpretation otherwise seems to be reaching hard to find a complex technical fault compared to the alternative of interpreting with hospitality and arriving at the conclusion that it was a simple colloquialism intended to describe the situation.
Also, judging by your comment you seem to believe I'm the one who made the comment that was interpreted as unkind.
"Slither" is definitely a negative term. A human doesn't slither, unless it is up to something nefarious, sneaky, malign, or evil. The devil is seen as serpentine in the Christian religion, and historically known as 'slithering about' to do evil. The apple offered to Eve, as part of the 'fall from grace' of humanity, was offered by Satan in serpent form.
The English language evolved and formed over centuries, in parallel with Christianity as a religion. Hence, many such negative or positively charged words and phrases exist.
For example, 'awesome' is "good awe" and "awful" is "bad awe", but why is "some awe" good, and "being full of awe" bad?
Because there is the concept that one cannot withstand being in full presence of God. Having some "awe" of God withstandable, but all? Will destroy you. To be filled with awe, something immensely wonderful to have some of, is horrible.
Irregardless of the current state of Christianity, English is derived from its historical, cultural roots, and some words can be "associated with malice". And again, I've only ever heard 'slither' used in reference to a human being in a highly negative connotation.
NOTE: I fully agree, especially on an international forum which has non-native speakers, assume good intent. However, the initial reply was not angry, or hateful, at least not from inakarmacoma.
Anyhow.
My 2 cents, worthful or not.
(Edit for all sorts of weird errors, and added a bit of context)
> Two hours after zolpidem administration, he gradually fell back into his diminished motivational state.
here is just a list of shit to be prepared for when you take them for more than a few short weeks:
please be VERY careful. ive been on then for years and it is a nasty and very long detox process.
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.
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.
That said, without the medication I'd be miserable and might not even be alive.
One of these is better than the other, so it's the choice I make.
Hydroxyzine works ok for me. Not great. Flexirol + hydrocodone work fantastic for me, but that's not a viable option.
Now, if one is dealing with something really serious like psychosis or acute mania, maybe it is a preventing a short-term harm which outweighs the risk of this long-term harm. But if it is just trouble sleeping, considering this risk, I think one should explore other options first.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476840/
https://www.sciencedirect.com/science/article/abs/pii/S09249...
https://pubmed.ncbi.nlm.nih.gov/30191724/
(I used to take Seroquel for insomnia and anxiety myself. I stopped when I discovered this research. It also contributed to our decision to get our son off risperidone.)