A man in Italy who was in what doctors call a "minimally conscious state" for nearly two years unexpectedly regained full consciousness and the ability to talk, according to a new report of his case. 
 
 The man woke up after he was given a drug normally used as a sedative before surgery and other medical procedures, the case report showed. 
 
 The 43-year-old man was admitted to a hospital after a car accident, and was in a coma for 40 days. People who are comatose are completely unconscious — they have no sleep/wake cycles, and do not respond to their surroundings in any way. 
 
 The man awoke from the coma but remained in a "minimally conscious state," which means that although he remained largely unable to communicate or move, he was able to voluntarily open and close his eyes, and reach for and touch objects. He also had a sleep-wake cycle. 
 
 When he was discharged from the hospital 10 months later, he still did not talk or communicate with other people, nor did he respond to simple commands asking him to, for instance, close his eyes. 
 
 Over the next year, the man's cognitive ability started to decline; his movements became abnormally slow; and he began to engage in aimless, repetitive behaviors, such as clapping. 
 
 But then, about two years after the accident, the man's doctors wanted to examine his brain using a CT scan. To do the scan, they gave the man a mild sedative called midazolam. [7 Mind-Bending Facts About Dreams] 
 
 A few minutes later, the man began to talk and interact with others. 
 
 "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," the researchers who treated the man wrote in the case report. However, the man did not remember the accident, and he was not aware of the way it had affected his health, they wrote. 
 
 This is the first report of midazolam having an "awakening" effect, the researchers said. 
 
 However, the effect wore off after about two hours, and the man returned to his previous state, unresponsive to the environment, according to the study. 
 
 To see whether it was indeed the drug that caused the brief improvement in the man's condition, the researchers gave the man midazolam again. Several minutes following the administration, the patient began to interact with his brother and answered questions the researchers asked him. He was also able to calculate simple math problems, such as 100 minus 7, as well as read and understand simple sentences, such as "Close your eyes." 
 
 This time around, the researchers scanned the man's brain before, during and after the administration of midazolam, and identified the locations within the brain that were affected by the drug. They found that those regions previously had been linked to the symptoms of catatonia, which is a state of unresponsiveness to stimuli that is often associated with schizophrenia. 
 
 Moreover, the researchers noted, patients with catatonia have been reported to respond to midazolam in the past. The symptoms of the man in this report were similar to those of catatonic patients, which may mean that he was indeed catatonic and therefore responded to the drug, according to the study. 
 
 However, it is not completely clear whether the patient did indeed suffer from catatonia or whether his condition merely included certain catatonic symptoms, the researchers wrote. 
 
 Although midazolam was effective as a short-term method of treating the man's symptoms, the researchers said they could not keep giving it to him. Usually, the drug is given only to people in intensive-care units, where they can be monitored continuously, said Dr. Maria Chiara Carboncini, medical director of the Brain Injury Unit in the University Hospital of Pisa's Department of Neuroscience in Italy, who treated the patient and was a co-author of the report. 
 
 The researchers tried treating the man with another drug called lorazepam, which belongs to the same class of drugs as midazolam but can be administered more easily, as the patient does not have to be monitored continuously, Carboncini told Live Science. 
 
 However, after several days of therapy with lorazepam, the man became agitated and aggressive. His doctors switched him to carbamazepine, a drug used to treat people with epilepsy. This drug allowed the man to "maintain the improvement of his ability to interact and communicate with people," Carboncini said. 
 
 The study was published in the November issue of the journal Restorative Neurology and Neuroscience. 
 
 Follow Agata Blaszczak-Boxe on Twitter. Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science. ||||| Description and Brand Names 
 
 Drug information provided by: Micromedex 
 
 US Brand Name 
 
 Versed 
 
 Canadian Brand Name 
 
 Midazolam 
 
 Descriptions 
 
 Midazolam is used to produce sleepiness or drowsiness and to relieve anxiety before surgery or certain procedures. Midazolam is also given to produce amnesia (loss of memory) so that the patient will not remember any discomfort or undesirable effects that may occur after a surgery or procedure . It is also used to produce loss of consciousness before and during surgery. Midazolam is sometimes used in patients in hospital intensive care units to cause unconsciousness. This may allow the patient to withstand the stress of being in the intensive care unit and help the patient cooperate when a machine must be used to assist with breathing. 
 
 Midazolam is given only by or under the immediate supervision of a doctor trained to use this medicine. If you will be receiving midazolam during surgery, your doctor or anesthesiologist will give you the medicine and closely follow your progress. 
 
 This product is available in the following dosage forms: 
 
 Solution ||||| Photo Advertisement Continue reading the main story 
 
 PHOENIX — Lawyers for an inmate who was executed last month by lethal injection said Friday that his executioners injected him with 15 times the standard dose of a sedative and a painkiller during a procedure that lasted nearly two hours before their client was declared dead. 
 
 
 
 
 
 
 
 
 
 The execution of the inmate, Joseph R. Wood III, which was the fourth troubled one in the nation this year, renewed debate over the death penalty and prompted Arizona’s attorney general to order a temporary halt to executions in the state. The Arizona Department of Corrections announced Friday that it was seeking an outside investigator to conduct an independent inquiry into Mr. Wood’s execution. 
 
 Mr. Wood was executed on July 23 for the murders of his girlfriend and her father in 1989. He was injected with a two-drug combination of hydromorphone, an opioid painkiller that suppresses breathing, and midazolam, a sedative. 
 
 “The Arizona execution protocol explicitly states that a prisoner will be executed using 50 milligrams of hydromorphone and 50 milligrams of midazolam,” Dale A. Baich, one of the lawyers who represented Mr. Wood, said in a statement. “The execution logs released today by the Arizona Department of Corrections show that the experimental drug protocol did not work as promised.” 
 
 Referring to the corrections department, he added, “Instead of the one dose as required under the protocol, A.D.C. injected 15 separate doses of the drug combination, resulting in the most prolonged execution in recent memory.” Mr. Wood was injected with 750 milligrams of hydromorphone and 750 milligrams of midazolam in all. 
 
 Prison officials had estimated that it would take 10 minutes for the combination of drugs to kill Mr. Wood, but once a vein had been tapped and the drugs began to flow, it took an hour and 53 minutes before he was declared dead. Some witnesses to the execution said that Mr. Wood gasped — seemingly for air — more than 600 times as he died. Other witnesses disputed that account, and Arizona officials said that Mr. Wood was completely sedated and never suffered. 
 
 Mr. Baich, an assistant federal public defender, said that an independent investigation by a nongovernmental authority was needed. 
 
 The director of the Arizona Department of Corrections, Charles L. Ryan, said Friday that he had set in motion such an inquiry, starting with the search for an outside investigator to lead the effort. 
 
 “I am committed to a thorough, transparent and comprehensive review process,” Mr. Ryan said in a statement. “This will be an authoritative review to ensure that fact-based conclusions are reached regarding every aspect of this procedure, including the length of time it took for the execution to be lawfully completed.” 
 
 Mr. Ryan justified the use of repeated doses of the drugs by citing a state law authorizing “an intravenous injection of substance or substances in lethal quantity sufficient to cause death.” 
 
 Medical experts said the amount of the drugs used in Mr. Wood’s execution was unprecedented and its effect unknown. Joel Zivot, an assistant professor of anesthesiology and surgery at Emory University Hospital, said there was inherent danger in repurposing drugs “designed to treat patients, to cure diseases,” because there was no dosage “indicated or prescribed as having the intent to kill.” 
 
 Advertisement Continue reading the main story 
 
 Advertisement Continue reading the main story 
 
 “They’re making this up as they go along,” Dr. Zivot said in a telephone interview. 
 
 Dr. Zivot said that midazolam acts “like a key in a lock,” attaching to a receptor in the body and causing sedation. Once the receptor is saturated, he said, “it doesn’t matter if you give the person 500 additional doses or five million doses. It won’t have any more effect.” 
 
 Deborah W. Denno, a law professor at Fordham University and a death penalty opponent who has studied execution methods, said Friday that the use of numerous doses of drugs whose efficacy as an execution method had already been in question “demonstrates yet again the extraordinary level of reckless disregard and incompetency that departments of corrections bring to the execution process.” 
 
 Arizona is one in several states using midazolam and hydromorphone in lethal injections. That two-drug combination was picked as a replacement to a three-drug protocol that included medication that acted to stop the heart. States were forced to seek alternatives after manufacturers of the three-drug mixture refused to continue selling it to them. 
 
 As part of a standard procedure, the state of Arizona released to Mr. Wood’s lawyers the documents related to the execution — 331 pages, including logs detailing the amount of drugs he received, his reactions and the work of the medical team. The defense team then shared with the news media the logs pertaining to the execution. 
 
 Death penalty experts have said that it was one of the longest executions ever in the United States. 
 
 The documents showed that Mr. Ryan personally directed the execution team to use the additional doses. In his statement, Mr. Ryan said the doses ensured that “the inmate remained deeply sedated throughout the process, and did not endure pain.” 
 
 “The inmate’s sedation level was continually monitored and verified by the IV team,” Mr. Ryan said. The intravenous team included a doctor, he said.
– A 43-year-old car-crash victim in Italy who fell into a "minimally conscious state" to the point where he could no longer speak suddenly started chatting again after receiving a sedative, LiveScience reports. A study published in November in Restorative Neurology and Neuroscience said it's the first case showing "the 'awakening' effect of midazolam," a drug typically used to induce sleepiness before surgery. The man was in a coma for 40 days after his accident, then a "vegetative state" for four weeks. He was discharged after 10 months, but his condition worsened: Two years after the accident he couldn't say a single word or respond to simple commands and was performing "aimless repetitive behaviors" like clapping. Doctors treated him with various meds to no avail but then gave him midazolam instead of the usual propofol (the same drug that killed Michael Jackson) before a CT scan. The man suddenly "began to interact with the anesthetist," then with others, the study notes. The effect wore off after two hours, but doctors were able to replicate the results during a second midazolam dosage. The study notes that patients with catatonia (a state of unresponsiveness they're not sure this man suffered from) have responded to this drug before. Because midazolam can only be used in a hospital setting, doctors switched the patient over to carbamazepine (an epilepsy drug), which has since helped the man "maintain the improvement of his ability to interact and communicate with people," a study co-author tells LiveScience. Interestingly, zolpidem (often sold under the brand name Ambien) has been "well documented in literature" as evoking response in similar patients, but it didn't work this time, the study notes. (Midazolam has also been cited in botched executions.)