Re: Zolpidem oral spray vs. other inhalable drugs (particularly Ereska)
Maxx, I held off responding to your original post about the potential for inhalable zolpidem, and would have asked the exact same question that Dew rasied. To put it another way, just how fast does one need zolpidem to work? An inhalable formulation would, it would seem, be faster acting. Personal and professional experience, however, indicate that the tablet form of zolpidem is quite satisfactory for the patients who respond to it.
Intranasal ketamine (Ereska by JAV) is another story altogether. Ketamine is available in liquid (injectible) form, but is being developed for breakthrough pain, so having it available as an inhalable makes all the sense in the world. I anticipate that Ereska will eventually become part of an "A-B" treatment for pain, alternating with opioid medications to limit patient exposure to opioids.
Of course, I'm biased here as I have considerable skin in the JAV game ;0
BTW: zolpidem is showing some modest paradoxical effects with severe traumatic brain injured patients. Use of the drug during the day increases arousal and responsivity in some patients with severe TBI who approach the chronic vegetative state end of the injury continuum. I have seen this with several of the patients in my care.
aj
