Altered State Research Articles

Ketamine-induced altered states of consciousness: a systematic review of implications for therapeutic outcomes in psychiatric practices.

This systematic review aims to elucidate the nexus between ketamine's psychoactive properties and its efficacy in treating a broad spectrum of psychiatric disorders. We searched three databases and used citation tracking to include 29 studies. Predominantly, mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD) (MDD + BD: + n = 25studies), a large part of them involve treatment-resistant patients (n = 14studies), substance use disorder (SUD, n = 3studies), and social anxiety disorder (SAD, n = 1study). From all included studies(n=29), 15 (51.72%) of themidentified a positive relation between ketamine-induced altered states of consciousness and clinical outcomes, while 13studies (44.83%)showed no linkage between them, and one study (3.45%)delineated a negative association. Focusing solely on intravenous (IV) ketamine infusions (n = 25), 14 studies(56%)reported a positive modulation of ketamine's psychoactive effects and therapeutic benefits, whereas 10 studies(40%)confirmed no relationship, and one study (4%)showed a negative association. The single study(33.34%) involving subcutaneous ketamine and allthree studies (66.6%)intranasal administration did not demonstrate a significant interaction between ketamine's psychoactive effects and therapeutic response. All three SUD studies reported a positive correlation between ketamine's psychoactive effects and therapeutic response. In contrast, the single SAD study did not find a relationship between these parameters. For studies involvingmood disorders (n = 25), 12 studies (48%)reported a positive relationship between psychoactive effects and therapeutic response.Others 12studies (48%)identified a null relationship, and one study (4%)found a significant negative association. Although we have found a larger association than previous studies between ketamine's psychoactive properties and its efficacy in treating a broad spectrum of psychiatric disorders, its topic remains indeterminate, mainly due to the high heterogeneity.

An exploratory study of alternative life experiences in comparison to transcendental near‐death experiences

AbstractThe term near‐death experience (NDE) generally refers to a state of altered consciousness that can occur during real or presumed near‐death circumstances and/or life‐threatening incidents. The NDE usually includes the impression of being conscious while out of and/or away from the physical body, often accompanied by other specific features. Furthermore, when the experient has the impression of being in a perceived locality that transcends the observable physical Earth, it is referred to by researchers as a transcendental NDE. Whereas transcendental NDEs have been widely studied, there is also another type of experience that can occur under similar life‐threatening conditions that I refer to as an alternative life experience (ALE), which consists of a perception of living another alternative life where the experient is aware of the self, but does not believe at the time of occurrence that they are either out of or away from their physical body. After providing a total of 15 examples, I note some similarities and differences between ALEs and transcendental NDEs while providing some qualitative and quantitative results, suggesting that ALEs might be similar to some aspects of transcendental NDEs despite their neglect in the study of altered states of consciousness during near‐death circumstances. I further postulate that ALEs might be subjective psychological experiences of dissociation and/or absorption. It is then pointed out that symptoms of derealization are a common ALE aftereffect and so an awareness of that association is stressed as having therapeutic importance.

Comparative proteomic analysis of male and female androgenetic alopecia: elucidating gender-specific molecular patterns.

This study presents a comprehensive comparative proteomic analysis aimed at elucidating the molecular mechanisms underlying male androgenetic alopecia (AGA) and female AGA. Scalp samples from both male AGA and female AGA patients, along with their respective normal controls, were subjected to proteomic analysis, followed by bioinformatics investigations. Our findings revealed distinct proteomic profiles between male AGA and female AGA, with a total of 68 differentially expressed proteins identified in male AGA and 84 in female AGA. Among these, specific proteins were altered in male AGA and female AGA, highlighting the sex-specific molecular pathways involved in the pathogenesis of pattern hair loss. Protein-protein interaction network analyses further delineated the most impacted biological processes, including cytoskeleton organization, stress response, and metabolic pathways, with particular emphasis on the differing altered stress responses and metabolic states associated with hair loss between sexes. Our study not only uncovered the complex molecular landscape of male AGA and female AGA but also identified potential biomarkers and therapeutic targets, offering new insights into the sex-specific pathogenesis of pattern hair loss.

The art of music. The representation of musical instruments in the rock art of Zimbabwe

ABSTRACT This article explores the relationship between music and rock art by looking at the occurrence of musical instruments at rock art sites in Zimbabwe. Much of the attention paid to the rich rock art heritage of this country has focused on the documentation of sites, the meaning of the painted and engraved motifs in them and the regional variability they display. Despite some brief mentions, the depiction of musical instruments is still in need of systematic study. This article’s first objective is to compile the information about this type of motifs found in publications and the SARADA archive. Having identified and classified them, it then explores whether musical instruments depicted at rock art sites are connected to altered states of consciousness. The possible relationship between gender and music is also explored and regional differences in the depiction of musical instruments are commented on.

A volitional account of aesthetic experience

Aesthetic experience is an altered state of consciousness characterized by a detached absorption in an aesthetic object; it is a pleasant—sometimes ecstatic—liberation from the self and its agenda. I briefly review perceptual-cognitive and affective approaches used by psychologists to understand the phenomenon and suggest the need for a volitional perspective. To illustrate the nature and scope of aesthetic experience, I discuss nine varieties, elicited by different qualities in objects and evoking distinctive responses in perceivers. Over centuries, aesthetic devices have been developed that induce the aesthetic state by manipulating such psychological mechanisms as attention, appraisal, and empathy. I propose explanations for how several important devices operate, and why they are particularly effective in individuals high in the personality trait of Openness to Experience.

Patellar Tendon Thermographic Reference Values in Healthy People: A Systematic Review

Introduction: The physiological response of the tendon structure has been the subject of several studies using clinical thermography, although the lack of normal values limits clinical practice despite being, according to several authors, an optimal diagnostic tool for the study and therapeutic monitoring of soft tissues. To this end, the aim of this systematic review was to explore all the scientific information on thermography and reference values in the patellar tendon. Method: A search was carried out in different health science databases using the MeSH terms “Health”, “Patellar Ligament”, and “Thermography” with their synonyms in free terms to collect the studies to be included in the systematic review. This review was conducted according with PRISMA guidelines and includes all of the literature up to 19 December 2023. All studies that were in accordance with the PICOS strategy in title and abstract were included in this review, while studies that performed the baseline thermographic test in an altered physiological state were excluded after reading the full text. The TISEM scale was used to assess the quality of the studies; the risk of bias was assessed with the QUADAS-2 scale. Result: A total of 6 articles was selected (n = 148); these were analyzed for quality and found to be highly heterogenous; the risk of bias was low in most domains of the QUADAS-2 scale. Discussion and Conclusion: There are several variabilities that can induce changes in the thermoregulation process distorting the thermograms. Looking deeper into the evidence behind each item, we can deduce the need to follow the TISEM protocol as closely as possible for an accurate response. The heterogeneity in the way the results were provided and the low quality in some of the studies did not allow for a reference of thermographic values to be obtained.

Mind-body medicine and altered states of consciousness in Homo

The mind-body relationship has long been a subject of inquiry from both philosophical and scientific perspectives. Ancient Greek philosophers such as Pythagoras and Plato posited dualistic models, where the mind and body are distinct substances. In contrast, modern approaches in Mind-Body Medicine (MBM) offer integrative models that emphasize the interconnectedness of mental and physical states and the proactive role of the patient in their own healing process. This review examines the evolutionary roots of altered states of consciousness (ASC) as a precursor to current MBM techniques. By tracing ASC to early hominins and their cognitive development, it posits that the ability to enter various ASC—such as those used in rituals, meditation, and other mind-body practices—provided evolutionary advantages, influencing both individual fitness and social cohesion. Moreover, this review discusses tonic immobility in animals as a survival mechanism and explores parallels in human and non-human primate behaviors involving ASC. Additionally, neurochemical pathways that govern ASC, such as serotonergic and dopaminergic regulation, are explored for their roles in promoting social behaviors, cognitive flexibility, and emotional regulation. Furthermore, the role of the default mode network is investigated in relation to psychotropic and mood altering substances and altered states of consciousness. This integrated perspective offers new insights into the origins of MBM and underscores the significance of ASC in both evolutionary and contemporary contexts.

Quantitative EEG Spectral Features Differentiate Genetic Epilepsies and Predict Neurologic Outcomes.

EEG plays an integral part in the diagnosis and management of children with genetic epilepsies. Nevertheless, how quantitative EEG features differ between genetic epilepsies and neurological outcomes remains largely unknown. Here, we aimed to identify quantitative EEG biomarkers in children with epilepsy and a genetic diagnosis in STXBP1 , SCN1A , or SYNGAP1 , and to assess how quantitative EEG features associate with neurological outcomes in genetic epilepsies more broadly. We analyzed individuals with pathogenic variants in STXBP1 (95 EEGs, n =20), SCN1A (154 EEGs, n =68), and SYNGAP1 (46 EEGs, n =21) and a control cohort of individuals without epilepsy or known cerebral disease (847 EEGs, n =806). After removing artifacts and epochs with excess noise or altered state from EEGs, we extracted spectral features. We validated our preprocessing pipeline by comparing automatically-detected posterior dominant rhythm (PDR) to annotations from clinical EEG reports. Next, as a coarse measure of pathological slowing, we compared the alpha-delta bandpower ratio between controls and the different genetic epilepsies. We then trained random forest models to predict a diagnosis of STXBP1 , SCN1A , and SYNGAP1 . Finally, to understand how EEG features vary with neurological outcomes, we trained random forest models to predict seizure frequency and motor function. There was strong agreement between the automatically-calculated PDR and clinical EEG reports ( R 2 =0.75). Individuals with STXBP1 -related epilepsy have a significantly lower alpha-delta ratio than controls ( P< 0.001) across all age groups. Additionally, individuals with a missense variant in STXBP1 have a significantly lower alpha-delta ratio than those with a protein-truncating variant in toddlers ( P< 0.001), children ( P =0.02), and adults ( P< 0.001). Models accurately predicted a diagnosis of STXBP1 (AUC=0.91), SYNGAP1 (AUC=0.82), and SCN1A (AUC=0.86) against controls and from each other in a three-class model (accuracy=0.74). From these models, we isolated highly correlated biomarkers for these respective genetic disorders, including alpha-theta ratio in frontal, occipital, and parietal electrodes with STXBP1 , SYNGAP1 , and SCN1A , respectively. Models were unable to predict seizure frequency (AUC=0.53). Random forest models predicted motor scores significantly better than age-based null models ( P< 0.001), suggesting spectral features contain information pertinent to gross motor function. In summary, we demonstrate that STXBP1 -, SYNGAP1- , and SCN1A -related epilepsies have distinct quantitative EEG signatures. Furthermore, EEG spectral features are predictive of some functional outcome measures in patients with genetic epilepsies. Large-scale retrospective quantitative analysis of clinical EEG has the potential to discover novel biomarkers and to quantify and track individuals' disease progression across development.

Association between Polypharmacy and Adverse Events in Patients with Alzheimer's Disease: An Analysis of the Japanese Adverse Drug Event Report Database (JADER).

Background and Objectives: Alzheimer's disease is a global health concern, with a rising prevalence among the elderly. Current pharmacological treatments, including acetylcholinesterase inhibitors (AChEIs) and N-Methyl D-Aspartate (NMDA) receptor antagonists, are associated with adverse events (AEs), particularly in the context of polypharmacy. This study aimed to investigate the relationship between Alzheimer's disease treatment combinations, the number of concomitant medications, and the occurrence of AEs. Materials and Methods: Data from the Japanese Adverse Drug Event Report database, spanning from April 2004 to June 2020, were analyzed. Patients aged 60 and older with Alzheimer's disease treated with AChEIs (donepezil, galantamine, and rivastigmine) or the NMDA receptor antagonist memantine were included. Logistic regression models were employed to assess the association between AEs and Alzheimer's disease drug combinations, as well as the number of concomitant medications. Results: Among 2653 patients, 47.7% were prescribed five or more drugs. The frequency of AEs was 6.4% for bradycardia, 4.6% for pneumonia, 3.6% for altered state of consciousness, 3.5% for seizures, 3.5% for decreased appetite, 3.5% for vomiting, 3.4% for loss of consciousness, 3.4% for fracture, 3.2% for cardiac failure, and 3.0% for falls. The combination of memantine with AChEIs was associated with a higher risk of bradycardia, whereas donepezil alone was linked to a reduced risk of fractures and falls. Polypharmacy was significantly correlated with an increased incidence of AEs, particularly altered state of consciousness, decreased appetite, vomiting, and falls. The adjusted odds ratios for using five or more drugs compared to no drugs was 10.45 for altered state of consciousness, 7.92 for decreased appetite, 4.74 for vomiting, and 5.95 for falls. Conclusions: In the treatment of Alzheimer's disease, the occurrence of AEs is associated with the number of concurrent medications, independently of the known AEs of Alzheimer's disease drugs and their combination patterns.

Transcriptome and proteome profiling reveals TREM2-dependent and -independent glial response and metabolic perturbation in an Alzheimer’s mouse model

Elucidating the intricate molecular mechanisms of Alzheimer's disease (AD) requires a multidimensional analysis incorporating various omics data. In this study, we employed transcriptome and proteome profiling of AppNL-G-F, a human APP knock-in model of amyloidosis, at the early and mid-stages of amyloid-beta (Aβ) pathology to delineate the impacts of Aβ deposition on brain cells. By contrasting AppNL-G-F mice with TREM2 (Triggering receptor expressed on myeloid cells 2) knockout models, our study further investigates the role of TREM2, a well-known AD risk gene, in influencing microglial responses to Aβ pathology. Our results highlight altered microglial states as a central feature of Aβ pathology, characterized by the significant upregulation of microglia-specific genes related to immune responses such as complement system and antigen presentation, and catabolic pathways such as phagosome formation and lysosome biogenesis. The absence of TREM2 markedly diminishes the induction of these genes, impairs Aβ clearance, and exacerbates dystrophic neurite formation. Importantly, TREM2 is required for the microglial engagement with Aβ plaques and the formation of compact Aβ plaque cores. Furthermore, this study reveals substantial disruptions in energy metabolism and protein synthesis, signaling a shift from anabolism to catabolism in response to Aβ deposition. This metabolic alteration, coupled with a decrease in synaptic protein abundance, occurs independently of TREM2, suggesting the direct effects of Aβ deposition on synaptic integrity and plasticity. In summary, our findings demonstrate altered microglial states and metabolic disruption following Aβ deposition, offering mechanistic insights into Aβ pathology and highlighting the potential of targeting these pathways in AD therapy.

Single-dose psilocybin for U.S. military Veterans with severe treatment-resistant depression – A first-in-kind open-label pilot study

BackgroundThe enduring and severe depression often suffered by Veterans causes immense suffering and is associated with high rates of suicide and disability. This is the first study to evaluate the efficacy and safety of psilocybin in Veterans with severe treatment-resistant depression (TRD). Methods15 Veterans with severe TRD (major depressive episode failing to respond to ≥5 treatments, or lasting >2 years) received 25 mg of psilocybin. Primary outcome was change in Montgomery-Åsberg Depression Rating scale (MADRS) at 3 weeks posttreatment. Response was defined s ≥ 50 % reduction in MADRS, and remission as ≤10 MADRS score. Psychedelic experience was assessed using the Five-Dimensional Altered States of Consciousness scale (5D-ASC). Safety measures included assessment of suicidality and adverse events. Participants on antidepressants were tapered to avoid drug interactions. ResultsOf 15 participants, 60 % met response and 53 % met remission criteria at Week 3. At 12 weeks, 47 % maintained response, and 40 % remission. Co-morbid PTSD did not significantly influence study outcomes. The psychedelic experience reported in 5D-ASC did not correlate with response. Participants judged to need antidepressants were restarted and considered non-responders from that timepoint (n = 4). No unexpected adverse events occurred. LimitationsLimitations include the small sample size, and the uncontrolled and unblinded nature of the study. ConclusionsIn this first study on psilocybin for Veterans with severe TRD, a surprising response and remission was seen. Many Veterans had PTSD though no moderating impact of response was observed. The degree of psychedelic experience did not correlate with depression changes. Further study is warranted.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04433858.

A Network Analytic Approach to Dissociation: New Insights from Clinical Data

ABSTRACT The transdiagnostic construct of dissociation, characterized by a disintegration of specific psychological functions such as consciousness, memory, identity, perception, body representation, and behavior, remains elusive to a unified conceptualization. Specifically, its dimensionality is a matter of ongoing controversy. Empirical approaches applying factor analyses to the Dissociative Experiences Scale (DES) have yielded inconsistent findings. This study adopts a novel methodological approach, utilizing Exploratory Graph Analysis (EGA) to address this issue. In a sample of 668 day-hospital patients undergoing psychotherapy for a variety of mental disorders, a Gaussian graphical model was estimated for the 28 items of the DES. Additionally, the stability of the results was ensured by bootstrap procedures. While both the original EGA and the bootstrap EGA suggested four dimensions, the structural consistency of this solution was low due to an instability of 12 items. After excluding 10 of these unstable items, re-analyses again revealed a four-factor structure, but boot EGA indicated that one factor had unsatisfactory structural consistency due to the multidimensionality of its two items. Upon removing these, our final network consisted of 16 items mapping onto 3 dimensions. Our study, using data from a diagnostically heterogeneous sample, replicates and extends previous findings on the dimensionality of dissociation as captured by the DES. The three dimensions identified correspond to segregated processes, derealization/depersonalization, and absorption. This solution aligns with a bipartite model of dissociation with two broader categories referring to either altered states of consciousness (often named detachment) or to non-integrated mental modules (labeled as compartmentalization).

Hypernetwork modeling and topology of high-order interactions for complex systems

Interactions among the underlying agents of a complex system are not only limited to dyads but can also occur in larger groups. Currently, no generic model has been developed to capture high-order interactions (HOI), which, along with pairwise interactions, portray a detailed landscape of complex systems. Here, we integrate evolutionary game theory and behavioral ecology into a unified statistical mechanics framework, allowing all agents (modeled as nodes) and their bidirectional, signed, and weighted interactions at various orders (modeled as links or hyperlinks) to be coded into hypernetworks. Such hypernetworks can distinguish between how pairwise interactions modulate a third agent (active HOI) and how the altered state of each agent in turn governs interactions between other agents (passive HOI). The simultaneous occurrence of active and passive HOI can drive complex systems to evolve at multiple time and space scales. We apply the model to reconstruct a hypernetwork of hexa-species microbial communities, and by dissecting the topological architecture of the hypernetwork using GLMY homology theory, we find distinct roles of pairwise interactions and HOI in shaping community behavior and dynamics. The statistical relevance of the hypernetwork model is validated using a series of in vitro mono-, co-, and tricultural experiments based on three bacterial species.

On Tesla-inspired Extended Quantum-Holographic Framework for Reprogramming Macro-Quantum Correlations of Individual and Collective Consciousness

Nikola Tesla's visions and inventions realized in his controlled altered states of consciousness were considered previously as manifestations of his meditative insights within extended framework of quantum-holographic macroquantum correlations of individual &amp; collective consciousness. This Tesla-inspired paper now focuses on some related psychosomatice aspects of quantum entropy &amp; entanglement, and consequences on the usually observablebiological arrow of time &amp; spiritual-informational time reversal. Finally we discuss some spiritual-informational implicationson free will &amp; individual and collective consciousness reprogramming.

Psychedelic research at a crossroads

There is an urgent need to develop better treatments for mental health conditions that affect one in every eight people in the world. To combat this concern, psychedelic drugs have been combined with psychotherapy and studied in clinical trials in the United States and Europe. Psychedelics are hallucinogenic drugs that alter brain activity and facilitate altered states of consciousness. The proposed benefits of psychedelic-assisted therapy (PAT) include relatively short treatment times and stronger effects compared to other treatments. Although results of trials using MDMA for trauma or psilocybin for depression are promising, PAT is controversial because many questions about its safety and effectiveness are unanswered. This is evident in the recent ruling by the US Food and Drug Administration against the approval of MDMA therapy for post-traumatic stress disorder and the retraction of several papers about MDMA trials owing to unethical conduct by study therapists and data integrity, among other concerns. This field is at a crossroads, and the research community must address several obstacles to transition from exploratory trials to established, evidence-based treatments while avoiding pitfalls that can hinder advancement.

Divergent pattern of functional connectivity within the dorsal attention network differentiates schizophrenia and bipolar disorder patients.

Schizophrenia (SZ) and bipolar disorder (BD) share common clinical features, symptoms, and neurocognitive deficits, which results in common misdiagnosis. Recently, it has been suggested that alterations within brain networks associated with perceptual organization yield potential to distinguish SZ and BD individuals. The aim of our study was to evaluate whether functional connectivity (FC) of the dorsal attention network (DAN) may differentiate both conditions. The study involved 90 participants: 30 remitted SZ patients, 30 euthymic BD patients, and 30 healthy controls (HC). Resting state functional magnetic resonance imaging was used to compare the groups in terms of the FC within the core nodes of the DAN involving frontal eye fields (FEF) and intraparietal sulcus (IPS). BD patients presented weaker inter-hemispheric FC between right and left FEF than HC. While SZ did not differ from HC in terms of inter-FEF connectivity, they presented increased inter- and intra-hemispheric FC between FEF and IPS. When compared with BD, SZ patients showed increased FC between right FEF and other nodes of the network (bilateral IPS and left FEF). We have shown that altered resting state FC within DAN differentiates BD, SZ, and HC groups. Divergent pattern of FC within DAN, consisting of hypoconnectivity in BD and hyperconnectivity in SZ, might yield a candidate biomarker for differential diagnosis between both conditions. More highly powered studies are needed to confirm these possibilities.

Pregnancy Metabolic Adaptation and Changes in Placental Metabolism in Preeclampsia

AbstractPregnancy is a unique physiological state in which the maternal body undergoes a series of changes in the metabolism of glucose, lipids, amino acids, and other nutrients in order to adapt to the altered state of pregnancy and provide adequate nutrients for the fetus’ growth and development. The metabolism of various nutrients is regulated by one another in order to maintain homeostasis in the body. Failure to adapt to the altered physiological conditions of pregnancy can lead to a range of pregnancy issues, including fetal growth limitation and preeclampsia. A failure of metabolic adaptation during pregnancy is linked to the emergence of preeclampsia. The treatment of preeclampsia by focusing on metabolic changes may provide new therapeutic alternatives.

A real-world disproportionality analysis of baloxavir marboxil: post-marketing pharmacovigilance data

ABSTRACT Objective Baloxavir marboxil (hereafter referred to as baloxavir) is the only cap-dependent endonuclease inhiabitor approved for the treatment and prevention of influenza. However, as a new drug marketed in 2018, the long-term safety of baloxavir in large sample population was unclear. This study aims to evaluate baloxavir-associated adverse events (AEs) through data mining of the international pharmacovigilance database of US FDA Adverse Event Reporting System (FAERS). Methods Disproportionality analysis was conducted to assess the association between baloxavir and its AEs. Data were collected from FAERS from March 2018 to June 2023. After standardizing the data, signal quantification techniques including ROR, PRR, BCPNN and MGPS were used for analysis. Results A total of 49 significant baloxavir-related preferred terms (PTs) in 20 system organ classes (SOCs) were identified in our data analysis. Compared to baloxavir’s FDA label, some new PTs emerged, with the top 10 being pneumonia, loss of consciousness, rhabdomyolysis, seizure, altered state of consciousness, hepatic function abnormal, delirium, depressed level of consciousness, encephalopathy and cardio-respiratory arrest. Conclusion In clinical application of baloxavir, attention should be paid to the new AE signals in addition to the those recorded in the labels, so as to ensure the safety of the patients.

Nursing intervention in acute or critically ill patients with thirst: an integrated review

Aim: Analyze the existing nursing interventions and their effectiveness in managing thirst and promoting the person’s comfort. Background: Thirst is a symptom often experienced by people hospitalized in an acute and/or critical situation, but it is still frequently under-evaluated and under-treated in clinical practice, one of the main reasons being the difficulty in assessing thirst when it comes to people with an altered state of consciousness. Methods: To analyze the existing nursing interventions in managing thirst and promoting the person’s comfort, an integrative review was elaborated through electronic databases MEDLINE, CINAHL, PubMed, and other sources from March 2023 to August 2023. The review protocol is registered (PROSPERO CRD42023413584) and this review integrates a Project in a Higher School of Nursing. Results: After assessing eligibility, 16 final documents were obtained for data extraction and analysis. The results obtained show that several effective strategies were identified to thirst relief, such as drinking cold liquids, ingestion of carbohydrate drinks when fasting is really necessary, the use of ice, performing oral hygiene, applying lip moisturizer, using mentholated substances, controlling the ambient temperature, use of salivary stimulants and artificial saliva. Conclusions: This is a sensitive area of nursing care. Thus, a more significant investment in the scope of nursing research and the development of innovative technology that can improve nursing interventions for the management and thirst relief, would be beneficial to improve the quality of the nursing care provided for hospitalized patients in critical care.

Pharmacological and non-pharmacological predictors of the LSD experience in healthy participants

The pharmacodynamic effects of lysergic acid diethylamide (LSD) are diverse and different in different individuals. Effects of other psychoactive substances have been shown to be critically influenced by non-pharmacological factors such as personality traits and mood states. The aim of this study was to determine pharmacological and psychological predictors of the LSD effects in healthy human subjects. This analysis is based on nine double-blind, placebo-controlled, cross-over studies with a total of 213 healthy subjects receiving between 25–200 µg LSD. The influence of sex, age, dose, body weight, pharmacogenetic, drug experience, personality, setting, and mood before drug intake on the peak autonomic and total subjective responses to LSD was investigated using multiple linear mixed effects models and Least Absolute Shrinkage and Selection Operator regression. Results were adjusted for LSD dose and corrected for multiple testing. LSD dose emerged as the most influential predictor, exhibiting a positive correlation with most response variables. Pre-drug mental states such as “Well-Being”, “Emotional Excitability”, and “Anxiety” were also important predictor for a range of subjective effects but also heart rate and body temperature. The trait “Openness to Experiences” was positively correlated with elevated ratings in “Oceanic Boundlessness” and mystical-type effects. Previous experiences with hallucinogens have been negatively associated with the overall altered state of consciousness and particularly with “Anxious Ego Dissolution”. Acute anxiety negatively correlated with the genetically determined functionality of the Cytochrome 2D6 enzyme. In summary, besides the amount of drug consumed, non-pharmacological factors such as personal traits and current mood also significantly predicted the subjective drug experience. Sex and body weight were not significant factors in influencing the drug experience.