Showing posts sorted by relevance for query Midazolam. Sort by date Show all posts
Showing posts sorted by relevance for query Midazolam. Sort by date Show all posts

Tuesday, March 21, 2017

Anti-anxiety medication dampens helping behavior in rats

In continuation of my updates on midazolam  

Rats given midazolam, an anti-anxiety medication, were less likely to free trapped companions because the drug lessened their empathy, according to a new study by University of Chicago neuroscientists.

The research, published in the journal Frontiers in Psychology, validates studies that show rats are emotionally motivated to help other rats in distress. In the latest study, rats treated with midazolam did not open the door to a restrainer device containing a trapped rat, although control rats routinely freed their trapped companions. Midazolam did not interfere with the rats' physical ability to open the restrainer door, however. In fact, when the restrainer device contained chocolate instead of a trapped rat, the test rats routinely opened the door. The findings show that the act of helping others depends on emotional reactions, which are dampened by the anti-anxiety medication.

"The rats help each other because they care," said Peggy Mason, PhD, professor of neurobiology at the University of Chicago. "They need to share the affect of the trapped rat in order to help, and that's a fundamental finding that tells us something about how we operate, because we're mammals like rats too."

The experiments utilize a rat-helping test originally established in a 2011 study published in Science by Mason, Inbal Ben-Ami Bartal, PhD, a post-doctoral scholar now at the University of California, Berkeley, and Jean Decety, PhD, Irving B. Harris Professor of Psychology and Psychiatry at the University of Chicago. In those early experiments, the team placed two rats that normally shared a cage into a special test arena. One rat was held in a restrainer--a closed tube with a door that can be nudged open only from the outside. The second rat roamed free in the cage around the restrainer, able to see and hear the trapped cage mate.

In the previous study, the free rats quickly learned to release their trapped cage mates, seen as a sign of empathy for their companions in distress. In the latest research, rats injected with midazolam did not free a companion rat trapped inside a restrainer. Yet rats injected with midazolam did open the same restrainer when that restrainer contained chocolate chips.

Stress, like what happens after seeing and hearing a trapped companion, triggers the adrenal gland and sympathetic nervous system and causes physical symptoms such as increased heart rate and high blood pressure. To test if the rats' helping behavior was driven by these physical changes, Mason and her team conducted a separate series of experiments by giving the rats nadolol, a beta-blocker similar to those used to treat high blood pressure. Nadolol prevents the pounding heart and other bodily signs of a stress response. Rats given nadolol were just as likely to help their companions as those injected with saline or nothing at all.

Midazolam.svg Midazolam  Nadolol.svgnadolol 

"What that tells you is that they don't have to be physiologically, peripherally aroused in order to help. They just have to care inside their brain," Mason said.

Mason's team also created a statistical model to find out if helping other rats was a rewarding, behavior for the animals that became reinforced over time, or if they simply became more comfortable with the testing environment and improved their ability to open the restrainer. Using data collected from the rats' behavior during the experiments, Haozhe Shan, an undergraduate student at UChicago, calculated the probability that each rat would free a companion in each testing session. He then projected these probabilities over 10,000 simulated attempts while keeping each trial independent, meaning that if a rat opened the restraint one day it was no more likely to open on the next day.

When Shan compared the simulated data to those from the experiments, he saw that the untreated rats performed better than the simulations predicted. If they freed a companion one day, the probability that they would do so again the next day increased, meaning the behavior was being reinforced. Meanwhile, rats given midazolam were no more likely to free a companion one day to the next, even if they did so on a previous day.

"We take that as a sign that the rats given midazolam don't find the outcome rewarding, presumably because they didn't find it a troubling situation in the first place," Shan said.

Mason and her team also tested levels of corticosterone, a stress hormone, in the rats when first exposed to the trapped cage mate and compared them to their later behavior. Those with low- to mid-level responses were most likely to free their companions later. They found that those with the highest levels of corticosterone, or those that were under the most stress from the situation, were the least likely to help their cage mates. This fits well with findings in humans suggesting that eventually high stress becomes immobilizing rather than motivating.

Mason said that this research further confirms the previous research that rats, and by extension other mammals--including humans--are motivated by empathy and find the act of helping others gratifying.
"Helping others could be your new drug. Go help some people and you'll feel really good," she said. "I think that's a mammalian trait that has developed through evolution. Helping another is good for the species."

Thursday, January 29, 2015

Midazolam drug helps recover full consciousness in traumatic brain injury patient



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A patient who had suffered a traumatic brain injury unexpectedly recovered full consciousness after the administration of midazolam, a mild depressant drug of the GABA A agonists family. This resulted in the first recorded case of an "awakening" from a minimally-conscious state (MCS) using this therapy. Although similar awakenings have been reported using other drugs, this dramatic result was unanticipated. It is reported in Restorative Neurology and Neuroscience.

Traumatic brain injuries occur at high rates all over the world, estimated at 150-250 cases per 100,000 population per year. These injuries can result in several outcomes, ranging from vegetative state, minimally conscious state, severe disability to full recovery. In most cases, the outcome will cause catastrophic changes for his/her family and a significant drain on both human and financial resources.

Two years after the injury caused by a motor vehicle accident, the patient was mildly sedated, in order to undergo a CT scan, using midazolam instead of the more commonly used propofol. As the authors described in the article, the patient began to interact with the anesthetist and soon after with his parents. He talked by cellphone with his aunt and congratulated his brother when he was informed of his graduation; he recognized the road leading to his home. When he was asked about his car accident, he did not remember anything and apparently he was not aware of his condition. This clinical status lasted about two hours after drug administration and disappeared quickly thereafter, taking the patient back to the previous condition.

Wednesday, November 27, 2019

FDA Approves Nayzilam (midazolam) Nasal Spray to Treat Seizure Clusters



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UCB announced   that the U.S. Food and Drug Administration (FDA) has approved a New Drug Application for the company’s newest anti-epileptic drug (AED) Nayzilam (midazolam) nasal spray CIV, a benzodiazepine indicated for the acute treatment of intermittent, stereotypic episodes of  frequent seizure activity (i.e., seizure clusters, acute repetitive seizures) that are distinct from a patient’s usual seizure pattern in patients with epilepsy 12 years of age and older. Nayzilam now provides patients and caregivers with the first and only FDA-approved nasal option for treating seizure clusters.  


It is estimated that more than 150,000 people in the U.S. with uncontrolled epilepsy also experience seizure clusters.2 Rescue treatment of seizure clusters is critical because when left untreated, seizure clusters can increase the risk of physical injury, neurological damage, prolonged seizures, and status epilepticus. Despite the impact of seizure clusters, many diagnosed patients may go untreated because currently available treatment options are not preferred.



Nayzilam is a short-term treatment for seizure clusters in patients with epilepsy. The nasal spray is designed as a single-use treatment that can be carried with a patient. Nayzilam allows for administration by a non-healthcare professional in patients actively seizing when and where a seizure cluster occurs. Nayzilam can provide value to patients who are experiencing these disruptive seizures.



“As global leaders in epilepsy, the approval of Nayzilam complements our already strong epilepsy portfolio, improving our ability to provide value to people living with poorly controlled seizures, and builds on our passion and expertise in this field. We are pleased to expand and diversify the solutions we can offer to the epilepsy community, providing an innovative and differentiated solution to help support management of seizure clusters,” said Jean-Christophe Tellier, Chief Executive Officer, UCB.



Nayzilam is the first new medication approved to treat seizure clusters in more than 20 years in the U.S. Its nasal delivery could provide significant value to patients who currently have limited treatment options.



“When a patient experiences seizure clusters, there is often significant impact on their overall quality of life, in addition to posing greater risks for increased emergency department related hospitalizations and more serious seizure emergencies,” said Dr. Steven S. Chung, MD, Executive Director and Program Chair of the Neuroscience Institute and Director of the Epilepsy Program at Banner – University Medical Center. “Further, as a neurologist specializing in epilepsy, treating seizure clusters today presents a challenging barrier for many patients. The availability of a new treatment option, such as Nayzilam, has potential to help improve the lives of patients and their families by providing another option for rescue care.”


https://www.drugbank.ca/drugs/DB00683

Tuesday, January 23, 2018

Study: Ketamine more effective than common sedative in reducing suicidal thoughts

In continuation of my update on ketamine
Ketamine.svg
Ketamine was significantly more effective than a commonly used sedative in reducing suicidal thoughts in depressed patients, according to researchers at Columbia University Medical Center (CUMC). They also found that ketamine's anti-suicidal effects occurred within hours after its administration.
The findings were published online last week in the American Journal of Psychiatry.
According to the Centers for Disease Control and Prevention, suicide rates in the U.S. increased by 26.5 percent between 1999 and 2015.
"There is a critical window in which depressed patients who are suicidal need rapid relief to prevent self-harm," said Michael Grunebaum, MD, a research psychiatrist at CUMC, who led the study. "Currently available antidepressants can be effective in reducing suicidal thoughts in patients with depression, but they can take weeks to have an effect. Suicidal, depressed patients need treatments that are rapidly effective in reducing suicidal thoughts when they are at highest risk. Currently, there is no such treatment for rapid relief of suicidal thoughts in depressed patients."
Most antidepressant trials have excluded patients with suicidal thoughts and behavior, limiting data on the effectiveness of antidepressants in this population. However, previous studies have shown that low doses of ketamine, an anesthetic drug, causes a rapid reduction in depression symptoms and may be accompanied by a decrease in suicidal thoughts.
The 80 depressed adults with clinically significant suicidal thoughts who enrolled in this study were randomly assigned to receive an infusion of low-dose ketamine or midazolam, a sedative. Within 24 hours, the ketamine group had a clinically significant reduction in suicidal thoughts that was greater than with the midazolam group. The improvement in suicidal thoughts and depression in the ketamine group appeared to persist for up to six weeks.
Those in the ketamine group also had greater improvement in overall mood, depression, and fatigue compared with the midazolam group. Ketamine's effect on depression accounted for approximately one-third of its effect on suicidal thoughts, suggesting the treatment has a specific anti-suicidal effect.
Side effects, mainly dissociation (feeling spacey) and an increase in blood pressure during the infusion, were mild to moderate and typically resolved within minutes to hours after receiving ketamine.
"This study shows that ketamine offers promise as a rapidly acting treatment for reducing suicidal thoughts in patients with depression," said Dr. Grunebaum. "Additional research to evaluate ketamine's antidepressant and anti-suicidal effects may pave the way for the development of new antidepressant medications that are faster acting and have the potential to help individuals who do not respond to currently available treatments."