Work

Psilocybin for disorders of consciousness: A case-report study

Year: 2025

Type: article

Abstract: • This is the first report of a patient with a disorder of consciousness administration of psilocybin as a treatment. • We observed new spontaneous behaviour, no improved diagnosis, increased brain complexity and changes in power and connectivity. • This work complements the literature on brain complexity and consciousness, and the feasibility of psychedelic in medicine. With very few treatments available, post-comatose disorders of consciousness (DoC) pose one of the hardest challenges in modern neurology. Following promising clinical trial results in psychiatry, and a deepening understanding of their brain mechanisms, psychedelics have been suggested as a novel therapeutic drug for DoC patients, given that they increase the entropy or complexity of spontaneous activity in healthy participants. However, no attempts have been so far performed in patients with DoC. In this case report, we describe the first-ever administration of psilocybin, a classic psychedelic (i.e., agonist at the 5-HT2A receptor), to a patient in a minimally conscious state plus. We report the behavioural effects and changes in neurophysiology measured with EEG. We report no increase in overt behavioural repertoire with validated scales, yet new spontaneous behaviour not previously seen, and increased brain complexity, as measured by the Lempel-Ziv complexity index, with changes in the underlying periodic rhythms. This study contributes to future investigations exploring the use of psychedelics in DoC, enriching the discussion surrounding the role of psychedelics in medicine, and the link between brain complexity and consciousness. This is the first-ever report of a classic psychedelic used as a treatment for post-comatose DoC.

Source: Clinical Neurophysiology

DOI: 10.1016/j.clinph.2025.02.264