Abstract

Background: Ayahuasca, a traditional Amazonian decoction with psychoactive properties, is made from bark of the Banisteriopsis caapi vine (containing beta-carboline alkaloids) and leaves of the Psychotria viridis bush (supplying the hallucinogen N,N-dimethyltryptamine, DMT). Originally used by indigenous shamans for the purposes of spirit communi-cation, magical experiences, healing, and religious rituals across several South American countries, ayahuasca has been in-corporated into folk medicine and spiritual healing, and several Brazilian churches use it routinely to foster a spiritual experi-ence. More recently, it is being used in Europe and North America, not only for religious or healing reasons, but also for rec-reation.Objective: To review ayahuasca’s behavioral effects, possible adverse effects, proposed mechanisms of action and potential clinical uses in mental illness.Method: We searched Medline, in English, using the terms ayahuasca, dimethyltryptamine, Banisteriopsis caapi, and Psy-chotria viridis and reviewed the relevant publications.Results: The following aspects of ayahuasca are summarized: Political and legal factors; acute and chronic psychological ef-fects; electrophysiological studies and imaging; physiological effects; safety and adverse effects; pharmacology; potential psychiatric uses.Conclusion: Many years of shamanic wisdom have indicated potential therapeutic uses for ayahuasca, and several present day studies suggest that it may be useful for treating various psychiatric disorders and addictions. The side effect profile ap-pears to be relatively mild, but more detailed studies need to be done. Several prominent researchers believe that government regulations with regard to ayahuasca should be relaxed so that it could be provided more readily to recognized, credible re-searchers to conduct comprehensive clinical trials.

Highlights

  • For the current review, we searched Medline, in English, with the terms “ayahuasca,” “dimethyltryptamine,” “N,Ndimethyltryptamine,” “Banisteriopsis caapi,” and “Psychotria viridis”

  • The harmala alkaloids harmine and harmaline are monoamine oxidase inhibitors (MAOIs), without which the DMT would be inactivated by the gut and liver MAOs, while tetrahydroharmine acts as a weak serotonin reuptake inhibitor without any MAOI action [4]

  • In a study of cerebral blood flow using single photon emission computed tomography (SPECT) with 15 male volunteers, Riba et al [69] reported that ayahuasca produced an activation of frontal and paralimbic brain regions and increased blood perfusion bilaterally in the anterior insula; greater intensity was observed in the right hemisphere and in the anterior cingulate and frontomedial cortex of the right hemisphere

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Summary

Objective

To review ayahuasca’s behavioral effects, possible adverse effects, proposed mechanisms of action and potential clinical uses in mental illness. Method: We searched Medline, in English, using the terms ayahuasca, dimethyltryptamine, Banisteriopsis caapi, and Psychotria viridis and reviewed the relevant publications

Conclusion
INTRODUCTION
POLITICAL AND LEGAL FACTORS
Acute Psychological Effects
Long-term Psychological Effects
EEG Studies
Single Photon Emission Computed Tomography
Magnetic Resonance Imaging
Brain Structures Involved in the Ayahuasca Experience
Psychiatric Symptoms
Endocrine System
Immune System
Pupil Size and Body Temperature
Cardiovascular System
Toxicity
PHARMACOLOGY
Long Term Neurochemical Modulation
Pharmacokinetics
DRUG-DRUG INTERACTIONS
Addictions
Cocaine Dependence
Alcoholism
Pain Treatment and Opioid Dependence
Depression
Anxiety
Psychotherapy
CONCLUSION
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