Electroencephalography (EEG) can help evaluate patients with altered states of consciousness. Diffuse slowing of background rhythms and triphasic waves suggest metabolic dysfunction, especially hepatic. Generalized fast activity may indicate drug intoxication. Abnormalities such as PLEDs or focal continual PDA support a diagnosis of supratentorial lesion, while a normal EEG in a comatose patient suggests a brain-stem lesion. The EEG may also reveal nonconvulsive status epilepticus. Certain patterns have prognostic implications but are not specific to a single cause. For example, burst suppression or diffuse alpha pattern coma can occur in hypoxia or drug intoxication; with hypoxia the prognosis is extremely poor, but complete recovery often follows drug ingestion. If the cause is unknown, sequential records are needed for prognosis.
Pain is a complex experience involving sensory, emotional, and cognitive dimensions. A review of 3424 articles, narrowing to 143 relevant studies, shows progress in pain management through improved treatment algorithms, novel medications including ketamine, psychedelics, and cannabinoids, and innovative noninvasive neuromodulation techniques. The article outlines current practices and promising future research directions, emphasizing the potential for new interventions to address diverse causes of pain.
Placebo effects in depression treatment trials are substantial and can obscure the true efficacy of new drugs, especially for psychedelic-like compounds. Expectancy, the therapeutic setting, and trial design all interact to shape patient outcomes. This review examines these factors and discusses emerging methods to mitigate, measure, or harness placebo effects in future research on rapid-acting antidepressants and psychedelic therapies.