Psilocybin for disorders of consciousness: A case-report study.
Paolo Cardone, Pablo Núñez, Naji Alnagger, Charlotte Martial, Glenn J M van der Lande, Robin Sandell, Robin Carhart-Harris, Olivia Gosseries
Clinical Neurophysiology May 1, 2025 DOI: 10.1016/j.clinph.2025.02.264 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | Patient in a minimally conscious state plus |
| Intervention | Psilocybin |
| Topics | Philosophy of mind Psilocybin |
| Keywords | Brain complexity Disorders of consciousness Psychedelics Severe brain injury Therapy Minimally conscious state Traumatic brain injury Tbi Brain damage Vegetative state Coma |
| Citations | 7 |
| Key findings | Psilocybin administration did not increase overt behavioral repertoire on validated scales but elicited new spontaneous behavior and increased brain complexity in a patient with a disorder of consciousness. |
Abstract
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.
Comparable studies
Other case reports and case series on psilocybin, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psilocybin Mushroom (Psilocybe semilanceata) Intoxication with Myocardial Infarction 18-year-old man | 1998 | Case study | n = 1 |
| Relief from intractable phantom pain by combining psilocybin and mirror visual-feedback (MVF) Person with leg amputation and phantom-limb pain | 2018 | Case study | n = 1 |
| Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication | 2005 | Case study | n = 1 |
| Microdosing psilocybin for chronic pain: a case series Individuals with chronic neuropathic pain | 2022 | Case series | n = 3 |
| Psilocybin and Obsessive Compulsive Disorder Individual with Obsessive Compulsive Disorder | 2014 | Case study | n = 1 |
Citations in the library
Cited by 6
- Pharmacological therapies for early and long-term recovery in disorders of consciousness: current knowledge and promising avenues. Expert Review of Neurotherapeutics June 1, 2025
- A Virtual Clinical Trial of Psychedelics to Treat Patients With Disorders of Consciousness Advanced Science November 20, 2025
- The entropic brain today Brain December 12, 2025
- A critical review of brain entropy as a biomarker of the psychedelic state. Neuroscience & Biobehavioral Reviews July 1, 2026
- Acute Effects of Esketamine on the EEG Power Spectrum and Signal Complexity in Prolonged Disorders of Consciousness: A Prospective Exploratory Cohort Study. Journal of neurosurgical anesthesiology June 15, 2026
and 1 more in the library
Cites 51
- Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Journal of Psychopharmacology November 30, 2016
- Psilocybin with psychological support for treatment-resistant depression: an open-label feasibility study. The Lancet Psychiatry May 17, 2016
- Trial of Psilocybin versus Escitalopram for Depression New England Journal of Medicine April 14, 2021
- A Theoretically Based Index of Consciousness Independent of Sensory Processing and Behavior Science Translational Medicine August 14, 2013
- Psychedelics Promote Structural and Functional Neural Plasticity Cell Reports June 1, 2018
and 46 more in the library