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Psychelics and Comas Options
 
Gonzukes
#1 Posted : 2/4/2016 4:42:50 AM

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Does anyone know of any research that's been done with psychedelics and people in comas? I don't know much about the nature of comas (and I'm sure there are many different types), but I have a feeling that psychedelic compounds could have the capacity to awake someone from a coma do to their consciousness-expanding effects.

What do you guys think?
 

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Nathanial.Dread
#2 Posted : 2/4/2016 4:08:17 PM

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As a rule, it's considered to be unethical to give drugs to people who cannot consent except in very extenuating circumstances, and I cannot think of a justification for taking a comatose person and giving them hallucinogens.

There has been some interesting results of people in vegetative states who receive zolpidem, however.

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universecannon
#3 Posted : 2/4/2016 5:20:33 PM

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Quote:
As a rule, it's considered to be unethical to give drugs to people who cannot consent except in very extenuating circumstances, and I cannot think of a justification for taking a comatose person and giving them hallucinogens.


Agreed.

It is an intriguing idea but I don't understand the neurology of comas enough to really have any clue if it would work or not. I wouldn't be too surprised, but that's just a guess. Maybe if in the future there was a study where somehow people could consent first that doctors could try to wake them up with psychedelics should they fall into a coma in their lifetime. Or even just an agreement with their friends or family that they would be ok with them trying it once, should they fall into a coma.



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Nathanial.Dread
#4 Posted : 2/4/2016 5:54:55 PM

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universecannon wrote:
Quote:
As a rule, it's considered to be unethical to give drugs to people who cannot consent except in very extenuating circumstances, and I cannot think of a justification for taking a comatose person and giving them hallucinogens.


Agreed.

It is an intriguing idea but I don't understand the neurology of comas enough to really have any clue if it would work or not. I wouldn't be too surprised, but that's just a guess. Maybe if in the future there was a study where somehow people could consent first that doctors could try to wake them up with psychedelics should they fall into a coma in their lifetime. Or even just an agreement with their friends or family that they would be ok with them trying it once, should they fall into a coma.

Psychedelics work by scrambling signalling in existing neural circuits, comas *usually* occur in people who have varying degrees of damage to those, and other, circuits. I don't think giving someone who was comatose psilocybin wouldn't really do much since the circuits associated with expanded consciousness no longer exist.

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EDITED: Removed 'brain dead' and replaced it with comatose, since that's more accurate. Coma and brain-death are distinct states. Mea culpa.
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pinkoyd
#5 Posted : 2/4/2016 8:46:15 PM

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Brain dead and coma are not necessarily the same thing. People can be fully aware of what's going on around them and even consolidate memories of such even if they show no outward signs of conscioussness when in a coma.

Brain death is usually pronounced only when a catastrophic event occurs such as a brain bleed when the brain gets smushed over to one side of the skull or traumatic brain injury, say from a car crash. Declaring brain death is usually a prelude to making the decision whether to withdraw life support or not, i.e. "pulling the plug."

I'll have to re-read some of the research but it seems to me that rather than scrambling signals, psychedelics inhibit specific parts of the brain that are normally inhibitory themselves. Whether those areas are still active in a coma I think is anybody's guess and probably would vary from case to case depending on what kind of injury and where it occurred.
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Nathanial.Dread
#6 Posted : 2/4/2016 11:20:55 PM

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pinkoyd wrote:
Brain dead and coma are not necessarily the same thing. People can be fully aware of what's going on around them and even consolidate memories of such even if they show no outward signs of conscioussness when in a coma.

Brain death is usually pronounced only when a catastrophic event occurs such as a brain bleed when the brain gets smushed over to one side of the skull or traumatic brain injury, say from a car crash. Declaring brain death is usually a prelude to making the decision whether to withdraw life support or not, i.e. "pulling the plug."

I'll have to re-read some of the research but it seems to me that rather than scrambling signals, psychedelics inhibit specific parts of the brain that are normally inhibitory themselves. Whether those areas are still active in a coma I think is anybody's guess and probably would vary from case to case depending on what kind of injury and where it occurred.

'Scrambled' was kind of a colloquial word to use in this context. If you have 'Homological Scaffolds of Brain Function Networks,' by Petri et al., that paper goes into the dynamics of the brain on psychedelics in a really elegant way.

Coma and locked-in-syndrome are generally considered to be different. Come, by definition requires a loss of conscious awareness.

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Psybin
#7 Posted : 2/5/2016 1:30:44 AM

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Nathanial.Dread wrote:
pinkoyd wrote:
Brain dead and coma are not necessarily the same thing. People can be fully aware of what's going on around them and even consolidate memories of such even if they show no outward signs of conscioussness when in a coma.

Brain death is usually pronounced only when a catastrophic event occurs such as a brain bleed when the brain gets smushed over to one side of the skull or traumatic brain injury, say from a car crash. Declaring brain death is usually a prelude to making the decision whether to withdraw life support or not, i.e. "pulling the plug."

I'll have to re-read some of the research but it seems to me that rather than scrambling signals, psychedelics inhibit specific parts of the brain that are normally inhibitory themselves. Whether those areas are still active in a coma I think is anybody's guess and probably would vary from case to case depending on what kind of injury and where it occurred.

'Scrambled' was kind of a colloquial word to use in this context. If you have 'Homological Scaffolds of Brain Function Networks,' by Petri et al., that paper goes into the dynamics of the brain on psychedelics in a really elegant way.

Coma and locked-in-syndrome are generally considered to be different. Come, by definition requires a loss of conscious awareness.

Blessings
~ND


It is not so cut and dry. There are actually several different Coma Scales, the Glasgow being widely used, that measure a spectrum of conscious awareness. Also, unconsciousness isn't something that can necessarily be proven, so using such black and white definitions is sort of pointless. We can only make inferences based on external signals and symptoms, and recently there have been many cases of individuals awakening from what was assumed to be brain death and lived to tell the tale. And even then, not all coma's are the same or feature the same exact presentation of symptoms or mechanisms of inury.
 
Nathanial.Dread
#8 Posted : 2/5/2016 3:01:42 AM

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Psybin wrote:

It is not so cut and dry. There are actually several different Coma Scales, the Glasgow being widely used, that measure a spectrum of conscious awareness. Also, unconsciousness isn't something that can necessarily be proven, so using such black and white definitions is sort of pointless. We can only make inferences based on external signals and symptoms, and recently there have been many cases of individuals awakening from what was assumed to be brain death and lived to tell the tale. And even then, not all coma's are the same or feature the same exact presentation of symptoms or mechanisms of inury.

I work as an EMT, believe me, I know about the Glascow Coma Scale, I'm basing this based off of the NIH definition of Coma, which is what I was taught in training.

http://www.ninds.nih.gov/disorders/coma/coma.htm

"A coma, sometimes also called persistent vegetative state, is a profound or deep state of unconsciousness. Persistent vegetative state is not brain-death...Individuals in such a state have lost their thinking abilities and awareness of their surroundings, but retain non-cognitive function and normal sleep patterns..."

There are people who suffer locked-in syndrome who are not comatose but are assumed to be in a coma (called a pseudocoma), but that's not a true coma (and whether someone suffering locked-in syndrome would benefit from psychedelics is an open question, although it probably would NOT restore them to their prior state).

In general, you can probably find some counter-example to every commonly accepted medical definition: biology is not as 'hard' as something like physics, or logic, and we know so little about how living systems work (esp. the nervous system) that it's accepted that we use the heuristics we tend to simply because we don't have much better.

As far as I know, though, comas are almost always a neurological phenomena, a disruption in information flow in neural circuits associated with high-level cognitive processing. If those circuits are damaged, they either need to be repaired, or the brain needs to reorganize itself so other systems to take on the load. Since psychedelics effect (presumably) similar high-level circuits, if those aren't online, our comatose patient won't get much from the drug.

Also, I edited my original post - 'brain dead' was the wrong word to use, I was in a hurry when I banged out that comment and was not as rigorous as I could have been.

Blessings
~ND
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Gonzukes
#9 Posted : 2/5/2016 7:46:15 AM

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Thanks for the discussion so far guys. I totally understand that it's immoral to administer a psychoactive without consent, but I would totally give consent if I would ever fall into a coma.

With that being said, It's interesting how the family morally can make the call to end the life, but not try something such a psychedelic. Just an interesting thought I had.

Anyways, so based off what you guys have said, it could be possible but it would depend on the severity of the coma or the damaged neurological circuits? I mean, really we don't know exactly how psychedelics work and how much power they/the mind has, so technically speaking could it not be a probability that if someone was in a coma a psychedelic could somehow introduce consciousness via an alternate neurological network that wouldn't otherwise be used in a sober state? I'm obviously not an expert on neuroscience, so correct me if I'm coooompleeetely wrong Razz.
 
 
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