Ayahuasca: what mental health professionals need to know

Background Ayahuasca is a psychoactive ethnobotanical concoction that has been used for decades by indigenous groups of the Northwestern Amazon and by syncretic religious organizations for ritual and therapeutic purposes. In the last two decades, it is being used worldwide in evolving practices. Ayahuasca seem to therapeutic effects, but controlled studies are lacking. Moreover, its safety and toxicity are not completely understood. Objectives To present an overview of the effects of ayahuasca based on the most recent human studies. Methods Narrative review. Results Ayahuasca administration in controlled settings appears to be safe from a subjective and physiological perspective, with few adverse reactions being reported. More frequent adverse reactions occur in non-controlled settings. Prolonged psychotic reactions are rare and seem to occur especially in susceptible individuals. Ayahuasca showed antidepressive, anxiolytic, and antiaddictive effects in animal models, observational studies, and in open-label and controlled studies. Discussion Ayahuasca administration in controlled settings appear to be safe. Moreover, ayahuasca seem to have therapeutic effects for treatment-resistant psychiatric disorders that should be further investigated in randomized controlled clinical trials. However, medical complications and cases of prolonged psychotic reactions have been reported, and people with personal or family history of psychotic disorders should avoid ayahuasca intake

Psychological variables implied in the therapeutic effect of ayahuasca: A contextual approach

Ayahuasca is a psychedelic decoction originating from Amazonia. The ayahuasca-induced introspective experience has been shown to have potential benefits in the treatment of several pathologies, to protect mental health and to improve neuropsychological functions and creativity, and boost mindfulness. The underlying psychological processes related to the use of ayahuasca in a psychotherapeutic context are not yet well described in the scientific literature, but there is some evidence to suggest that psychological variables described in psychotherapies could be useful in explaining the therapeutic effects of the brew. In this study we explore the link between ayahuasca use and Decentering, Values and Self, comparing subjects without experience of ayahuasca (n = 41) with subjects with experience (n = 81). Results confirm that ayahuasca users scored higher than non-users in Decentering and Positive self, but not in Valued living, Life fulfillment, Self in social relations, Self in close relations and General self. Scores in Decentering were higher in the more experienced subjects (more than 15 occasions) than in those with less experience (less than 15 occasions). Our results show that psychological process variables may explain the outcomes in ayahuasca psychotherapy. The introduction of these variables is warranted in future ayahuasca therapeutic studie

Psychometric properties of the EPQ-A personality questionnaire in a sample of Spanish-speaking adolescents

Se han estudiado las propiedades psicométricas de la escala de personalidad EPQ-A (Eysenck Personality Questionnaire, forma A) en una muestra de adolescentes de El Salvador, México y España, formada por 1.035 participantes con una edad media de 17 años (en la muestra del EPQ-A). La consistencia interna del EPQ-A se ha calculado mediante el coeficiente de fiabilidad alfa de Cronbach, cuyo valor ha sido de .810 en la dimensión de neuroticismo (N), .678 en la dimensión de extraversión (E) y .702 en la de psicoticismo (P). Con respecto a la validez, la estructura factorial hallada explica un porcentaje elevado de varianza (34.26%). También se estudió la validez convergente, correlacionando el EPQ-A con información sociodemográfica, criminológica y otras escalas de personalidad. Se presentan los baremos elaborados por primera vez en una muestra de adolescentes hispanohablantes correspondientes a tres países. De esta manera, los resultados obtenidos sugieren que el inventario de personalidad EPQ-A es un instrumento válido y fiable en población adolescente hispanohablanteA sample of 1,035 adolescents from El Salvador, Mexico, and Spain, with a mean age of 17 years, participated in the study of the psychometric characteristics of the EPQ-A (Eysenck Personality Questionnaire, form A). EPQ-A internal consistency was calculated through Chronbach’s reliability coefficient, with an alpha = .810 for the neuroticism dimension (N), .678 for the extraversion dimension (E), and .702 for the psychoticism dimension (P). As for validity, the factorial structure found explains a high percentage of variance (34.26%); convergent validity was studied by means of correlations between EPQ-A and sociodemographics, criminological information, and other personality scales. Scales were determined for the first time ever in a sample of Spanish-speaking adolescents from three countries. The results suggest that the EPQ-A is a valid and reliable personality inventory in a Spanish-speaking populatio

Therapeutic potential of ayahuasca in grief : a prospective, observational study

Recent studies have assessed the therapeutic potential of ayahuasca for the treatment of depression with promising preliminary results. Here, we examine the course of grief over 1 year of follow-up in a bereaved sample that attended a center in Peru to participate in indigenous Shipibo ayahuasca ceremonies. We also explore the roles of experiential avoidance and decentering as mechanisms of change. Bereaved participants who attended the ayahuasca center responded to an online survey that included the Texas Revised Inventory of Grief, Symptom Assessment-45, WHO Quality of Life-Bref, Acceptance and Action Questionnaire, and Decentering. Baseline assessment was completed by 50 individuals (T0). Of these, 39 completed the post-assessment at 15 days (T1), 31 at 3 months (T2), 29 at 6 months (T3), and 27 at 12 months (T4) after leaving the retreat. Pearson's analysis was performed to examine the relationship between the severity of grief and mechanisms of change during the period of T0 and T1. A significant decrease in Texas Revised Inventory was observed at all time points (T1: Cohen's d = 0.84; T2: Cohen's d = 1.38; T3: Cohen's d = 1.16; T4: Cohen's d = 1.39). We found a relationship between experiential avoidance (r = 0.55; p < .01), decentering (r = − 0.47; p < .01), and a reduction in the severity of grief. Our results suggest that the ceremonial use of ayahuasca has therapeutic value by reducing the severity of grief. Acceptance and decentering are both psychological processes that mediate the improvement of grief symptoms

Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey

Introduction Ayahuasca is a plant-based decoction native to Amazonia, where it has a long history of use in traditional medicine. Contemporary ritual use of ayahuasca has been expanding throughout the world for mental health purposes, and for spiritual and personal growth. Although researchers have been conducting clinical trials and observational studies reporting medical and psychological benefits, most of these do not report ayahuasca’s immediate or medium-term adverse effects, so these are underrepresented in the literature. With the expansion of ayahuasca ceremonies from their traditional contexts to countries around the world, there is an important public health question regarding the risk/benefit balance of its use. Methods We used data from an online Global Ayahuasca Survey (n = 10,836) collected between 2017 and 2019 involving participants from more than 50 countries. Principal component analysis was performed to assess group effects. Logistic regression analysis was performed to test for adverse effects associated with history of ayahuasca use, clinical, context of use and spiritual effect variables. Results Acute physical health adverse effects (primarily vomiting) were reported by 69.9% of the sample, with 2.3% reporting the need for subsequent medical attention. Adverse mental health effects in the weeks or months following consumption were reported by 55.9% of the sample, however, around 88% considered such mental health effects as part of a positive process of growth or integration. Around 12% sought professional support for these effects. Physical adverse effects were related to older age at initial use of ayahuasca, having a physical health condition, higher lifetime and last year ayahuasca use, having a previous substance use disorder diagnosis, and taking ayahuasca in a non-supervised context. Mental health adverse effects were positively associated with anxiety disorders; physical health conditions; and the strength of the acute spiritual experience; and negatively associated with consumption in religious settings. Conclusions While there is a high rate of adverse physical effects and challenging psychological effects from using ayahuasca, they are not generally severe, and most ayahuasca ceremony attendees continue to attend ceremonies, suggesting they perceive the benefits as outweighing any adverse effects. Knowing what variables might predict eventual adverse effects may serve in screening of, or providing additional support for, vulnerable subjects. Improved understanding of the ayahuasca risk/benefit balance can also assist policy makers in decisions regarding potential regulation and public health responses

Ayahuasca-induced personal death experiences: prevalence, characteristics, and impact on attitudes toward death, life, and the environment

IntroductionDespite an emerging understanding regarding the pivotal mechanistic role of subjective experiences that unfold during acute psychedelic states, very little has been done in the direction of better characterizing such experiences and determining their long-term impact. The present paper utilizes two cross-sectional studies for spotlighting – for the first time in the literature – the characteristics and outcomes of self-reported past experiences related to one’s subjective sense of death during ayahuasca ceremonies, termed here Ayahuasca-induced Personal Death (APD) experiences.MethodsStudy 1 (n = 54) reports the prevalence, demographics, intensity, and impact of APDs on attitudes toward death, explores whether APDs are related with psychopathology, and reveals their impact on environmental concerns. Study 2 is a larger study (n = 306) aiming at generalizing the basic study 1 results regarding APD experience, and in addition, examining whether APDs is associated with self-reported coping strategies and values in life.ResultsOur results indicate that APDs occur to more than half of those participating in ayahuasca ceremonies, typically manifest as strong and transformative experiences, and are associated with an increased sense of transcending death (study 1), as well as the certainty in the continuation of consciousness after death (study 2). No associations were found between having undergone APD experiences and participants’ demographics, personality type, and psychopathology. However, APDs were associated with increased self-reported environmental concern (study 1). These experiences also impact life in profound ways. APDs were found to be associated with increases in one’s self-reported ability to cope with distress-causing life problems and the sense of fulfillment in life (study 2).DiscussionThe study’s findings highlight the prevalence, safety and potency of death experiences that occur during ayahuasca ceremonies, marking them as possible mechanisms for psychedelics’ long-term salutatory effects in non-clinical populations. Thus, the present results join other efforts of tracking and characterizing the profound subjective experiences that occur during acute psychedelic states

Effects of ayahuasca on mental health and quality of life in naïve users: A longitudinal and cross-sectional study combination

Ayahuasca is a hallucinogenic decoction used as a traditional medicine in several Amazonian regions. The ritualistic use of ayahuasca has spread throughout many countries, making it necessary to study its risks and benefits. Two sub-studies were designed for this investigation. In sub-study 1, a psychiatric interview and a battery of questionnaires were administered to subjects (n = 40) before their first ayahuasca use. Two follow-ups were conducted at 1 and 6 months. In sub-study 2, the same interview and battery of questionnaires were administered to long-term ayahuasca users (n = 23) and their scores were compared with those of the ayahuasca-naïve group. In the first assessment, nearly half (45%) of the naïve users were found to meet the diagnostic criteria for a psychiatric disorder. After the ayahuasca use, more than 80% of those subjects showed clinical improvements that persisted at 6 months. The questionnaires showed significant reductions in depression and psychopathology. Regarding sub-study 2, long-term users showed lower depression scores, and higher scores for self-transcendence and quality of life, as compared to their peers in sub-study 1. Further controlled and observational naturalistic studies assessing the eventual risks and potential benefits of ayahuasca are warranted

Personality, psychopathology, life attitudes and neuropsychological performance among ritual users of ayahuasca: a longitudinal study

Ayahuasca is an Amazonian psychoactive plant beverage containing the serotonergic 5-HT2A agonist N,N-dimethyltryptamine (DMT) and monoamine oxidase-inhibiting alkaloids (harmine, harmaline and tetrahydroharmine) that render it orally active. Ayahuasca ingestion is a central feature in several Brazilian syncretic churches that have expanded their activities to urban Brazil, Europe and North America. Members of these groups typically ingest ayahuasca at least twice per month. Prior research has shown that acute ayahuasca increases blood flow in prefrontal and temporal brain regions and that it elicits intense modifications in thought processes, perception and emotion. However, regular ayahuasca use does not seem to induce the pattern of addiction-related problems that characterize drugs of abuse. To study the impact of repeated ayahuasca use on general psychological well-being, mental health and cognition, here we assessed personality, psychopathology, life attitudes and neuropsychological performance in regular ayahuasca users (n = 127) and controls (n = 115) at baseline and 1 year later. Controls were actively participating in non-ayahuasca religions. Users showed higher Reward Dependence and Self-Transcendence and lower Harm Avoidance and Self-Directedness. They scored significantly lower on all psychopathology measures, showed better performance on the Stroop test, the Wisconsin Card Sorting Test and the Letter-Number Sequencing task from the WAIS-III, and better scores on the Frontal Systems Behavior Scale. Analysis of life attitudes showed higher scores on the Spiritual Orientation Inventory, the Purpose in Life Test and the Psychosocial Well-Being test. Despite the lower number of participants available at follow-up, overall differences with controls were maintained one year later. In conclusion, we found no evidence of psychological maladjustment, mental health deterioration or cognitive impairment in the ayahuasca-using group

Tripping to cope: coping strategies and use of hallucinogens during the COVID-19 pandemic in three cultural contexts

The COVID-19 pandemic has made evident the need to develop effective strategies to cushion the psychological consequences of social catastrophes. Preliminary evidence suggests that the use of hallucinogens is a protective factor that mitigates against such stressors. However, the underlying mechanisms must be further explored. This study specifically focused on the potential role of coping strategies in this regard, analyzing them through an online survey completed by a total of 2971 subjects who were followed up with from the beginning of the COVID-19 pandemic until six months after baseline. The survey was published in three different cultures (English, Spanish, and Portuguese), allowing for the collection of data from three different cultural contexts. The results show that coping strategies were generally more related to psychological well-being and psychopathology than to hallucinogenic drug use. However, regarding the latter, users of hallucinogens had higher scores on problem-focused engagement and disengagement and lower scores on wishful thinking than non-users. Longitudinally, while most baseline coping scores were associated with psychological distress and the severity of psychological symptoms, some coping strategies were related to the use of hallucinogens. These results show an adaptive pattern of coping strategies among hallucinogen users. Further research should take into account that coping strategies are only marginally associated with hallucinogenic drug use. Other underlying mechanisms explaining the better adjustment of users of hallucinogens to pandemics should be explore