Is the awakening produced by benzodiazepines due to excitatory actions of GABA?

Abstract Benzodiazepines (BZDs) such as Zolpidem can produce a temporary revival of patients who have been akinetic and apathic for years. The mechanisms underlying this “awakening” reaction are suggested globally to be related an activation gamma-aminobutyric acid (GABA) inhibitory systems. However, brain trauma or cerebro-vascular infarcts, like many other pathological insults, associated with shift the polarity GABA from inhibition excitation consequently increase intracellular chloride concentration ([Cl − ] i ) levels. Experimental clinical observations suggest that BZDs generate paradoxical reactions in these conditions, hence transient “awakening”. NKCC1 (Na-K-2Cl co-transporter isoform 1) importer antagonist Bumetanide restores low [Cl levels efficient drive. It is therefore administration might provide persistent by shifting GABAergic actions attenuating mechanism apathic/akinetic state.