Psilocybin for disorders of consciousness: A case-report study.

Abstract

<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.<h4>Significance</h4>This is the first-ever report of a classic psychedelic used as a treatment for post-comatose DoC.

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Keywords