Ayahuasca e saúde mental: efeitos do seu uso associado a casos de depressão / Ayahuasca and mental health: effects of its use in association with depresion cases / Ayahuasca y salud mental: efectos de sue uso en asociación con casos de depressión

O aumento de casos de depressão na população mundial leva ao questionamento sobre a eficácia dos tratamentos farmacológicos e fomenta a busca por tratamentos alternativos. Estudos a respeito da ayahuasca e seus efeitos na depressão vêm sendo realizados. Por meio de uma revisão integrativa, a partir da questão norteadora: "Quais são os efeitos da ayahuasca em indivíduos com depressão?", neste estudo buscou-se: (1) identificar potenciais usos terapêuticos do chá de ayahuasca; (2) analisar as características de segurança e riscos à saúde no seu uso; (3) investigar se o contexto do uso influencia seus efeitos. A busca de artigos foi realizada nas bases BVS e PubMed, produzidos entre 2017-2022, resultando em 8 artigos para análise. Os estudos evidenciaram efeitos antidepressivos advindos das interações neuroquímicas e das experiências psicológicas por meio da ayahuasca e apresentaram que a segurança e potencial terapêutico estão atrelados ao contexto de uso e à dosagem ingerida do chá (AU).

The increase in cases of depression in the world's population leads to questioning the effectiveness of pharmacological treatments and encourages the search for alternative treatments. Studies about ayahuasca andyour effectsondepressionhavebeenconducted. Guided by the question: "What are the effects of ayahuasca in individuals with depression?" this study was a integrativereview that aimed to: (1) identify potential therapeutic uses of ayahuasca tea;(2) analyzethesafetycharacteristics andhealthrisks inyour use; (3) investigatewhetherthecontextofuseinfluences your effects.The search for articles was conducted in the BVS and PubMed databases, produced between 2017-2022, resulting in 8 articles for analysis. Thestudies showed antidepressanteffectsresultingfromneurochemical interactions andpsychologicalexperiences as results of the use of ayahuasca and showed that the safety and therapeutic potential are linked to the context of use and the ingested dosage of the tea (AU).

El aumento de los casos de depresión en la población mundial lleva a cuestionar la eficacia de los tratamientos farmacológicos y fomenta la búsqueda de tratamientos alternativos. Se han realizado estudios sobre la ayahuasca y sus efectos sobre la depresión. Por medio de la cuestión: "¿Cuáles son los efectos de la ayahuasca en personas con depresión?", este estudio de revisión integrativabuscó: (1) identificar los usos terapéuticos potenciales del té de ayahuasca; (2) analizar las características de seguridad y los riesgos para la salud en su uso; (3) investigar si el contexto de uso influye en sus efectos. La búsqueda de artículos se realizó en las bases de datos BVS y PubMed, producidas entre 2017-2022, resultando 8 artículos para análisis. Fueron observados en los estudios efectos antidepresivos advenidos de la ayahuasca y que la seguridad y potencial terapéutico están vinculados al contexto de uso y la dosis ingerida del té (AU).

Relatos de exploradores e viajantes e primeiras pesquisas científicas com a ayahuasca, 1850-1950, no debate atual sobre o "renascimento psicodélico" / Reports by explorers and travelers and the first scientific studies on ayahuasca (dating from 1850 to 1950) within the current debate on the "psychedelic renaissance"

Resumo O artigo descreve associações e controvérsias entre usos indígenas e ocidentais da ayahuasca, de 1850 a 1950, na relação com o "renascimento psicodélico". Destaque na ciência desde 2000, esse movimento faz referência a 1960-1970, quando políticas antidrogas suspenderam pesquisas sobre "potenciais terapêuticos" de substâncias psicoativas. Argumenta-se que estudos pioneiros com a ayahuasca datam do início do século XX e mencionam relatos de expedições à Amazônia desde 1850. Esses artigos e relatos são analisados pelo aspecto histórico da teoria do ator-rede e de estudos recentes. Infere-se que a história ilumina o debate político atual sobre os usos, classificações e significados indígenas; o interesse farmacêutico na ayahuasca; e a discussão sobre "drogas".

Abstract This article describes the associations and controversies between indigenous and western uses of ayahuasca between 1850 and 1950 in relation to the "psychedelic renaissance." This movement has gained scientific attention since 2000, but hearkens back to the 1960s and 1970s, when anti-drug policy halted research on the "therapeutic potential" of psychoactive substances. Pioneering studies on ayahuasca date back to the early twentieth century and mention reports of expeditions to Amazonia from 1850 onward. Here, these articles and reports are analyzed according to the historical aspect of actor-network theory and recent studies. We infer that history casts light on the current political debate about indigenous uses, classifications, and meanings, pharmaceutical interest in ayahuasca, and the debate on "drugs."

Psicosis por consumo de ayahuasca: un reporte de caso / Ayahuasca-Induced Psychosis: A Case Report

RESUMEN La inducción de psicosis por ayahuasca es un evento poco frecuente. Sin embargo, debido a un aumento en el acceso y la distribución de esta sustancia, resulta menester destacar los casos en que se presenta. Se describe el caso de un paciente varón de 26 arios que ingresó al servicio de psiquiatría por un cuadro clínico de 7 meses de evolución dado por cambios en el comportamiento, ideas delirantes y posterior exacerbación de los síntomas, tras participar en una ceremonia ritual en la que consumió por vez primera un brebaje de ayahuasca. Requirió inicialmente tratamiento hospitalario para controlar el episodio psicótico agudo, con buena respuesta y tolerancia al tratamiento farmacológico, lo que permitió continuar su seguimiento clínico ambulatorio.

ABSTRACT Psychosis induced by ayahuasca is a rare occurrence. However, due to an increase in the access and distribution of this substance, it is necessary to highlight the cases in which it occurs. We describe the case of a 26-year-old man who was admitted to the psychiatric service after seven months of changes in behaviour, delusions and the subsequent exacerbation of symptoms, after participating in a ritual ceremony during which he consumed an ayahuasca concoction for the first time. Initially, he required hospital treatment to control the acute psychotic episode, but after tolerating and responding well to the antipsychotic treatment, he was discharged with an outpatient follow-up.

Behavioral characterization of ayahuasca treatment on Wistar rats in the open field test

Abstract Ayahuasca (AYA) is a psychedelic beverage with therapeutic potential for many mood and anxiety disorders. Although there are some preclinical studies, no published reports have tested the behavioral effects of AYA gavage in animal models. This investigation aimed to characterize the behavior of Wistar rats after acute ingestion of AYA for 40 min in the open field test (OFT). The sample consisted of three experimental groups treated with different dosages of AYA (125, 250, or 500 mg kg-1) and a control group. Each group consisted of 10 participants. After gavage, the number of crossings of the OFT grid lines, latency to enter the central area of the device, grooming frequency, and time spent in the central perimeter of the device were immediately evaluated. Analyses were based on one-way ANOVA and a linear-regression mixture model for longitudinal data. AYA intake did not interfere with habituation. The 500 mg kg-1 group showed a decrease in the time spent in the center of the device and in the number of crossings compared to the control group in the last 10 min. These results suggest that gavage with AYA did not interfere with the results, and the behavioral effects were perceived only between 30 and 40 min after gavage. Taken together, the results indicate that three aspects should be considered in OFT studies of AYA acute effects: the moment when the observation starts, the observation period, and the AYA dosage.

O renascimento dos psicodélicos como potenciais agentes psicoterapêuticos: trajetória, avanços recentes e perspectivas / The renaissance of psychedelics as potential psychotherapeutic agents: trajectory, recent advances and perspectives

Utilizados em vários contextos pela humanidade desde tempos imemoriais até os dias atuais, os psicodélicos despertaram a atenção dos pesquisadores na primeira metade do século passado. Desde então, mesmo com o longo período de restrições às pesquisas científicas devido à implementação da Controlled Substance Act em 1970, inúmeras investigações, principalmente nos últimos anos, vêm indicando o renascimento dos psicodélicos como importantes ferramentas em psicoterapia assistida. Esta revisão narrativa pretende divulgar a trajetória de pesquisa de psicodélicos selecionados (LSD, psilocibina, ayahuasca e MDMA), lançando luz sobre estudos clínicos que indicam a eficácia e a segurança médica dessas substâncias no tratamento de distúrbios mentais como depressão, ansiedade, dependência química e transtorno de estresse pós-traumático. Adicionalmente, também são apontados alguns eventos históricos e culturais relevantes que, de alguma forma, dialogam com esta trajetória.(AU)

Used in various contexts by mankind from immemorial time to nowadays, psychedelics aroused the attention of researchers in the first half of last century. Since then, even with the long period of restrictions on scientific research due to the implementation of the Controlled Substance Act in 1970, accumulated investigations, especially in recent years, have been indicating the renaissance of psychedelics as important tools in assisted psychotherapy. This narrative review intends to disclose the research trajectory of selected psychedelics (LSD, psilocybin, ayahuasca and MDMA) shedding light on clinical studies which support medical efficacy and safety of these substances to treat mental diseases such as depression, anxiety, substance use disorder and post-traumatic stress disorder. Additionally, some relevant historical and cultural events that somehow had dialogued with this trajectory are also approached.(AU)

Utilizados en diversos contextos por la humanidad desde tiempos inmemoriales hasta nuestros días, los psicodélicos despertaron la atención de los investigadores en la primera mitad del siglo pasado. Desde entonces, incluso con el largo período de restricciones en las investigaciones científicas debido a la implementación de la Controlled Substance Act en 1970, numerosas investigaciones, principalmente en los últimos años, han indicado el resurgimiento de los psicodélicos como herramientas importantes en la psicoterapia asistida. Esta revisión narrativa tiene como objetivo dar a conocer la trayectoria de investigación de psicodélicos seleccionados (LSD, psilocibina, ayahuasca y MDMA), arrojando luz sobre estudios clínicos que demuestran la eficacia médica y la seguridad de estas sustancias en el tratamiento de desordenes mentales como la depresión, la ansiedad, dependencia química y trastorno de estrés postraumático. Adicionalmente, también se señalan algunos hechos históricos y culturales relevantes que, de alguna manera, dialogan con esta trayectoria.(AU)

Ayahuasca prevents oxidative stress in a rat model of depression elicited by unpredictable chronic mild stress

ABSTRACT Background: Depression is a highly disabling common mental disorder and, due to its multifactorial nature, the development of effective therapies is challenging and of great relevance. Ayahuasca (AYA), an entheogenic traditional beverage, has emerged as an alternative for antidepressant treatment, however, AYA preclinical and clinical trials are still incipient. Objectives: This investigation aimed to evaluate some behavioral and biochemical effects of AYA subchronic administration in rats submitted to a model of depression elicited by unpredictable chronic mild stress (UCMS). Methods: 500 mg/kg of AYA was administered in adult male rats once a day for 15 days before submitting the animals to UCMS. Anhedonia-like and locomotion behavior, lipid peroxidation, antioxidant enzyme activities, and sulfhydryl/nitrite content were evaluated. Results: AYA intake failed to prevent anhedonia-like behavior. Locomotion was not altered by AYA consumption or by the experimental condition. UCMS increased TBARS and nitrites levels, decreased the levels of catalase in the cerebral cortex and of Sulfhydryl in the hippocampus. AYA treatment counteracted these biochemical alterations but did not display any alterations in non-stressed rats. Conclusions: Taken together, results indicate an adaptogenic antioxidant molecular mechanism of AYA in relation to depression induced by stress.

Psychosis induced by abuse of ayahuasca: a case report / Psicosis inducida por el abuso de la ayahuasca: un caso clínico

A B S T R A C T Ayahuasca is a psychotropic infusion prepared by boiling the bark of Amazonian plants and has many psychopharmacological effects not fully understood. Some of those effects are used as treatment for different diseases. However, the side effects of ayahuasca, including ayahuasca-induced psychosis, are an important issue. Here we report the case of a patient who had a psychotic episode after taking ayahuasca and who was successfully treated with antipsychotic medication. Given the current spread of ayahuasca consumption in developed societies, the present case highlights the need for better understanding and regulation of the social-legal condition of ayahuasca and the need for further research. Additionally, psycho-education seems advisable in order to create awareness of the potential risks of the use of ayahuasca.

RESUMEN La ayahuasca es una bebida psicotrópica preparada a través de la cocción de plantas de la cuenca amazónica que tiene muchos efectos psicofarmacológicos no del todo estudiados. Algunos de esos efectos son usados como tratamiento de diversas patologías. Sin embargo, existen efectos secundarios de la ayahuasca que deben ser tenidos en cuenta, entre ellos psicosis inducida por ayahuasca. Reportamos un caso de un paciente que, tras autoadministración de ayahuasca, presentó un episodio psicótico y que fue satisfactoriamente tratado con antipsicóticos. Dada el uso cada vez más frecuente de ayahuasca en las sociedades desarrolladas, el caso actual resalta las necesidades de entender, regular e investigar el uso de la ayahuasca. Además, crear conciencia de los potenciales riesgos del uso de ayahuasca a través de la psicoeducación debería ser implementado.

When formulation procedures strongly matter: a case study of ayahuasca use in Centro Luz Divina, Piedade, São Paulo, Brazil

Objectives: The objectives of this study were (a) to describe the history of the formation of the Centro Luz Divina (CLD), Piedade, São Paulo, (b) to describe the plants and recipes involved in making ayahuasca, and (c) to provide information for future chemical and pharmacological studies of ayahuasca. Methods: During the 578 hours of fieldwork between 2017 and 2019, 10 interviewees were interviewed (two priests and eight CLD leaders). The methods and techniques from cultural anthropology were used to conduct a snowball sampling to select respondents and record data through unstructured interviews, participant observation and field diaries. Data on the history of the CLD's formation, plants and beverage recipes were recorded. The plants were dry collected and deposited at the UNIFESP Herbarium. Results: The history of the formation of the CLD, which was founded in 2002, was detailed. This center produces several recipes of the ayahuasca beverage during rituals named feitios in Portuguese by using the plants Psychotria viridis and Banisteriopsis caapi. The process of making two of these recipes was detailed in the present study, and they are the "First Degree beverage" and "Second Degree beverage", which vary in preparation time, concentration, diversity and amount of the plant used and may lead to different "potencies of the beverage", according to the interviewees' reports. From a pharmacological point of view, higher degree beverages are probably richer beverages from the chemical and pharmacological perspectives. Conclusion: Ayahuasca recipes produced at the CLD may have different "potencies". However, future chemical and pharmacological investigations should consider these and other types of ayahuasca found in other Daimist centers in their protocols since many studies suggest the use of the substances in this beverage for treating Parkinson's, anxiety, depression, and other ailments, as described in the scientific literature.

The pharmacological interaction of compounds in ayahuasca: a systematic review

Ayahuasca is a South American psychoactive plant brew used as traditional medicine in spiritual and in cultural rituals. This is a review of the current understanding about the pharmacological mechanisms that may be interacting in ayahuasca. Searches were performed using PubMed, PsycINFO, and Web of Science databases and 16 papers were selected. As hypothesized, the primary narrative in existing research revolved around prevention of deamination of N,N-dimethyltryptamine (N,N-DMT, also referred to as DMT) by monoamine oxidase inhibitors (MAOIs) in ayahuasca. Two of the constituents, DMT and harmine, have been studied more than the secondary harmala alkaloids. At present, it is unclear whether the pharmacological interactions in ayahuasca act synergistically or additively to produce psychoactive drug effects. The included studies suggest that our current understanding of the preparation's synergistic mechanisms is limited and that more complex processes may be involved; there is not yet enough data to determine any potential synergistic interaction between the known compounds in ayahuasca. Our pharmacological understanding of its compounds must be increased to avoid the potential risks of ayahuasca use.

Compreensão de sentidos atribuídos à ayahuasca: percursos terapêuticos do uso ritualístico / Understanding of meanings attributed to ayahuasca: therapeutic paths of ritual use / Comprensión de los sentidos atribuidos a la ayahuasca: recorridos terapéuticos del uso ritual

Ayahuasca é uma bebida psicoativa de origem amazônica preparada a partir do cipó conhecido como jagube e/ou mariri (Banisteriopsis caapi) e do arbusto chacrona (Psychotria viridis). Seu uso cultural e ritualístico tem reconhecimento milenar por etnias indígenas da Amazônia Ocidental e ganhou influência mundial na década de 1980, por meio da expansão do seu uso religioso. No campo biomédico, estudos têm atestado a segurança na administração da bebida em humanos e encontraram características de bem-estar físico e mental em usuários. Este artigo tem como objetivo discutir os resultados de uma pesquisa que investigou histórias de vida de pessoas com itinerários terapêuticos ligados ao uso ritualístico da ayahuasca, a partir de uma compreensão fenomenológica-existencial e da gestalt-terapia. A metodologia de trabalho baseou-se na postura fenomenológica e no método de história de vida, possibilitando uma apreensão da experiência vivida nos rituais. Verificou-se, assim, que as experiências ritualísticas e os itinerários terapêuticos contribuíram no reconhecimento dos participantes de que a saúde é uma postura de maturidade ou sabedoria associada a suas relações com o mundo, atribuindo à ayahuasca a capacidade de operar ressignificações no processo cotidiano do autocuidado e, acima de tudo, no amor a si mesmos.

Ayahuasca is a psychoactive drink of Amazonian origin prepared from vine known as jagube and/or mariri (Banisteriopsis caapi) and chacrona bush (Psychotria viridis). Its cultural and ritualistic use have been recognized from millennia by indigenous ethnic groups in the Western Amazon and gained worldwide influence in the 1980s through the expansion of it religious use. In the biomedical field, studies have attested the safety in the administration of the beverage in humans and found features of physical and mental wellbeing on users. This article aims to discuss the results of a research that investigated life histories of people with therapeutic itineraries connected to the ritualistic use of ayahuasca, from a phenomenological-existential understanding and gestalt-therapy approach. The methodology was based on a phenomenological stance and in life history method, enabling an apprehension of lived experience of the rituals. Thus, it was verified that the ritualistic experiences and the therapeutic itineraries contributed in the participants' recognition that health is a posture of maturity or wisdom associated to their relations with the world, attributing to ayahuasca the capacity to operate re-significations in the daily process of self-care and, above all, in love of oneself.

Ayahuasca es una bebida psicoactiva de origen amazónico, preparado a partir de la cepa jagube o mariri (Banisteriopsis caapi) y del arbusto chacrona (Psychotria viridis). Su uso cultural y ritual tiene reconocimiento milenario de etnias indígenas de la Amazonia occidental y ha ganado influencia mundial en la década de 1980, mediante la expansión de su uso religioso. En el campo biomédico, los estudios garantizaron seguridad en la administración de la bebida en humanos y encontraron características de bienestar mental y físico en sus usuarios. El objetivo es discutir los resultados de una investigación de la historia de vida de personas con recurridos terapéuticos de uso ritual de ayahuasca, desde una comprensión fenomenológica-existencial y de la terapia gestáltica. La metodología se basa en la actitud fenomenológica y en el método de historia de vida, lo que permite una aprehensión de la experiencia vivida. Así, se verificó que las experiencias rituales y los recurridos terapéuticos contribuyeron al reconocimiento de los participantes de que la salud es una postura de madurez o sabiduría asociada a sus relaciones con el mundo, atribuyendo a la ayahuasca la capacidad de operar resignificaciones en el proceso diario de autocuidado y, sobre todo, de amor a sí mismo.

Subjective time under altered states of consciousness in ayahuasca users in shamanistic rituals involving music

Ayahuasca is described as a hallucinogenic substance whose property is to alter the subjective experience of time and impair the perception of the passage of time during stimuli of more than two to three seconds. The dose-dependent effects of two concentrations of ayahuasca in the ritualistic context were investigated employing temporal reproduction tasks in participants experienced in shamanistic ayahuasca rituals. The study was conducted on nine healthy volunteers who ingested two doses of ayahuasca at two times during a ritual session. The doses of each session, consumed in amounts ranging from 20 to 60 mL, were either of low concentration or of experimental ayahuasca according to a double-blind procedure. Participants performed the task of immediately listening and reproducing, with a laptop, 20-s musical stimuli during the session. The results showed that significant temporal distortion was triggered by the musical stimulus presented without the ingestion of ayahuasca, with means of 16.33 to 16.52 s. There were minor temporal distortions after ingestion of ayahuasca: a mean of 17.91 s for control ayahuasca and of 18.38 s for experimental ayahuasca. These results with less temporal distortion among participants with ayahuasca intake disagree with other studies of hallucinogens involving temporal reproduction.

Pesquisas com ayahuasca na psicologia: revisão de literatura sobre o potencial terapêutico / Research with ayahuasca in psychology: a literature review of its therapeutic potential

A Ayahuasca é uma bebida alucinógena utilizada em contexto religioso, sendo associada a melhorias na saúde mental dos usuários. O presente estudo teve como objetivo fazer um levantamento da produção de pesquisas que avaliam o seu potencial terapêutico no campo da Psicologia. Foi realizada uma revisão narrativa de literatura com os descritores "Psicologia" e "Ayahuasca" indexados no portal CAPES, nas plataformas Medline e Scielo. Foram obtidos 34 artigos e foram aplicados critérios de inclusão ­ serem escritos nas línguas portuguesa ou inglesa, e possuírem o descritor "Ayahuasca" no título ­ e de exclusão ­ não abordarem o uso terapêutico da ayahuasca como problema de pesquisa. Após a filtragem, obteve-se 8 artigos publicados entre 2006 e 2018, divididos em 10 estudos, sendo 7 de pesquisa básica e 3 de pesquisa aplicada. Conclui-se que a produção de estudos sobre a eficácia terapêutica da Ayahuasca e seus efeitos na saúde mental dos usuários é recente e escassa. É importante que estudos futuros abordem além de parâmetros psicopatológicos ou farmacológicos questões sociais e culturais atrelados ao uso de substâncias. É essencial que particularidades do ambiente no qual a substância foi ingerida e da história de vida do usuário sejam consideradas e investigadas minunciosamente

The Ayahuasca is a hallucinogenic drink used in religious context and its use is associated with improvements in mental health of users. This study aimed to do a survey of the researches that evaluate the therapeutic potential of Ayahuasca in Psychology. A narrative literature review was performed with the descriptors "Psychology" and "Ayahuasca" indexed on the CAPES portal, on Medline and Scielo platforms. Thirty-four articles were obtained and inclusion criteria were applied - written in Portuguese or English, and having the descriptor "Ayahuasca" in the title - and exclusion - not addressing the therapeutic use of ayahuasca as a research problem. After filtering, we obtained 8 articles published between 2006 and 2018, divided into 10 studies: 7 of basic research and 3 of applied research. It is concluded that the production of studies on the therapeutic efficacy of Ayahuasca and its effects on users' mental health is recent and scarce. It is important that future studies address beyond psychopathological or pharmacological parameters, analising social and cultural issues linked to substance use. It is essential that particularities of the environment in which the substance was taken and of the user's life history are considered and investigated in detail.

Yagé: Crisis de occidente y trabajo espiritual / Yagé: Western crisis and spiritual work

Resumen Introducción: Ante la crisis epistemológica y sistémica que se encuentra en la civilización occidental, el yagé emerge como alternativa que invita a una reponderación axiológica profunda. Asimismo, el ritual del yagé evidencia los límites del conocimiento médico moderno, dando pauta al abordaje transdisciplinario. Por otro lado, se presentan consecuencias de inserción en el libre mercado, implicando problemas de lucro a costa de tradiciones originarias. En este contexto, se explora el concepto «trabajo espiritual¼ como práctica que busca descolocarse del colonialismo mercantil al tiempo que se aleja del modelo médico moderno. Objetivo: Reflexionar la incorporación del ritual de yagé en Occidente y sus posibilidades como alternativa epistemológica y médica. Materiales y métodos: Revisión de artículos de la base de datos especializados Web of Science, con la palabra clave: "ayahuasca". Resultados: Se estructuró la información teniendo en cuenta los aspectos relacionados con: (a) el contexto de incorporación del yagé al occidente, (b) los límites del conocimiento médico moderno y (c) los problemas de inserción al libre mercado. Conclusiones: Se apoya el diagnóstico de la ruptura epistemológica con occidente, pero reconociendo el estado inicial de las investigaciones y la falta de evidencias documentadas para entrar en una etapa más fructífera para el debate.

Abstract Introduction: In the face of epistemological and systemic crisis in Western civilization, yagé emerges as an alternative that invites a deep axiological reponderation. The yagé ritual demonstrates the limits of modern medical knowledge, giving guidance to a transdisciplinary approach. On the other hand, there are consequences of insertion into the free market, involving profit problems at the expense of original traditions. Thus, the concept of "spiritual work" is explored as a practice that seeks to dislodge itself from commercial colonialism while moving away from the modern medical model. Objective: To reflect on the incorporation of the yage ritual in the West and its possibilities as an epistemological and medical alternative. Materials and methods: Review of articles from the specialized Web of Science database, with the keyword: "ayahuasca". Results: The information was structured considering aspects related to: (a) the context of incorporation of yagé into the West, (b) the limits of modern medical knowledge and (c) the problems of insertion into the free market. Conclusions: The diagnosis of the epistemological rupture with the West is supported while recognizing the initial state of the investigations and the lack of documented evidence in order to enter into a more fruitful debate.

Ayahuasca en el tratamiento de adicciones: Estudio de cuatro casos tratados en IDEAA, desde una perspectiva interdisciplinaria / Ayahuasca in the treatment of addictions: Study of four cases treated in IDEAA, using an interdisciplinary perspective

La ayahuasca es una sustancia psicoactiva de origen amazónico, usada tradicionalmente con fines espirituales, médicos y religiosos. En la década de los ‘90 adquiere gran popularidad, tanto a través de las redes internacionales de espiritualidad y religiosidad, como en el denominado renacimiento de los estudios psicodélicos, donde se retoma la investigación y experimentación sobre los posibles usos clínicos de estas sustancias. El presente artículo tiene como objetivo la descripción y análisis de los procesos de cura de cuatro casos de adicciones tratados en el Instituto de Etnopsicología Amazónica Aplicada (IDEAA), un centro dedicado al tratamiento de adicciones, con pacientes españoles llevados al Amazonas de Brasil. El procedimiento ha implicado una metodología cualitativa del tipo biográfica, bajo una mirada interdisciplinaria que integra enfoques cognitivos y culturales. En los resultados, se describen el proceso de intervención utilizado en el centro y las narrativas biográficas de los casos estudiados. Se realiza una descripción de los distintos tipos de experiencias recurrentes durante los rituales de ayahuasca: revisiones biográficas, insights psicológicos, experiencias emocionales y/o trascendentales. Se analiza la importancia de la memoria de la experiencia, en tanto disparadora de nuevas reconfiguraciones en las narrativas biográficas de los sujetos, mostrándose la centralidad de dicha dinámica en el proceso terapéutico. Se analizan otros mecanismos específicos interviniendo en el proceso de cura de cada caso: psicosomáticos, simbólicos, de cognición social y psiconeuroinmunológicos. Se concluye sobre la relevancia terapéutica del contexto ritual, social y cultural, así como de las estrategias de integración de la memoria de la experiencia en las narrativas biográficas de los sujetos.

Ayahuasca is an Amazon psychoactive compound traditionally used for spiritual, religious, and medical purposes. In the 1990s the brew gains popularity, both through the transnational networks of religiosity/spirituality and the renaissance of psychedelic studies, where these kinds of substances are investigated for its possible clinical applications. The goal of the current article is to describe and analyze the therapeutic process of four cases from IDEAA, a center located in the Brazilian Amazon forest, dedicated to the treatment of addicts taken from Spain. An interdisciplinary perspective is proposed, combining cognitive and cultural insights from different fields (medical anthropology, cognitive science of religion, psychoneuroimmunology, qualitative sociology, cultural psychology). Ritual of ayahuasca will be considered as a way of producing a variety of experiences, and the memories of these experiences as ways of producing new biographic narratives. Biographic narratives are considered as a higher mental competence that includes functions related to self-knowledge, episodic memory, reflexivity, and psychosocial homeostasis. Under the appropriate set & setting, this process of narrative reconstruction helps the individual to cope with difficult situations, including addictions. The procedure used in this research consisted in a qualitative biographic methodology. The four cases described were treated in the period between 2000 and 2007. They started as poly drug users in the 1980s, at the end of the dictatorship period, when heroin made its entrance to Spain. The results describe the process of intervention used in the center, and the biographic narratives of each case. Most common types of experiences are mentioned: biographical revisions, psychological insights, emotional and transcendental experiences. Specific therapeutic mechanisms are also described. In the first case, a psychosomatic style of expression, where the subject describes strong embodied experiences of suffering his illnesses, and embodied expressions of coping with them. In the second case, a therapeutic process that includes the recognition of the former biographic narrative as a “lie”, and a symbolic way of producing new narratives of the self that spins around the presence of the jaguar. This animal acted as symbolic figure that triggered different meanings, useful for there covery of the patient. The third case is a subject who was involved in drug traffic, robberies, and violent activities. Experiences related to social cognition (e.g. empathy, shame, self-forgiveness) played a major role in his therapeutic process. Last, the narrative of a woman addicted to heroin is analyzed. Biographical remembrances and self-forgiveness played an importantrole, but also her symbolic experiences with the proximity of death, related to her medical conditions (addiction to heroin, hepatitis C, HIV). The case is also a good example of how the treatment had a positive psychoneuroimmunology impact in the HIV viral load of the patient. As we will analyze, the effect cannot be explained by ayahuasca itself (in fact, the scientific literature suggest a negative or neutral impact), but by the therapeutic strategy as a whole, with its various components. The article concludes addressing the importance of the “memory of the experience” of the ritual as catalyzer of new meanings in the biographic narratives of the patients. The new narratives can be considered assystem for self-regulation in the different, psychological, social, and cultural levels. Besides, it can also triggers different top-down psychoneuroimmunology and psychosomatic effects. The production of new narratives is related to what is usually called “integration”, and involves different psychological, social and cultural elements that are of great importance for a positive or negative therapeutic outcome.

Long-term effects of ayahuasca in patients with recurrent depression: a 5-year qualitative follow-up

Background Ayahuasca is a botanical hallucinogenic preparation traditionally used by indigenous populations of Northwestern Amazonian countries for ritual and therapeutic purposes. It is rich in β-carboline alkaloids and N,N-dimethyltryptamine (DMT). Preclinical, observational, and experimental studies suggest that ayahuasca and its alkaloids have anxiolytic and antidepressive effects. We recently reported in an open-label trial that ayahuasca administration was associated with significant decreases in depression symptoms for 2-3 weeks after the experimental session in 17 patients with treatment-resistant major depressive disorder. Objectives To investigate if the experiment had any long-lasting effects on patients Methods Eight patients were interviewed 4 to 7 years after ayahuasca intake. Results Our results suggest that ayahuasca was well tolerated and that symptom reductions were limited to a few weeks. Importantly, most patients believed that the experience was among the most important of their lives, even 4-7 years later. Discussion To the best of our knowledge, this is the first long-term follow-up of a clinical sample that participated in an ayahuasca trial. Further studies with different and repeated dosing should be designed to further explore the antidepressive and anxiolytic effects of ayahuasca.

Pre-clinical interaction of ayahuasca, a brew used in spiritual movements, with morphine and propofol

ABSTRACT Ayahuasca is a beverage with psychoactive properties used in religious and ceremonial rituals by some religious groups. The main active components of ayahuasca are dimethyltryptamine and the harmala alkaloids with ß-carboline structure acting as monoamine oxidase A inhibitors. This combination produces a pronounced activation of serotonergic pathways and presents potential interaction with other psychotropics. The objective of this study was to investigate the possible interactions between ayahuasca and agents employed in general anesthesia. The pharmacological interactions between ayahuasca and morphine or propofol were evaluated in mice using doses of 12, 120 and 1200 mg/kg (0.1 to 10 times the average dose consumed by humans in religious rituals). Ayahuasca alone showed an antinociceptive effect in the writhing and formalin tests, and intensified the analgesic effect of morphine in the hot plate test. Concerning the pharmacological interactions between ayahuasca and propofol, the results were opposite; ayahuasca intensified the depressant effect of propofol in the rotarod test, but decreased the sleeping time induced by propofol. These set of results showed the occurrence of some interactions between ayahuasca and the drugs morphine and propofol, possibly by both pharmacokinetics and pharmacodynamics mechanisms

Ayahuasca: what mental health professionals need to know

Abstract 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.

Reproductive effects of the psychoactive beverage ayahuasca in male Wistar rats after chronic exposure

Abstract Ayahuasca is a psychoactive beverage used ancestrally by indigenous Amazonian tribes and, more recently, by Christian religions in Brazil and other countries. This study aimed to investigate the reproductive effects of this beverage in male Wistar rats after chronic exposure. The rats were treated by gavage every other day for 70 days at 0 (control), 1×, 2×, 4× and 8× the dose used in a religious ritual (12 animals per group), and animals euthanized on the 71st day. Compared to controls, there was a significant decrease in food consumption and body weight gain in rats from the 4× and 8× groups, and a significant increase in the brain and stomach relative weight at the 8× group. There was a significant increase in total serum testosterone, and a decrease in spermatic transit time and spermatic reserves in the epididymis caudae in the 4× group, but not in the highest dose group. No significant changes were found in the other reproductive endpoints (spermatozoid motility and morphology, total spermatozoid count and daily sperm production), and histology of testis and epididymis. This study identified a no-observed-adverse-effect-level for chronic and reproductive effects of ayahuasca in male Wistar rats at 2× the ritualistic dose, which corresponds in this study to 0.62 mg/kg bw N, N-dimethyltryptamine, 6.6 mg/kg bw harmine and 0.52 mg/kg bw harmaline. A potential toxic effect of ayahuasca in male rats was observed at the 4× dose, with a non-monotonic dose-response. Studies investigating the role of ayahuasca components in regulating testosterone levels are needed to better understand this action.

Efecto de la ingestión de Banisteriopsis caapi y Psychotria viridis 'Binomio ayahuasca' en el hipocampo del cerebro de ratas / Effect of Banisteriopsis caapi and Psychotria viridis "Binomio ayahuasca" ingestion in the rat hippocampus

Objetivo: Evaluar el efecto de la ingestión de Banisteriopsis caapi y Psychotria viridis 'Binomio ayahuasca' en el hipocampo de cerebro de ratas. Diseño: Estudio experimental, descriptivo, analítico, transversal. Institución: Instituto de Investigación en Ciencias Farmacéuticas y Recursos Naturales, Facultad de Farmacia y Bioquímica, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico: Ratas. Intervenciones: Administración del binomio ayahuasca por vía orogástrica a ratas albinas adultas de la especie Rattus novergicus y de cepa Holtzman. A siete grupos de cinco con un peso promedio de 240 ± 30 g se les administró (GI) blanco, (GII) 2,5 mL diazepam, (GIII) 0,7 mL solución de Banisteriopsis caapi, (GIV) 0,7 mL Psychotria viridis, y a los grupos (GV), (GVI) y (GVII) se administró 0,7 mL, 3,5 mL y 7,0 mL de solución del binomio ayahuasca, respectivamente. Principales medidas de resultados: Macroscópicos: comportamiento de reflejos y actividad motora. Microscópicos: número de células piramidales y granulosas, y desorganización celular. Resultados: En el tamizaje fitoquímico del extracto se caracterizó presencia de alcaloides, antraquinonas, triterpenoides y esteroides, fenoles, flavonoides y saponinas. Los volúmenes de droga administradas a los grupos de intervención con el binomio en la dosis de 0,7 mL manifestaron significativo aumento en el número de células granulosas sobre las células piramidales; a dosis de 3,5 mL el número de células granulosas fue menor con presencia de células piramidales grandes y pequeñas; y a dosis de 7,0 mL se manifestó desorganización celular, presencia de células piramidales grandes y pequeñas, y aumento de células granulosas. Conclusiones: El extracto alcohólico del binomio ayahuasca presenta efecto neuropatológico en el hipocampo del cerebro de ratas. (AU)

Las propiedades farmacocinéticas del ayahuasca / The pharmacological properties of ayahuasca

Se describe las características químicas y los efectos del consumo del ayahuasca para conocer el estado actual de los descubrimientos existentes hasta la fecha sobre sus propiedades farmacocinéticas. Se realizó una revisión bibliográfica sobre estudios del ayahuasca hasta el año 2013 en inglés, español y portugués en las bases de datos de PubMed, PsycINFO, Psyke, Psicodoc y Redalyc, así como en capítulos de libros y bibliografía relacionada obtenida de investigaciones afines. Se concluye que uno de los componentes del ayahuasca, la harmina, puede ser utilizada para tratar diferentes patologías.

It describes the chemical characteristics and the effects of Ayahuasca consumption, in order to know the current status of the discoveries to date regarding their pharmacological properties. A literature review was performed on studies of ayahuasca until 2013 in English, Spanish, and Portuguese in the databases of PubMed, PsycINFO, Psyke, Psicodoc, and Redalyc; as well as chapters in books and literature obtained from related research. It is concluded that one of the components of ayahuasca û harmina û can be used to treat different pathologies.