If you have come to Coma Foundation looking for a cure, then sadly we do not have one. Currently, there is no medically accepted treatment for comas or vegetative states. Nevertheless, it does not mean there is no chance of recovery as recovery is dependent on what caused the coma.
There is nothing that directly you can do as a family to wake your loved one or repair the internal damage if there has been any. It is very much a case of self-help where the individuals will make their own recovery in their own time. The longer the individual is in a coma, the lower the chance of full recovery (remember though there have been exceptions).
You have probably heard about these miracle drugs such as zolpidem and levodopa that can bring back coma victims and vegetative state victims within minutes. The newspapers have been ripe with stories and there has been discussion on this subject for over ten years. It is truly a case of the drug working for some and not for others and it seems to be linked to the initial cause of the coma.
Therefore, the reason it has worked for some and not for others is no two comas or vegetative states are alike.
Zolpidem is available as a hypnotic drug for sleep disorders; however, at low doses it has been reported to produce some improvement in patients in a persistent vegetative state. There are no long-term well-controlled double blind studies and therefore the prescription will be prescribed outside the licence. It is normally prescribed six months after the initial accident. Interestingly, the drug is not expensive - it will cost around £3.50 for 12 tablets.
It is always important to be sceptical when using drugs as they do not always give the results you expect. Further, it is still a drug and there are always implications and side effects in giving any individual a new drug. One of the main ones for Zolpidem is that it will do its medically licensed job - make the individual sleep.
Therefore whatever you decide to do please discuss its use thoroughly with the victim’s doctor.
1. Obtain consent for the use of this drug from the victim’s doctor and pharmacist.
2.Consent by family- you need to establish realistic expectations. As vegetative state victims are often unable to give permission themselves, you will need to make sure a family member has the legal right to consent to the administration of the drug.
A. Explain the drug has only helped a small group of people. The likely effects are still unknown.
B. Side effects - it is a sleeping pill so one of the side effects is sedation. There is also a small of risk of aspiration resulting from this intervention if it makes the patient more drowsy.
3. Give test dose (5-10 mg)
4. Record response very carefully
A. Observe from 1/2 hours - 4 hours (presumed ‘on time’)
B. and again at about 6-8 hours after dose (presumed ‘off time’) – if effect is due to the drug, it should have reversed by this time.
5. Measure response
A. Record using a standardised measure if possible such as the Wessex Head Injury Matrix (whim) or the sensory modality assessment and rehabilitation technique (smart).
B. Otherwise record targeted outcomes based on response observed following first or early dosage (you may even decide to film this).
6. If no response, repeat daily dose and repeat process 3 and 4 to confirm absence of effect.
7. If response is observed
A. Describe nature of response carefully.
B. You will need to record the effects of the zolpidem when on and off it.
C. Repeat the above procedure with an independent observer.
Lorena suffered hypoxia to the brain and was given two weeks to live and survived for nearly four years. She became like a baby and had to be taught everything again such as opening her mouth to brush her teeth. We pushed forward with a family programme that ensured stimulation of all her senses every day.
For more information, please read on here.