Ayahuasca is a preparation made from plants. A name or a photo is never proof of what is in a cup.

Natural Psychedelics · Traditional plant brew

Ayahuasca

Q: Is ayahuasca dangerous with antidepressants?

Yes, it can be. Ayahuasca contains compounds that block the enzyme MAO, so serotonin-raising medicines can build up to dangerous levels. A 1998 paper warned of serotonin syndrome with SSRIs, and a 2026 model predicts that fluoxetine and paroxetine raise exposure to ayahuasca's compounds. Never stop or change a prescribed medicine on your own; talk with the prescriber.

Q: Can it be dangerous with cough or cold medicines?

Yes. A 2026 case report describes severe serotonin syndrome with respiratory failure after ayahuasca followed by dextromethorphan and diphenhydramine. The man needed a breathing tube and intensive care and recovered. Check every product, even over-the-counter ones, with a pharmacist or doctor.

Q: What are the most common side effects?

Vomiting is the most common. In a large online survey, 69.9% reported acute physical effects, mainly vomiting, and 2.3% needed later medical attention. In screened trials, nausea, vomiting, headache and short rises in blood pressure or heart rate were common.

Q: Can ayahuasca cause psychosis?

It has been reported. A systematic review found rare psychotic episodes after ayahuasca, often in people with a personal or family history of psychosis or mania, but some without. A 2024 case describes a long psychotic episode with violence in a man with no known risk factors. People with these conditions are excluded from trials.

Q: Can people die from ayahuasca?

Rarely, but deaths are reported. One death followed an extract that contained a large amount of 5-MeO-DMT. A review of DMT deaths found three earlier cases, two in ayahuasca ceremonies and judged accidental. Many reported cases involved other drugs, so the cause is often uncertain, and no count of how often it happens was found.

Q: Is ayahuasca the same as DMT?

No. DMT is one compound in the brew. Swallowed alone, DMT is nearly inactive because the body breaks it down quickly. The beta-carbolines in ayahuasca block that breakdown, and they are also the reason for the medicine-interaction risk. Our DMT page covers the compound itself.

Q: Does ayahuasca treat depression?

It has not been shown to. One small randomized trial of 29 adults with treatment-resistant depression found lower depression scores than placebo up to seven days after one dose, and a six-person open trial pointed the same way. Follow-up was very short and no large trial was found. Ayahuasca is not an approved medicine for any condition in the sources we read.

Q: Are retreats safe, and are they regulated?

We did not find a regulator that tests or licenses retreats. Physical adverse effects in the survey were linked to non-supervised settings, and content varies a great deal between plant samples and brews. A retreat leader may not know your medicines or health history. See our guide to evaluating retreat claims. This is not advice to attend or to avoid.

Q: Who should not take ayahuasca?

A critical review of severe cases lists current use of serotonin-raising medicines and previous heart or liver disease as contraindications. Trials exclude people with psychosis, bipolar disorder and heart conditions. No pregnancy data for people were found, and the authors of a scoping review say that is not evidence of safety. Talk with a doctor first.

Q: Whose tradition is ayahuasca?

It belongs to the traditions of Amazonian Indigenous peoples. Sources read for this page name the Shipibo people of Peru, and describe use in Brazil, Peru, Colombia and Ecuador. Santo Daime and the UDV are Brazilian religions that also use it. Indigenous scholars raise concerns about appropriation, patents and consent, and have published ethical principles for outsiders.

A preparation of Banisteriopsis caapi with a DMT-containing plant such as Psychotria viridis · also called Ayahuasca; related to the plants called ayahuasca vine and chacruna

Ayahuasca is a traditional plant brew from the Amazon, used for healing and ritual by Indigenous peoples, and now also in churches, ceremonies and retreats around the world. It contains DMT plus plant compounds that block an enzyme called MAO, and that makes it dangerous with antidepressants and many other medicines. Vomiting is common, and psychotic episodes and deaths have been reported. One small trial found lower depression scores a week after a supervised session; it does not show a treatment.

General information, not medical advice. Last substantive update October 25, 2026 · Not medically reviewed. A named clinician has not signed off on this page. Not yet reviewed by Indigenous or cultural experts. How this page is made

About Ayahuasca

Ayahuasca is a traditional Amazonian plant brew made from a vine and a leafy plant that supplies DMT. Its MAO-blocking compounds make it dangerous with antidepressants, over-the-counter cough and cold products and many other drugs, and serious harms including psychosis, kidney injury and deaths have been reported. Retreats are not regulated like medicine, and the contents of what is served vary. One small randomized trial found lower depression scores a week after a supervised session. The brew belongs to the traditions of Amazonian peoples, and their voices matter in how it is discussed.

Danger first: medicines, the mind and the body

Ayahuasca contains compounds that block an enzyme called monoamine oxidase (MAO). That is why serotonin-raising medicines can build up to dangerous levels. In 2026, doctors described a man who developed severe serotonin syndrome with respiratory failure after taking ayahuasca and then over-the-counter dextromethorphan and diphenhydramine. He needed a breathing tube and intensive care and recovered. A computer-model study predicts that common SSRIs such as fluoxetine and paroxetine raise the body's exposure to ayahuasca's compounds, and a review of severe reports concluded that current use of serotonin-raising medicines is a contraindication.

Other serious harms are reported as cases, not rates: a long psychotic episode that led to violence, severe muscle breakdown with kidney injury, delirium with several other drugs in the blood, and deaths, including one after an extract that held a large amount of 5-MeO-DMT. Researchers who reviewed severe reports say some lacked toxicology data and others involved different preparations, so these cases show that harm happens, not how often.

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What most people experience, and what the surveys show

In a self-selected online survey of 10,836 people from more than 50 countries, 69.9% reported acute physical effects, mainly vomiting, and 2.3% needed later medical attention. 55.9% reported adverse mental health effects in the following weeks or months; about 88% saw them as part of a positive process and about 12% sought professional support. A history of anxiety or depression was linked to more adverse mental states. Physical effects were linked to non-supervised settings.

In placebo-controlled trials with screened volunteers, no serious adverse events were reported among 108 administrations. Trials exclude many people, so this cannot be applied to unscreened ceremonies.

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What ayahuasca is, and what it is not

Ayahuasca is a preparation, not a single chemical. Reviews describe a vine, Banisteriopsis caapi, that supplies MAO-blocking beta-carbolines such as harmine, and the leaves of a shrub, Psychotria viridis (chacruna), that supply DMT. A third plant, Diplopterys cabrerana, is also named as a DMT source. This page does not describe how the brew is made or how much is taken.

DMT on its own is nearly inactive when swallowed, because the body breaks it down quickly. The beta-carbolines block that breakdown. This is why ayahuasca differs from DMT as a compound. Brews made with substitute plants (called anahuasca) or with extracted or lab-made compounds (called pharmahuasca) are different products again. Chemical studies show large differences in content between plant samples and brews, so a label or a name does not tell you what is in a cup.

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Indigenous and religious contexts

Reviews describe ayahuasca as traditionally used for healing and ritual by Indigenous peoples of northwestern Amazonian countries such as Brazil, Peru, Colombia and Ecuador. Papers read for this page name the Shipibo people of Peru, whose healers lead ayahuasca ceremonies. Each people's tradition has its own meaning and rules, and they belong to those peoples; this page does not describe them.

Santo Daime and the UDV are Brazilian religions, not Indigenous traditions, that use ayahuasca as a sacrament. Indigenous authors and scholars have raised concerns about cultural appropriation, patenting of traditional medicines, exclusion of Indigenous voices from research, and the need for free, prior and informed consent and benefit-sharing. A tradition is not a clinical trial, and a trial does not replace a tradition.

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What research shows

The best human evidence is small. A 2019 randomized trial of 29 adults with treatment-resistant depression found lower scores than placebo at one, two and seven days after one dose, with 64% responding versus 27%. Remission was higher but only trended (36% vs 7%). A 2015 open trial of six people had no placebo. A 2026 review says psilocybin has stronger evidence for lasting effects, and that trials struggle with blinding, high expectations and small samples.

Observational studies of ceremony and retreat attenders report improvements in wellbeing, but they have no control group and also report some people with lasting psychiatric problems. Registered trials are mostly early-stage and exclude people with heart or mental health conditions. Brain imaging shows consistent acute changes in a resting network, which is a measurement, not a treatment result.

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Law: a general picture, not legal advice

The International Narcotics Control Board says in its 2010 report that no plants are controlled under the 1971 or 1988 UN conventions, and that preparations such as decoctions from them are not under international control; it names ayahuasca as an example. That is not a statement that ayahuasca is legal anywhere: each country decides its own law, and laws change.

In the United States, the federal Schedule I list names dimethyltryptamine (DMT); the section text we searched does not name ayahuasca or the plants. How US courts and agencies treat the brew, and any religious exemption, were not verified here. A 2012 review describes how Brazil moved from prohibition to a 2010 resolution on religious and ritual use. We did not read Brazilian law itself. For other countries see our guides on how we verify legal information and on legal status by country.

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At a glance

Traditional uses history, not proof

Used for healing and ritual by Indigenous peoples of northwestern Amazonian countries such as Brazil, Peru, Colombia and Ecuador (Dos Santos 2024).
Described as used originally by Indigenous shamans for spirit communication, magical experiences, healing and religious rituals (Hamill 2019).
Shipibo healers in Peru lead ayahuasca ceremonies, including healing programmes that welcome international visitors (Gonzalez 2021; Gearin 2024).
Used as a sacrament in Brazilian religions such as the Santo Daime and the UDV, which are not Indigenous traditions (Blainey 2015).

Studied for research

Treatment-resistant depression: one small randomized trial (29 people) and one six-person open trial, low certainty
Wellbeing in ceremony attenders: observational studies only, very low certainty
Alcohol and drug use problems: one uncontrolled study of 52 people, very low certainty
PTSD and anxiety: interest only, not enough evidence
Brain scan changes: a measurement, not a treatment result

Main compounds

DMT (a psychedelic that acts on serotonin receptors; weak when swallowed alone)
Harmine, harmaline and tetrahydroharmine (MAO blockers that let DMT work and cause the medicine-interaction risk)

Common forms

The traditional brew (how it is made is not described on this page)
Brews sold with substitute plants or with extracted or lab-made compounds (anahuasca, pharmahuasca): a different product
Retreat and ceremony offerings: contents and screening are not regulated like medicine

Research links: Severe serotonin syndrome after ayahuasca and cough medicine (case report, 2026) · Ayahuasca and SSRIs: computer prediction of the interaction (2026) · Global Ayahuasca Survey: adverse effects of 10,836 people (2022) · Randomized trial in treatment-resistant depression, 29 patients (2019) · INCB 2010 report: plants and preparations are not under UN control · Poison Control (US): get help online or call 1-800-222-1222 · Ethical principles of traditional Indigenous medicine for Western psychedelic research (2023) · Research Library · Genes & Biomarkers Library

What it is and its history

Accepted scientific name: Ayahuasca (a traditional plant preparation, not a single species)
Common names: Ayahuasca (Name used in English and Spanish (origin of the word NOT verified here)); Yage (yagé) (Name used in Colombia (per general sources; NOT verified here)); Daime / Hoasca (Names used in Brazilian religions (NOT verified here))
Family or group: Not applicable: a preparation. Typical sources named in reviews are a vine of the Malpighiaceae family (Banisteriopsis caapi) and a shrub of the Rubiaceae family (Psychotria viridis). A third plant, Diplopterys cabrerana, is named in a 2026 case report as another DMT source.
Classification: Plantae (the brew is made from plants) > n/a > n/a > n/a > Banisteriopsis caapi: Malpighiaceae (GBIF key 3191340). Psychotria viridis: Rubiaceae (GBIF key 2921300). Diplopterys cabrerana: Malpighiaceae (GBIF key 3983665). > n/a (several genera) > Banisteriopsis caapi (Spruce ex Griseb.) C.V.Morton; Psychotria viridis Ruiz & Pav.; Diplopterys cabrerana (Cuatrec.) B.Gates
Native range: The component plants are indigenous to the Amazon basin of South America, according to the INCB 2010 report. Reviews describe traditional use by Indigenous groups of northwestern Amazonian countries such as Brazil, Peru, Colombia and Ecuador. Range maps and native status by country were not checked.
Habitat: Not checked.
What it looks like: Part used: Reviews say the vine's stalks or bark supply beta-carbolines (such as harmine) and the shrub's leaves supply DMT. How the brew is made is intentionally not described on this page.
Look-alikes and adulterants: Name: Anahuasca (substitute plants); Note: A 2012 review describes the sale of brews made with other plants, called anahuasca, to achieve similar effects. These are not the same product.; Name: Pharmahuasca (extracted or lab-made compounds); Note: Brews made with extracted or synthetic compounds instead of the plants. They are a different thing from the traditional preparation (2012 review; a 2013 review urges caution).; Name: Other Malpighiaceae lianas; Note: In a Brazilian chemical study the other Malpighiaceae samples did not contain beta-carbolines, except one Diplopterys pubipetala sample, so a vine's name or look does not guarantee its chemistry.
Sustainability and conservation: Not checked. No IUCN or CITES source for these plants was read, and concerns about plant sustainability raised by Indigenous authors were not independently verified here.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Indigenous peoples of the Amazon (northwestern Amazonian countries such as Brazil, Peru, Colombia and Ecuador)	Reviews describe ayahuasca as traditionally used by Indigenous groups for therapeutic and ritual purposes, and originally by Indigenous shamans for spirit communication, magical experiences, healing and religious rituals. Reviews do not name particular peoples, and we do not describe any people's practices. Each tradition's meaning and rules belong to its people.	Dos Santos & Hallak 2024; Hamill et al. 2019
Shipibo (Peruvian Amazon)	A 2021 observational study examined an Indigenous Shipibo healing programme in which traditional healers work in a series of ayahuasca ceremonies, and a 2024 anthropology paper describes Shipibo shamans and their international clients at a retreat in the Peruvian Amazon. The Shipibo people are credited here as named in those papers; other peoples' traditions should be added after cultural review.	Gonzalez et al. 2021; Gearin 2024
Santo Daime and UDV (Brazilian religions, 20th century onward)	The Santo Daime religion is organized around ayahuasca, which its members (daimistas) call a medicinal sacrament. Santo Daime and UDV are Brazilian religions, not Indigenous traditions, and have congregations in the USA, Canada, Japan, South Africa, Australia, Europe and Latin America.	Blainey 2015; Labate & Feeney 2012
Brazil, 1980s to 2010	Brazil moved from prohibition in the mid-1980s to a 2010 national council (CONAD) resolution setting rules for religious and ritual use.	Labate & Feeney 2012; INCB 2010
Global spread and Indigenous concerns (recent decades)	Use has spread to Europe, North America and elsewhere, including drug tourism and retreats. Indigenous authors and scholars raise concerns about cultural appropriation, patenting of traditional medicines, exclusion of Indigenous voices from research, and consent and benefit-sharing.	Celidwen et al. 2023; Schenberg & Gerber 2022

Traditional use shows how it was used. It does not show that it works or is safe today.

What is inside, and how it may work

What it contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
N,N-Dimethyltryptamine (DMT) PubChem 6089	tryptamine alkaloid	Leaves of Psychotria viridis or Diplopterys cabrerana (reviews)	Psychedelic; acts as an agonist at serotonin 5-HT1A/2A/2C receptors. Nearly inactive when swallowed alone because of rapid metabolism. ^{25 12 13}	Human data
Harmine PubChem 5280953	beta-carboline alkaloid	Stalks or bark of Banisteriopsis caapi (reviews)	Reversible MAO-A inhibitor; allows swallowed DMT to be active; other targets are described in lab work (imidazoline receptors, DYRK1A, dopamine transporter). ^{26 7 43}	Human, animal and lab
Harmaline PubChem 3564	beta-carboline alkaloid	Banisteriopsis caapi	MAO-A inhibitor; showed the most problems of the harmala alkaloids in preclinical toxicity models. ^{26 42 36}	Animal and lab
Tetrahydroharmine (THH) PubChem 442118	beta-carboline alkaloid	Banisteriopsis caapi	One of the three main beta-carbolines; measured in brew samples and found in the blood in a poisoning case. Its own pharmacology was not read for this page. ^{26 36 14}	Lab
Other tryptamines (5-MeO-DMT, bufotenine)	tryptamine alkaloids	Not established for the traditional brew in the sources read	Found in blood in a fatal case with an unusual extract (5-MeO-DMT) and in a poisoning case (bufotenine). ^{38 14}	Case report

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
Monoamine oxidase A (MAO-A)	MAOA	Harmine blocks MAO-A, which would otherwise break DMT down quickly after it is swallowed. This allows DMT to reach the brain, and it is also why serotonin-raising medicines can become dangerous together with the brew. ^{43 7 13 33}	Human (model) and lab
Serotonin receptors	HTR1A, HTR2A, HTR2C	DMT acts as an agonist at serotonin 1A/2A/2C receptors, the same family as other classic psychedelics. ^{13 12}	Human and lab
Default mode network	brain imaging	Consistent acute disruption of connectivity within a resting brain network, and more connectivity between other networks; it is unclear how central this is to any therapeutic potential. ¹⁶	Human data
Other proposed harmine targets	imidazoline receptors, DYRK1A, dopamine transporter	Suggested to explain possible effects on drug use; speculative. ⁷	Lab and animal

Absorption, metabolism and elimination

Absorption: DMT is nearly inactive when swallowed alone because of rapid first-pass metabolism; beta-carbolines greatly raise its bioavailability and duration (review). Models predict blood levels across routes.
Distribution: Not established in the sources read.
Metabolism: DMT is broken down by MAO-A, which harmine blocks. Both DMT and harmine are processed by liver enzymes, and a model predicted that strong CYP2D6 inhibitors (fluoxetine, paroxetine) raise exposure to both (computer simulation, not a clinical test).
Elimination: Not established in the sources read.
Bioavailability: See absorption. A chemical study found that harmine is partly converted to harmaline and tetrahydroharmine during preparation of the brew.

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Isolated compounds versus whole extracts

Ayahuasca is a preparation of plants, not a single chemical. DMT on its own is not the same product: it is nearly inactive when swallowed unless an MAO inhibitor is present, and the brew contains several beta-carbolines as well. Brews made with substitute plants (anahuasca) or extracted and lab-made compounds (pharmahuasca) are different again. Clinical trials used a research-supplied product; ceremony products vary a great deal. Nothing found for one can be assumed for another.

Nutritional composition

Not applicable.

4benefits and uses looked at

46studies and sources checked

Low certaintybest evidence rating found

1lab markers tracked in trials

1 low certainty2 very low certainty1 not enough evidence

What is Ayahuasca good for?

The uses people ask about and how strong the human evidence is for each. None is proven. Read every row together with the Safety tab: ayahuasca can interact dangerously with common medicines.

Treatment-resistant depressionLow certaintyOne small randomized trial of 29 adults found lower depression scores than placebo up to a week after one supervised session, and 64% responded versus 27% with placebo. A six-person open trial pointed the same way. Follow-up was short, the people were screened, and psychedelic effects are hard to hide from participants. This does not show that ayahuasca is a treatment. Mood and wellbeing in people who attend ceremoniesVery low certaintyFollow-up studies of retreat and ceremony attenders often report better wellbeing, but they have no comparison group and the people chose to attend. The same reviews report subsets of people with lasting psychological problems. Alcohol and drug use problemsVery low certaintyOne uncontrolled study of 52 people in a Peruvian addiction programme that includes ayahuasca reported lower alcohol and drug use severity after a year. It cannot show that ayahuasca helped. Post-traumatic stress and anxietyNot enough evidenceReviews mention interest, but we did not find a controlled trial that shows benefit.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Treatment-resistant depression

Low certainty

One small, controlled trial of 29 adults with depression that had not improved on other treatments found lower depression scores a week after a single supervised session of ayahuasca than after placebo. A small open trial of six people pointed the same way. These results are early, short, and from research settings. They do not show that ayahuasca is a treatment, and they do not apply to ceremonies or retreats.

4 studiesNot covered. This page gives no amounts or ways of preparing or takin…

Studies, doses and limits

What the trials found

A 2019 randomized, double-blind, placebo-controlled trial (29 adults with treatment-resistant depression, one dose, checked at 1, 2 and 7 days) and a 2015 open-label trial (6 adults, no placebo). A 2026 narrative review says psilocybin shows more robust evidence for lasting effects than ayahuasca.

Results

Randomized trial: depression scores (MADRS) were lower with ayahuasca than placebo at day 1 and day 2 (p=0.04) and day 7 (p<0.0001). At day 7, 64% responded vs 27% with placebo (p=0.04). Remission was 36% vs 7% and only trended (p=0.054). Open trial: depression scores fell by up to 82% at 1, 7 and 21 days; mania ratings did not change significantly.

Effect sizes as reported

Between-group Cohen's d 0.84 at days 1 and 2 and 1.49 at day 7 (one small trial, so these numbers are imprecise).

Why this rating

One small randomized trial (29 people) with one-week follow-up, plus a six-person open trial. Psychedelic effects are hard to hide, so people may have known what they received (a general limit of psychedelic trials, not stated in the abstract). No large or long trial, and no replication was read.

Form and dose studied

Not covered. This page gives no amounts or ways of preparing or taking ayahuasca. The trial used a research-supplied product in a clinical setting.

Who was studied

Adults with treatment-resistant depression, screened and supervised. People with psychosis or bipolar disorder are generally excluded from such trials, so results do not apply to them.

Limits

Tiny samples, one dose, follow-up of 7 to 21 days, one research group's setting, possible unblinding and high expectations. Trials of ayahuasca are mostly screened volunteers. The two trials do not tell us about unsupervised or retreat use.

Why researchers looked

Ayahuasca contains DMT, which acts on serotonin receptors, and harmine, which blocks the enzyme that would otherwise break DMT down. Reports that people felt better after ceremonies led researchers in Brazil to test it in clinic.

Traditional use

Ayahuasca is traditionally used by Indigenous peoples of the Amazon for healing and ritual. That tradition is not the same as a clinical trial, and its purposes are the traditions' own. Needs Indigenous/cultural review by the owner.

Proposed mechanism Pharmacological theory

DMT acts on serotonin receptors (5-HT1A/2A/2C). Harmine and other beta-carbolines block monoamine oxidase A, so DMT is not broken down quickly after it is swallowed. Links to brain plasticity are proposed from lab and imaging work and are not proven to explain any benefit.

A proposed mechanism does not show that the effect happens in people.

Ayahuasca can interact dangerously with many medicines, especially antidepressants and some cold and cough products, and it can cause vomiting, frightening experiences and, rarely, psychosis. See the Safety tab first.

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Mood and wellbeing in people who attend ceremonies

Very low certainty

Surveys and follow-up studies of people who attended ayahuasca ceremonies or retreats often report better wellbeing, mood and quality of life months later. These studies have no comparison group and mostly follow people who chose to attend, so they cannot show that ayahuasca caused the changes. The same studies also report people with lasting psychological problems after ceremonies.

4 studiesNot covered. Studies used ceremony products of unknown and varying co…

Studies, doses and limits

What the trials found

A 2026 systematic review of 18 prospective studies, mostly of retreat attenders. A 2021 observational study of 200 people in a Shipibo healing programme (well-being scales up to 12 months, with about 94 completing the last follow-up). A reanalysis of the 10,836-person Global Ayahuasca Survey.

Results

The systematic review noted long-term changes in wellbeing, depression and other psychiatric symptoms, substance misuse, cognitive flexibility, personality and prosocial behavior, but also subsets of people with persisting psychiatric complications. The Shipibo study found increases on all well-being scales at all follow-up points. In the survey reanalysis, average mental health scores were comparable to the general population, and a history of anxiety or depression was linked to more adverse mental states.

Effect sizes as reported

Not summarized. The studies used different scales and had no control groups.

Why this rating

Observational, uncontrolled, self-selected and often self-reported. People who choose ceremonies may differ from others, and many did not finish follow-up. Cannot separate ayahuasca from the setting, the group, expectations or time.

Form and dose studied

Not covered. Studies used ceremony products of unknown and varying content.

Who was studied

Adults who chose to attend ceremonies or retreats, mostly in Peru, Brazil and other countries, often self-selected online.

Limits

No control groups, unstandardized products and doses, loss to follow-up, and no checking of medicines or mental health histories in many cases. Positive reports do not cancel the harms reported in the same studies.

Why researchers looked

Many people now attend ceremonies outside the Amazon, and researchers want to know what happens to their mental health afterwards.

Traditional use

Ceremonies are rooted in Indigenous Amazonian healing. One observational study followed Westerners who joined an Indigenous Shipibo healing programme in Peru. Whether Western reports match the traditions' own aims is a question for the peoples concerned. Needs Indigenous/cultural review by the owner.

Proposed mechanism Pharmacological theory

Proposed ideas include altered self-awareness, a more flexible way of thinking about distress (decentering), and changes in resting brain networks. These are theories and survey findings, not proven mechanisms.

A proposed mechanism does not show that the effect happens in people.

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Alcohol and drug use problems

Very low certainty

Some addiction programmes include ayahuasca ceremonies, and one Peruvian programme (52 people) reported lower alcohol and drug use severity after a year. The study had no comparison group and the programme includes many other parts, so it cannot show that ayahuasca helped.

4 studiesNot covered.

Studies, doses and limits

What the trials found

A 2024 uncontrolled observational study of 52 participants in an addiction programme at the Takiwasi Centre (Peru), followed for one year. A 2019 review mentions interest in addiction without proving benefit.

Results

Group scores improved on alcohol and drug use severity, depression, anxiety and some quality-of-life measures at one year, with large differences between individuals.

Effect sizes as reported

Not reported in the abstract.

Why this rating

One uncontrolled study of 52 people in a multi-part programme. No placebo or comparison group.

Form and dose studied

Not covered.

Who was studied

People in a residential addiction programme in Peru.

Limits

Cannot attribute change to ayahuasca rather than the whole programme, time or selection. Reviews say the evidence is not established.

Why researchers looked

Harmine and DMT act on brain systems involved in craving and reward in lab research, and ceremonial use is part of some Amazonian traditions of treating addiction.

Traditional use

Amazonian healing traditions use ayahuasca in many ways. Treatment centres that blend traditional and clinical care are modern programmes. Needs Indigenous/cultural review by the owner.

Proposed mechanism Animal research

Proposed mechanisms include MAO blockade, serotonin 5-HT2A effects, imidazoline receptors, DYRK1A inhibition and the dopamine transporter. These come from lab and animal work.

A proposed mechanism does not show that the effect happens in people.

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Post-traumatic stress and anxiety

Not enough evidence

Reviews say there is interest in ayahuasca for PTSD and anxiety, but we did not find a controlled trial that shows benefit. There is not enough evidence to judge.

2 studiesNot covered.

Studies, doses and limits

What the trials found

No controlled trial for PTSD or anxiety disorders was read. A 2024 review says interest exists and that benefit is not established. A 2026 review of registered trials found most are early-stage and focus on safety.

Results

Nothing measured in the studies we read.

Effect sizes as reported

None.

Why this rating

Reviews mention interest only. No trial results were read for these conditions.

Form and dose studied

Not covered.

Who was studied

Not applicable.

Limits

Planned trials are early and exclude many people with heart or mental health conditions.

Why researchers looked

Researchers are interested in whether psychedelics could help with trauma and anxiety, and some ceremony attenders say they feel less anxious.

Traditional use

No traditional use specifically for trauma is described in the sources we read.

Proposed mechanism Animal research

Animal studies of fear memory exist but were not read for this page, and the idea is untested in people.

A proposed mechanism does not show that the effect happens in people.

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Connections to the rest of health

How Ayahuasca connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Nervous system	Adverse effect or risk	Low certainty	Vomiting, strong emotional reactions, delirium and psychosis reports. Preparation or compound: Ayahuasca (DMT and beta-carbolines)	^{6 14}
Nervous System	Biological association	Low certainty	Studied for: Treatment-resistant depression Studied for: Mood and wellbeing in people who attend ceremonies	^{31 29 10 12 21 18 2 6 35 20 7 39}
Stress Mood	Biological association	Low certainty	Studied for: Treatment-resistant depression Studied for: Mood and wellbeing in people who attend ceremonies	^{31 29 10 12 21 18 2 6}

E. Health conditions

Connected to	Kind of connection	Evidence status	Context	Studies
Depression (treatment-resistant)	Potential benefit	Low certainty	One small randomized trial and one six-person open trial; one-week follow-up. Preparation or compound: Ayahuasca (research-supplied)	^{31 29}
Serotonin syndrome	Adverse effect or risk	Low certainty	Case report with respiratory failure after ayahuasca and over-the-counter medicines. Preparation or compound: Ayahuasca with serotonergic medicines	^{30 8}
Psychosis	Adverse effect or risk	Low certainty	Case reports; a systematic review calls episodes rare. Preparation or compound: Ayahuasca	^{11 4}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Default mode network connectivity (resting brain network)	Biological association	Low certainty	Measured in trials: decrease within the network; increase between other networks (acute). A lab change is not the same as a health benefit.	¹⁶

J. Genes, receptors and enzymes

Connected to	Kind of connection	Evidence status	Context	Studies
MAOA	Preliminary mechanism	Human (model) and lab	Target of harmine; central to the interaction risk.	^{43 7}
CYP2D6	Preliminary mechanism	Model	Liver enzyme; SSRIs that inhibit it were predicted to raise exposure to DMT and harmine (model).	³³
5-HT2A	Preliminary mechanism	Human and lab	Serotonin receptor targeted by DMT.	¹³

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
N,N-Dimethyltryptamine (DMT)	Biological association	Human	Psychedelic; acts as an agonist at serotonin 5-HT1A/2A/2C receptors. Nearly inactive when swallowed alone because of rapid metabolism. Preparation or compound: Leaves of Psychotria viridis or Diplopterys cabrerana (reviews)	^{25 12 13}
Harmine	Biological association	Human, animal and lab	Reversible MAO-A inhibitor; allows swallowed DMT to be active; other targets are described in lab work (imidazoline receptors, DYRK1A, dopamine transporter). Preparation or compound: Stalks or bark of Banisteriopsis caapi (reviews)	^{26 7 43}
Harmaline	Biological association	Animal and lab	MAO-A inhibitor; showed the most problems of the harmala alkaloids in preclinical toxicity models. Preparation or compound: Banisteriopsis caapi	^{26 42 36}
Tetrahydroharmine (THH)	Biological association	Lab	One of the three main beta-carbolines; measured in brew samples and found in the blood in a poisoning case. Its own pharmacology was not read for this page. Preparation or compound: Banisteriopsis caapi	^{26 36 14}
Other tryptamines (5-MeO-DMT, bufotenine)	Biological association	Case report	Found in blood in a fatal case with an unusual extract (5-MeO-DMT) and in a poisoning case (bufotenine). Preparation or compound: Not established for the traditional brew in the sources read	^{38 14}

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).

The evidence

The research centre for Ayahuasca. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Treatment-resistant depression 4 studies Low certainty Mood and wellbeing in people who attend ceremonies 4 studies Very low certainty Alcohol and drug use problems 4 studies Very low certainty Post-traumatic stress and anxiety 2 studies Not enough evidence

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed and read the abstracts of 38 papers, read the INCB 2010 report paragraphs, the US eCFR Schedule I text, NIDA, Poison Control and NHS pages, and checked plant names in GBIF and chemical identifiers in PubChem. Where a statement came second-hand it is marked as unverified in our notes.

Study library: every study we checked 46

Design Research type Year from Search

Study	Design	People	Product, dose, length	Result
Albert 2026 Psychedelic exposure in pregnancy: a scoping review to inform perinatal drug safety and clinical counseling. Ther Adv Drug Saf · PMID 41930230 · DOI	Scoping review	23 human sources (1968-2020) on prenatal psychedelic exposure	psychedelics n/a not extracted n/a · vs n/a	No eligible primary human pregnancy-outcome studies were found for psilocybin or DMT/ayahuasca. The authors state that absence of data should not be read as evidence of safety. Methods, limits and funding Outcomes: Pregnancy outcomes Limitations: No data for ayahuasca in pregnancy. Funding and conflicts: Not stated in the abstract. Read: abstract
Andión Ó 2025 A new insight into ayahuasca's adverse effects: Reanalysis and perspectives on its mediating role in mental health from the Global Ayahuasca Survey (GAS). PLOS Ment Health · PMID 41661937 · DOI	Survey reanalysis	10836 Global Ayahuasca Survey participants	ayahuasca, naturalistic use n/a not extracted n/a · vs n/a	A history of anxiety or depression was linked to more adverse mental states after ayahuasca. Overall SF-12 mental health scores were comparable to the general population, and some experiences often labelled negative (visual distortions) correlated with better mental health. Methods, limits and funding Outcomes: Adverse mental states and mental health (SF-12) Limitations: Self-selected online sample; association only. Funding and conflicts: Not stated in the abstract. Read: abstract
Apud 2023 Ayahuasca, Personality and Acute Psychological Effects in Neo-Shamanic and Religious Settings in Uruguay. J Psychoactive Drugs · PMID 37750012 · DOI	Observational study with chemical analysis	Users from one neo-shamanic and one Santo Daime group in Uruguay	ayahuasca (two groups' samples) n/a not extracted n/a · vs n/a	Chemical analysis of the ayahuasca samples showed a typical alkaloid composition and no adulterants. The two samples differed in beta-carboline to DMT ratio, which may relate to different effects. Methods, limits and funding Outcomes: Personality, acute effects, sample chemistry Limitations: Only two groups' samples; do not generalize. Funding and conflicts: Not stated in the abstract. Read: abstract
Baker 2024 Drug-induced psychosis following use of Ayahuasca: a presentation to forensic psychiatric services. BMJ Case Rep · PMID 39142841 · DOI	Case report	1 Man with no known risk factors or forensic history	ayahuasca n/a not extracted n/a · vs n/a	After what was described as controlled ayahuasca use he developed a long psychotic episode, assaulted a relative and was admitted to a forensic psychiatric unit. He improved on an antipsychotic and stayed well at 18 months. Methods, limits and funding Outcomes: Clinical course Limitations: One case; cannot show how often it happens or exclude other causes. Funding and conflicts: Not stated in the abstract. Read: abstract
Blainey 2015 Forbidden therapies: Santo Daime, ayahuasca, and the prohibition of entheogens in Western society. J Relig Health · PMID 24477460 · DOI	Anthropological paper n/a	Santo Daime	n/a n/a not extracted n/a · vs n/a	Santo Daime is a Brazilian religion organized around ayahuasca, practiced across Europe and North America. Members call it a medicinal sacrament. Most Western governments treat ayahuasca as a dangerous hallucinogen and prosecute participants. The author says empirical studies support the claim that it is benign and can be beneficial in controlled contexts. Methods, limits and funding Outcomes: Cultural and legal analysis Limitations: One author's argument; the empirical claim is the author's reading, not a new study. Funding and conflicts: Not stated in the abstract. Read: abstract
Bouso 2022 Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey. PLOS Glob Public Health · PMID 36962494 · DOI	Online cross sectional survey	10836 Self-selected adults from more than 50 countries who had used ayahuasca (2017-2019)	ayahuasca, naturalistic use n/a not extracted n/a · vs n/a	69.9% reported acute physical effects, mainly vomiting, and 2.3% needed later medical attention. 55.9% reported adverse mental health effects in the following weeks or months, though about 88% saw them as part of a positive process, and about 12% sought professional support. Physical effects were related to older age at first use, having a physical health condition and a non-supervised context. Methods, limits and funding Outcomes: Self-reported physical and mental adverse effects Limitations: Self-selected online sample; self-reports; cannot show cause and effect or how common harms are in all users. Funding and conflicts: Not stated in the abstract. Read: abstract
Brierley 2012 Developments in harmine pharmacology--implications for ayahuasca use and drug-dependence treatment. Prog Neuropsychopharmacol Biol Psychiatry · PMID 22691716 · DOI	Review human, animal and lab	Pharmacology review of harmine	harmine, DMT n/a not extracted n/a · vs n/a	The two main constituents are DMT and harmine, an MAO inhibitor that slows the breakdown of DMT, which is otherwise broken down very quickly after swallowing. The authors describe the sale of compounds online and the use of substitute plants (anahuasca) or synthetic compounds (pharmahuasca), and discuss possible mechanisms for reduced return to alcohol or cocaine use, which remains an idea. Methods, limits and funding Outcomes: Mechanisms Limitations: Mostly lab and animal pharmacology; benefits for addiction are speculative. Funding and conflicts: Not stated in the abstract. Read: abstract
Callaway 1998 Ayahuasca preparations and serotonin reuptake inhibitors: a potential combination for severe adverse interactions. J Psychoactive Drugs · PMID 9924842 · DOI	Commentary n/a	Pharmacology commentary (1998)	ayahuasca with SSRIs n/a not extracted n/a · vs n/a	The authors warn that the MAO-blocking harmala alkaloids in ayahuasca and the SSRI class of antidepressants may cause serotonin syndrome with a potentially grave outcome, and advise caution when combining ayahuasca with certain medicines. Methods, limits and funding Outcomes: Interaction risk Limitations: A short 1998 warning based on pharmacology, not a measured clinical study. Funding and conflicts: Not stated in the abstract. Read: abstract
Celidwen 2023 Ethical principles of traditional Indigenous medicine to guide western psychedelic research and practice. Lancet Reg Health Am · PMID 36844020 · DOI	Review (Indigenous consensus process) n/a	Indigenous-led group of practitioners, scholars and lawyers	n/a n/a not extracted n/a · vs n/a	A global Indigenous consensus process identified eight principles for Western psychedelic research and practice: Reverence, Respect, Responsibility, Relevance, Regulation, Reparation, Restoration and Reconciliation, in response to cultural appropriation and patenting of traditional medicines. Methods, limits and funding Outcomes: Ethical principles Limitations: A guidance paper, not a clinical study. Funding and conflicts: Not stated in the abstract. Read: abstract
Civardi 2026 Psilocybin and ayahuasca in treatment-resistant depression: clinical evidence, methodological constraints and ethical challenges: a narrative review. Front Psychiatry · PMID 42812990 · DOI	Narrative review	Psilocybin and ayahuasca studies in treatment-resistant depression	psilocybin, ayahuasca n/a not extracted n/a · vs n/a	Both show rapid reductions in depressive symptoms, with psilocybin showing more robust evidence for sustained effects. Trials mostly exclude people with other conditions, high suicide risk or many medicines, and struggle with blinding, high expectations and small samples. Methods, limits and funding Outcomes: Efficacy, safety, study design problems Limitations: A narrative review. Funding and conflicts: Not stated in the abstract. Read: abstract
Dos Santos 2017 Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies. Ther Adv Psychopharmacol · PMID 28540034 · DOI	Systematic review	Case reports and series of psychotic episodes after ayahuasca or DMT (3 series, 2 reports for ayahuasca; 3 reports for DMT)	ayahuasca, DMT n/a not extracted n/a · vs n/a	Episodes seem rare in ritual and recreational settings. Many cases had a personal or family history of psychosis, mania or other drug use, but some did not. The authors suggest psychiatric screening before administration. Methods, limits and funding Outcomes: Psychotic episodes Limitations: Case reports cannot give frequency. Funding and conflicts: Not stated in the abstract. Read: abstract
Dos Santos 2024 Ayahuasca: pharmacology, safety, and therapeutic effects. CNS Spectr · PMID 39564645 · DOI	Review	Narrative review of ayahuasca pharmacology, safety and therapy	ayahuasca n/a not extracted n/a · vs n/a	Ayahuasca is traditionally used by Indigenous groups of northwestern Amazonian countries such as Brazil, Peru, Colombia and Ecuador. Human studies suggest good safety and tolerability, often with improvement in depressive and anxious symptoms, but there are few controlled studies, with small samples, single doses and short follow-up. Interest exists in depression, PTSD and substance use disorder. Methods, limits and funding Outcomes: Pharmacology, safety, therapeutic effects Limitations: A narrative review, not a systematic search. Authors call for larger controlled trials. Funding and conflicts: Not stated in the abstract. Read: abstract
Egger 2024 Neurobiological research on N,N-dimethyltryptamine (DMT) and its potentiation by monoamine oxidase (MAO) inhibition: from ayahuasca to synthetic combinations of DMT and MAO inhibitors. Cell Mol Life Sci · PMID 39254764 · DOI	Review human, animal and lab	Review of DMT neurobiology and MAO inhibition	DMT with MAO inhibitors n/a not extracted n/a · vs n/a	DMT is nearly inactive when swallowed because of rapid first-pass metabolism, but beta-carboline MAO-A inhibitors greatly raise its bioavailability and duration. DMT acts at serotonin 1A/2A/2C receptors. The authors link the combination to possible neuroplasticity. Methods, limits and funding Outcomes: Mechanisms Limitations: Mostly mechanisms and imaging; therapeutic claims are preliminary. Funding and conflicts: Not stated in the abstract. Read: abstract
Estrella-Parra 2025 Intoxication Associated with Ayahuasca Consumption, Characterization, and Comparative Analysis of the Beverage's Components: A Case Report. Rev Colomb Psiquiatr (Engl Ed) · PMID 41213743 · DOI	Case report	1 24-year-old regular ayahuasca user in Mexico	ayahuasca with other drugs n/a not extracted n/a · vs n/a	He arrived at an emergency room with cognitive decline and delirium. Blood analysis found DMT, harmaline, harmine, harmol, bufotenine and tetrahydroharmine, plus cannabis, amphetamine and cocaine-related compounds. The authors link the poisoning to ayahuasca and its interaction with other drugs. Methods, limits and funding Outcomes: Blood analysis and clinical course Limitations: One case with several substances found, so the cause is unclear. Funding and conflicts: Not stated in the abstract. Read: abstract
GBIF 2026 GBIF Backbone Taxonomy species match: Banisteriopsis caapi, Psychotria viridis, Diplopterys cabrerana · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	Banisteriopsis caapi (Spruce ex Griseb.) C.V.Morton, key 3191340, ACCEPTED, family Malpighiaceae. Psychotria viridis Ruiz & Pav., key 2921300, ACCEPTED, family Rubiaceae. Diplopterys cabrerana (Cuatrec.) B.Gates, key 3983665, ACCEPTED, family Malpighiaceae. Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: GBIF API species match (read 2026-10-25)
Gattuso 2023 Default Mode Network Modulation by Psychedelics: A Systematic Review. Int J Neuropsychopharmacol · PMID 36272145 · DOI	Systematic review	Brain imaging studies of LSD, psilocybin and ayahuasca	LSD, psilocybin, ayahuasca n/a not extracted n/a · vs n/a	Across psychedelics there is consistent acute disruption of connectivity within the default mode network and more connectivity between other networks. The review says it is unclear how central this network is to therapeutic potential. Methods, limits and funding Outcomes: Default mode network (a resting brain network) Limitations: A brain measurement is not a treatment outcome. Funding and conflicts: Not stated in the abstract. Read: abstract
Gearin 2024 Healing with Ayahuasca the Plant Teacher: Psychedelic Metaphoricity and Polyontologies. Med Anthropol · PMID 39374048 · DOI	Anthropological paper n/a	Healing retreat in the Peruvian Amazon with Shipibo shamans and international clients	n/a n/a not extracted n/a · vs n/a	Describes how Shipibo shamans and international clients hold different views of ayahuasca, for example as a plant teacher, and of purging and visions in healing. Methods, limits and funding Outcomes: Cultural analysis Limitations: A cultural study, not clinical evidence. Funding and conflicts: Not stated in the abstract. Read: abstract
Gonzalez 2021 The Shipibo Ceremonial Use of Ayahuasca to Promote Well-Being: An Observational Study. Front Pharmacol · PMID 34025402 · DOI	Observational study	200 Westerners joining an Indigenous Shipibo healing programme with ayahuasca ceremonies	ayahuasca ceremonies in an Indigenous Shipibo programme n/a not extracted n/a · vs n/a	Scores increased on all scales at all time points among those who completed follow-up (101 at 3 months, 94 at 12 months). The authors think this reflects the programme, not time passing, and found a link between decentering and well-being. Methods, limits and funding Outcomes: Well-being and quality-of-life scales to 12 months Limitations: No randomized comparison; many did not complete follow-up; self-report online. Funding and conflicts: Not stated in the abstract. Read: abstract
Halman 2024 Drug-drug interactions involving classic psychedelics: A systematic review. J Psychopharmacol · PMID 37982394 · DOI	Systematic review	52 human studies (from 36 reports) of classic psychedelics with other drugs; only 1 on ayahuasca	classic psychedelics (mostly LSD) n/a not extracted n/a · vs n/a	Combining psychedelics with other drugs gave weaker effects, stronger effects or no change. Apart from a few case reports, no serious adverse drug events were described. Only one included study concerned ayahuasca. Methods, limits and funding Outcomes: Interactions between classic psychedelics and other drugs Limitations: Very little ayahuasca-specific interaction data; most studies were on LSD. Funding and conflicts: Not stated in the abstract. Read: abstract
Hamill 2019 Ayahuasca: Psychological and Physiologic Effects, Pharmacology and Potential Uses in Addiction and Mental Illness. Curr Neuropharmacol · PMID 29366418 · DOI	Review	Narrative review of ayahuasca	ayahuasca n/a not extracted n/a · vs n/a	States that ayahuasca was originally used by Indigenous shamans for spirit communication, magical experiences, healing and religious rituals across several South American countries, and that several Brazilian churches use it routinely. Reviews effects, safety, pharmacology and potential psychiatric uses. Methods, limits and funding Outcomes: Effects, mechanisms, clinical uses Limitations: A 2019 narrative review that searched one database. Funding and conflicts: Not stated in the abstract. Read: abstract
Haupt 2026 Preliminary effects of ayahuasca on mental and physical health: A systematic review of prospective studies. Prog Neuropsychopharmacol Biol Psychiatry · PMID 41667049 · DOI	Systematic review	18 prospective studies, mostly retreat attenders	ayahuasca (retreat settings) n/a not extracted n/a · vs n/a	Long-term changes were noted in wellbeing, depression and other psychiatric symptoms, substance misuse, cognitive flexibility, personality and prosocial behavior. Subsets of participants had persisting psychiatric complications linked to their ayahuasca use. No study looked at physical health conditions specifically. Methods, limits and funding Outcomes: Long-term health outcomes Limitations: Small samples, unstandardized dosages, no control groups, non-randomized designs. Funding and conflicts: Not stated in the abstract. Read: abstract
INCB 2010 International Narcotics Control Board: Report 2010 (section on plant material containing psychoactive substances) · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	Paragraphs 284-285 say no plants are controlled under the 1971 or 1988 conventions, even where some of their active ingredients are, and that preparations such as decoctions made from such plants are also not under international control. Ayahuasca is named as an example: a preparation made from plants of the Amazon basin, mainly Banisteriopsis caapi and Psychotria viridis, containing DMT. Paragraph 500 notes Brazil's CONAD adopted a resolution on religious use of ayahuasca in January 2010. Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: full text of the paragraphs (PDF, read 2026-10-25)
Kermanshah 2025 Severe Rhabdomyolysis With Stage 3 Acute Kidney Injury After Ayahuasca Use Managed Without Renal Replacement Therapy: A Case Report. Cureus · PMID 41111708 · DOI	Case report	1 Previously healthy man after ayahuasca and prolonged travel	ayahuasca n/a not extracted n/a · vs n/a	He developed severe muscle breakdown (rhabdomyolysis) and stage 3 acute kidney injury, needed intensive care, and kidney function was still impaired at discharge. The authors think the cause was multifactorial (stimulation of the nervous system, dehydration and circumstances). They call it the first ayahuasca-associated case. Methods, limits and funding Outcomes: Muscle and kidney injury Limitations: One case; contributing factors cannot be separated. Funding and conflicts: Not stated in the abstract. Read: abstract
Labate 2012 Ayahuasca and the process of regulation in Brazil and internationally: implications and challenges. Int J Drug Policy · PMID 21856141 · DOI	Policy analysis n/a	Brazil's regulation of ayahuasca, 1980s to 2010	n/a n/a not extracted n/a · vs n/a	Summarizes how Brazil moved from prohibition in the mid-1980s to a 2010 CONAD resolution setting rules for religious and ritual use, and how the Santo Daime and UDV religions spread abroad. Three international themes: scope of treaties on plant-based substances, religious liberty, and potential dangers to health and public safety. Methods, limits and funding Outcomes: Regulatory history Limitations: A 2012 background paper, not current law. We did not read Brazilian law itself. Funding and conflicts: Not stated in the abstract. Read: abstract
NCBI PubChem 2026 PubChem: N,N-Dimethyltryptamine (CID 6089) · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	CID 6089, formula C12H16N2. Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: PubChem REST property lookup (read 2026-10-25)
NCBI PubChem 2026 PubChem: harmine (CID 5280953), harmaline (CID 3564), tetrahydroharmine (CID 442118) · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	Harmine C13H12N2O (CID 5280953); harmaline C13H14N2O (CID 3564); tetrahydroharmine C13H16N2O (CID 442118). Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: PubChem REST property lookup (read 2026-10-25)
NHS 2026 NHS (UK): Poisoning · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	Call 999 or go to A&E if you think someone swallowed something harmful, lost consciousness, stopped breathing, has severe breathing difficulty or has a seizure. Do not drive to A&E. Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: page text (read 2026-10-25)
National Capital Poison Center 2026 Poison Control (US): get help online or call 1-800-222-1222 · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	US poison centre help is free, expert and confidential at 1-800-222-1222. If the person collapses, has a seizure, has trouble breathing or cannot be awakened, call 911. Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: page text (read 2026-10-25)
Osório Fde 2015 Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report. Braz J Psychiatry · PMID 25806551 · DOI	Open label trial	6 Six volunteers in a current depressive episode, inpatient psychiatric unit	ayahuasca n/a not extracted n/a · vs n/a	Depression scores fell by up to 82% from baseline at 1, 7 and 21 days. Mania ratings did not change significantly. The authors suggest fast-acting anxiety and depression relief. Methods, limits and funding Outcomes: Depression and mania scores at 1, 7 and 21 days after one session Limitations: Six people, no placebo, no blinding, so changes could be due to expectation or time. Preliminary only. Funding and conflicts: Not stated in the abstract. Read: abstract
Pack 2026 Severe Serotonin Syndrome With Acute Respiratory Failure Following Ayahuasca and Dextromethorphan Use: A Case Report. Cureus · PMID 42713547 · DOI	Case report	1 46-year-old man	ayahuasca plus dextromethorphan and diphenhydramine n/a not extracted n/a · vs n/a	A man developed severe serotonin syndrome with acute respiratory failure after taking ayahuasca over three days and then over-the-counter dextromethorphan and diphenhydramine. He was intubated and treated in intensive care, improved quickly, was extubated on ICU day 2 and went home on hospital day 3. The authors say this appears to be the first report of ayahuasca plus these over-the-counter medicines causing this severity. Methods, limits and funding Outcomes: Clinical course Limitations: One case. Cannot show how often this happens. Funding and conflicts: Not stated in the abstract. Read: abstract
Palhano-Fontes 2019 Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychol Med · PMID 29903051 · DOI	Randomized controlled trial	29 Adults with treatment-resistant depression	ayahuasca (research-supplied) vs placebo n/a not extracted n/a · vs n/a	MADRS scores were lower with ayahuasca than placebo at day 1 and day 2 (p=0.04) and day 7 (p<0.0001). Effect sizes rose from 0.84 (days 1-2) to 1.49 (day 7). At day 7, 64% responded with ayahuasca vs 27% with placebo (p=0.04); remission 36% vs 7% only trended (p=0.054). Registered NCT02914769. Methods, limits and funding Outcomes: Depression scores (MADRS, Hamilton) at 1, 2 and 7 days after one session Limitations: Only 29 people and one week of follow-up. Psychedelic effects are hard to disguise, so people may have guessed which treatment they got (general limit of psychedelic trials, not stated in the abstract). It was one controlled research setting, not a retreat. Funding and conflicts: Not stated in the abstract. Registration: NCT02914769 Read: abstract
Pullen 2025 Fatalities following DMT use: two case reports and a review of the literature. J Anal Toxicol · PMID 40632616 · DOI	Case reports and literature review	2 Two UK deaths after DMT, plus review of earlier fatalities	DMT (mostly not ayahuasca) n/a not extracted n/a · vs n/a	Three earlier fatalities after DMT had been reported, all judged accidental, two in an ayahuasca ceremony. The two UK deaths were not in ayahuasca ceremonies and involved many other drugs, some of which raise serotonin. The authors suggest excess serotonin activity (serotonin syndrome) may have contributed. Methods, limits and funding Outcomes: Deaths involving DMT Limitations: Few cases; mostly polydrug use; not all about ayahuasca itself. Funding and conflicts: Not stated in the abstract. Read: abstract
Ribeiro 2026 Predicting drug-drug interactions between ayahuasca alkaloids and SSRIs using physiologically based pharmacokinetic modeling. Front Mol Biosci · PMID 41788629 · DOI	Pharmacokinetic computer model human (model)	6 Model built from plasma data of six volunteers given ayahuasca, plus published data on fluoxetine and paroxetine	ayahuasca alkaloids with SSRIs (simulated) n/a not extracted n/a · vs n/a	Fluoxetine and paroxetine raised harmine exposure and moderately raised DMT levels in the simulations, by blocking the liver enzyme CYP2D6 and strengthening MAO-A blockade. The authors conclude the interaction is likely clinically relevant. Methods, limits and funding Outcomes: Predicted blood levels of DMT and harmine when an SSRI is also taken Limitations: A computer simulation, not a test in people taking both. It predicts but does not prove. Funding and conflicts: Not stated in the abstract. Read: abstract
Rossi 2022 Ayahuasca, a potentially rapid acting antidepressant: focus on safety and tolerability. Expert Opin Drug Saf · PMID 35301934 · DOI	Review	Randomized placebo-controlled ayahuasca trials in healthy and clinical groups (108 administrations)	ayahuasca in trials n/a not extracted n/a · vs n/a	There were no reports of serious adverse events. The most common were nausea, vomiting, headaches and short-lived rises in cardiovascular measures. The authors note the absence of large, robust trials. Methods, limits and funding Outcomes: Adverse events Limitations: Small controlled trials in screened volunteers; says little about unscreened retreat settings. Funding and conflicts: Not stated in the abstract. Read: abstract
Rush 2024 Ayahuasca Treatment Outcome Project (ATOP): One-Year Results from Takiwasi Center and Implications for Psychedelic Science. J Stud Alcohol Drugs · PMID 37615330 · DOI	Uncontrolled observational study	52 Participants in an addiction treatment programme at the Takiwasi Centre, Peru	ayahuasca-assisted integrative programme n/a not extracted n/a · vs n/a	Group scores improved on alcohol and drug use severity, depression, anxiety and some quality-of-life measures at one year, with big differences between individuals. Methods, limits and funding Outcomes: Addiction severity, depression, anxiety, quality of life at 1 year Limitations: No comparison group; the programme includes many things besides ayahuasca; cannot attribute change to ayahuasca. Funding and conflicts: Not stated in the abstract. Read: abstract
Santos 2020 Biodiversity of β-Carboline Profile of Banisteriopsis caapi and Ayahuasca, a Plant and a Brew with Neuropharmacological Potential. Plants (Basel) · PMID 32660098 · DOI	Laboratory chemical analysis plant and brew samples	176 176 Malpighiaceae lianas (159 B. caapi) and 33 ayahuasca samples from Brazil	B. caapi and ayahuasca samples n/a not extracted n/a · vs n/a	Beta-carboline content in B. caapi varied enormously between samples (very high relative variability), and native samples had more harmine than cultivated ones. Other Malpighiaceae lianas mostly lacked beta-carbolines. Paired plant and brew samples showed harmine is partly converted to harmaline and tetrahydroharmine during preparation. Methods, limits and funding Outcomes: Beta-carboline content Limitations: Brazilian samples only. Funding and conflicts: Not stated in the abstract. Read: abstract
Schenberg 2022 Overcoming epistemic injustices in the biomedical study of ayahuasca: Towards ethical and sustainable regulation. Transcult Psychiatry · PMID 34986699 · DOI	Ethics and policy paper n/a	Indigenous rights and ayahuasca research	n/a n/a not extracted n/a · vs n/a	The authors argue that biomedical study of ayahuasca has committed epistemic injustices, and propose that new regulation respect the free, prior and informed consent of Indigenous peoples (ILO Convention 169) and benefit-sharing under the Convention on Biological Diversity. They discuss the Brazilian, Peruvian and Colombian cases. Methods, limits and funding Outcomes: Ethical analysis Limitations: An argument paper, not a trial. Funding and conflicts: Not stated in the abstract. Read: abstract
Sklerov 2005 A fatal intoxication following the ingestion of 5-methoxy-N,N-dimethyltryptamine in an ayahuasca preparation. J Anal Toxicol · PMID 16356341 · DOI	Case report	1 25-year-old man found dead	herbal extracts containing beta-carbolines, DMT and 5-MeO-DMT n/a not extracted n/a · vs n/a	No anatomical cause of death was found. Blood contained DMT, 5-MeO-DMT (at a much higher level), tetrahydroharmine, harmaline and harmine after he took herbal extracts with beta-carbolines and tryptamines. The cause was ruled hallucinogenic amine intoxication; manner of death undetermined. Methods, limits and funding Outcomes: Autopsy and toxicology Limitations: One case with an unusual extract, not the typical traditional brew. Funding and conflicts: Not stated in the abstract. Read: abstract
Stojanović 2026 Registered Clinical Trials of Ayahuasca and DMT: A Scoping Review. Clin Pharmacol Ther · PMID 42104189 · DOI	Scoping review n/a	26 registered trials of DMT, ayahuasca and DMT with harmine	n/a n/a not extracted n/a · vs n/a	Registered trials are mostly early-stage (phase I), mostly DMT alone, and use conservative eligibility with extensive cardiovascular and psychiatric exclusions. Primary outcomes mostly focus on acute safety, not on disease symptoms. Methods, limits and funding Outcomes: Trial designs Limitations: A map of trials, not results. Funding and conflicts: Not stated in the abstract. Read: abstract
US Government 2026 US eCFR, 21 CFR 1308.11 Schedule I (version dated 2026-10-20) · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	The Schedule I hallucinogenic substances list includes dimethyltryptamine (DEA code 7435), 5-methoxy-N,N-dimethyltryptamine and bufotenine. A text search of the section found no entry for ayahuasca, Banisteriopsis caapi, Psychotria viridis, harmine, harmaline or Diplopterys. Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: full section text, searched by keyword (read 2026-10-25)
US National Institute on Drug Abuse 2026 NIDA: Hallucinogens (psychedelic and dissociative drugs) · Source	Regulator or authoritative page n/a	n/a	n/a n/a not extracted n/a · vs n/a	Serotonin-raising medicines combined with psychedelics can cause serotonin toxicity (serotonin syndrome), usually mild but life-threatening in rare cases. An analysis of 34 clinical studies of LSD, psilocybin or ayahuasca (549 participants) found no evidence of longer-term adverse effects, but poor mental health outcomes may be more likely outside clinical use. DMT is described as a compound in Amazonian plants used to make ayahuasca. Methods, limits and funding Outcomes: n/a Funding and conflicts: n/a Read: page text, searched for ayahuasca and serotonin syndrome (read 2026-10-25)
White 2024 Ayahuasca and Dimethyltryptamine Adverse Events and Toxicity Analysis: A Systematic Thematic Review. Int J Toxicol · PMID 38363085 · DOI	Systematic review human and animal	78 articles on ayahuasca, DMT and harmala alkaloids (preclinical, clinical, survey, case reports)	ayahuasca, DMT, harmala alkaloids n/a not extracted n/a · vs n/a	Data suggested ayahuasca or DMT is generally safe in controlled settings and that serious effects are rarely reported in healthy people, but some adverse human events have been reported. Animal studies at higher doses showed abortifacient and teratogenic effects, and isolated harmala alkaloids showed possible toxicity at higher doses, which may increase with some medicines. Harmaline had the most problems in preclinical models. Methods, limits and funding Outcomes: Adverse events, safety and toxicity Limitations: Animal results may not carry over to people. Review authors note more randomized trials are needed. Funding and conflicts: Not stated in the abstract. Read: abstract
Wittayakarn 2025 Development of a physiologically based pharmacokinetic model of N,N-dimethyltryptamine, harmine, and their interactions from ayahuasca in rats and humans. Toxicol Sci · PMID 40839168 · DOI	Pharmacokinetic computer model rat and human (model)	Rat and human data used to build a model	DMT and harmine n/a not extracted n/a · vs n/a	Harmine blocks the MAO-A enzyme that would otherwise break DMT down, so more DMT reaches the body. The model predicted blood levels across routes and suggests harmine inhibition in liver and lungs matters. Methods, limits and funding Outcomes: Blood levels of DMT and harmine and their interaction Limitations: A model built from published data, not a clinical test. Funding and conflicts: Not stated in the abstract. Read: abstract
Wsół 2023 Cardiovascular safety of psychedelic medicine: current status and future directions. Pharmacol Rep · PMID 37874530 · DOI	Review human and animal	Cardiovascular safety review of psilocybin, LSD, DMT, ayahuasca, mescaline	classic psychedelics including ayahuasca n/a not extracted n/a · vs n/a	Psychedelics have sympathomimetic effects and raise concerns about serotonin-related heart toxicity. Trials in healthy volunteers point to relative cardiovascular safety, but evidence is insufficient for people with heart disease and for repeated low amounts. Methods, limits and funding Outcomes: Cardiovascular effects Limitations: A general review of several substances; ayahuasca-specific heart data are limited. Funding and conflicts: Not stated in the abstract. Read: abstract
da Motta 2018 Maternal and developmental toxicity of the hallucinogenic plant-based beverage ayahuasca in rats. Reprod Toxicol · PMID 29522798 · DOI	Animal study rat	Pregnant rats	ayahuasca n/a not extracted n/a · vs n/a	At 4 and 8 times the average human ritual amount, 44-52% of rats died and survivors showed kidney injury. Even at non-lethal amounts there were more embryo deaths and fetal anomalies. The authors suggest daily use in pregnancy might pose risks. Methods, limits and funding Outcomes: Maternal and fetal outcomes Limitations: Rat study at high amounts; cannot be read directly as human risk. Funding and conflicts: Not stated in the abstract. Read: abstract
dos Santos 2013 A critical evaluation of reports associating ayahuasca with life-threatening adverse reactions. J Psychoactive Drugs · PMID 23909005 · DOI	Critical review of case reports	Published reports linking ayahuasca or its alkaloids to severe intoxication	ayahuasca n/a not extracted n/a · vs n/a	Ayahuasca is generally well tolerated in traditional and ritual use, but some reports link it to severe intoxication. Some lack forensic and toxicology data, and others involve other preparations. Even so, the cases suggest that previous cardiac and liver disease and current use of serotonergic medicines are contraindications, and caution is needed with other botanical species and extracted or synthetic alkaloids. Methods, limits and funding Outcomes: Whether the cases support a risk assessment Limitations: A 2013 review by one author; case reports are incomplete. Funding and conflicts: Not stated in the abstract. Read: abstract

What we do not know yet

No large, long randomized trial of ayahuasca; the only placebo-controlled trial read had 29 people and one week of follow-up.
No reliable count of harms or deaths; reports are cases and a self-selected survey.
No data on pregnancy, breastfeeding, children or older adults, and no controlled interaction trial with antidepressants.
Retreat settings are studied only by surveys and observational follow-up, and product contents vary.
Law outside the INCB statement and the US federal Schedule I text was not checked.
Indigenous perspectives are described through sources read; a cultural review by Indigenous experts has not been done.

How new research is added

New studies are found by a saved PubMed search and are placed in a review queue. A person reads each one before it changes this page. Regulator statements are rechecked on a schedule.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Other 1

●

Default mode network connectivity (resting brain network)

Decrease within the network; increase between other networks (acute) in trials

A set of connected brain regions that are active at rest and linked to self-focused thinking, measured by brain imaging.

Low certainty

Results and what it means

Why it was measured

Researchers use it to describe how psychedelics change brain activity.

Statistical vs. clinical meaning

A brain scan finding. The review says it is unclear how central this network is to any therapeutic potential.

Safety implication

None for the reader. This is not a measure of safety or of benefit.

Study	Result	People	Product

¹⁶

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 6

Medicine interactions can be dangerous or life-threatening. Ayahuasca contains plant compounds that block an enzyme called monoamine oxidase (MAO), so serotonin-raising medicines can build up to dangerous levels. A 2026 case report describes a man who developed severe serotonin syndrome with respiratory failure after ayahuasca followed by over-the-counter dextromethorphan and diphenhydramine; he needed a breathing tube and intensive care and recovered. A computer-model study predicts that common SSRIs (fluoxetine, paroxetine) raise the body's exposure to ayahuasca's compounds. A critical review of reported severe cases concluded that current use of serotonergic medicines is a contraindication. Never stop or change a prescribed medicine on your own; talk with the prescriber. Case report ^{30 33 8 46 41}
Serious harms have been reported, including deaths and psychosis. Published reports describe death after a preparation that contained 5-MeO-DMT, two earlier deaths after DMT in ayahuasca ceremonies (accidental), a long psychotic episode with violence, severe muscle breakdown with kidney injury, and poisoning with several other drugs also found in the blood. These are case reports: they show that harm happens, not how often. Researchers who reviewed severe reports say some lacked toxicology data and others involved different preparations. Case report ^{38 32 4 23 14 46}
Common effects are vomiting and strong emotional reactions. In a self-selected online survey of 10,836 people, 69.9% reported acute physical effects, mainly vomiting, and 2.3% needed later medical attention. 55.9% reported adverse mental health effects in the following weeks or months; about 88% saw them as part of a positive process, and about 12% sought professional support. In placebo-controlled trials with screened volunteers (108 administrations) no serious adverse events were reported; common ones were nausea, vomiting, headache and short rises in blood pressure or heart rate. Cross sectional ^{6 34}
Retreats and ceremonies are not regulated like medicine. Outside research, the content of what is served is not tested by a regulator that we found, and the amount of active compounds varies a great deal between plant samples and brews. Physical adverse effects in the survey were linked to a non-supervised context. A person who runs a ceremony may not know your medicines or health history. See our guide to evaluating retreat claims. This is a safety statement, not a recommendation to attend or to avoid any particular practice. Cross sectional ^{6 36 3}
The brew can be confused with, or replaced by, other plants and extracts. The traditional brew is made from a vine (Banisteriopsis caapi) and a second plant that supplies DMT, usually Psychotria viridis (chacruna) or Diplopterys cabrerana. Products sold under the name ayahuasca may use other plants (called anahuasca), extracted or lab-made compounds (called pharmahuasca), or extracts with different tryptamines. A reviewer says caution is needed with other botanical species and extracted or synthetic alkaloids, and one death involved an extract with a large amount of 5-MeO-DMT. Names on labels do not guarantee identity. Narrative review ^{7 46 38 15}
If someone feels very unwell, call emergency services now. In the US call 911 if the person collapses, has a seizure, has trouble breathing or cannot be awakened, and Poison Help at 1-800-222-1222 for advice. In the UK call 999 in an emergency. For other countries see our poison help by country page. Tell staff exactly what was taken, including any medicines. Authoritative guidance ^{28 27}

Side effects 8

Effect	How often	Severity and recovery	Evidence
Vomiting and nausea Survey is self-selected.	69.9% reported acute physical effects, mainly vomiting (survey); common in trials	usually mild to moderate usually short-lived	Cross sectional ^{6 34}
Adverse mental health effects in the weeks or months afterwards A history of anxiety or depression was linked to more adverse mental states.	55.9% in the survey (about 88% of those saw them as part of a positive process; about 12% sought professional support)	mild to severe variable	Cross sectional ^{6 2 21}
Psychotic episodes Many cases had a personal or family history of psychosis, mania or other drug use, but some did not.	Not known; described as rare in ritual and recreational settings	severe some prolonged; one case lasted long enough to need hospital care and still treatment	Systematic review ^{11 4}
Serotonin syndrome (too much serotonin activity) Linked to combining with serotonin-raising medicines.	Not known	can be life-threatening recovered with intensive care in the case reported	Case report ^{30 8 41}
Severe muscle breakdown and kidney injury (rhabdomyolysis) Authors think dehydration and circumstances contributed.	One reported case	severe kidney function still impaired at discharge	Case report ²³
Delirium, confusion and stupor Several substances present.	One reported case with other drugs found in the blood	severe not stated	Case report ¹⁴
Death Cases involved an extract with 5-MeO-DMT, or DMT with many other drugs; two earlier DMT deaths were in ayahuasca ceremonies and judged accidental.	Rare; counts unknown	fatal none	Case report ^{38 32}
Headache and short rises in heart rate or blood pressure People with heart disease were not studied enough.	Common in trials	mild short-lived	Review ^{34 44}

Liver

No liver injury signal or case series for ayahuasca was found in the sources read. A critical review lists previous liver disease as a possible contraindication, and a systematic review notes isolated harmala alkaloids showed possible toxicity at higher amounts in animals. ^{46 42}

How often. Not found.

Monitoring. Not found. LiverTox was not read for ayahuasca.

This is a safety connection. It is not evidence that Ayahuasca supports liver health.

Medicines and supplements 5

With	Why it matters	Importance	Evidence	What to do
SSRI and other antidepressants (for example fluoxetine, paroxetine) serotonergic medicines	MAO-A blockade by harmine plus serotonin-raising medicine may cause serotonin syndrome; strong CYP2D6 inhibitors (fluoxetine, paroxetine) were predicted in a computer model to raise exposure to DMT and harmine.	Potentially severe. A 1998 paper warned of a grave outcome; a 2026 model suggests a clinically relevant interaction.	Pharmacological theory Low certainty ^{8 33 46}	Do not combine without prescriber advice; never stop an antidepressant on your own.
Dextromethorphan (cough medicine) and diphenhydramine over-the-counter medicines	Serotonin toxicity with MAO inhibitors.	A case report of severe syndrome with respiratory failure needing intubation.	Case report Low certainty ³⁰	Check every product, including over-the-counter cold and cough medicines, with a pharmacist or doctor first.
Other serotonin-raising drugs and stimulants (for example some antidepressants, amphetamine, cocaine) polydrug use	Added serotonergic and sympathetic stimulation.	Two DMT deaths in the UK involved venlafaxine, mirtazapine, cocaine or amphetamine among other drugs, and a poisoning case had cannabis, amphetamine and cocaine-related compounds in the blood. Cause is uncertain because many substances were present.	Case series Very low certainty ^{32 14}	Do not combine with other drugs.
Classic psychedelics and other drugs generally systematic evidence	Varied	A systematic review found only one human study of ayahuasca among 52 studies of classic psychedelics with other drugs; effects ranged from weaker to stronger to unchanged.	Systematic review Low certainty ¹⁹	Ayahuasca-specific interaction data are very limited, so absence of reports is not evidence of safety.
MAO-inhibiting foods, supplements and other MAOI drugs MAOI class	Harmine is a reversible MAO-A inhibitor.	Not checked in a source for this page. See our guide to MAO-inhibiting preparations and interactions.	Pharmacological theory Not enough evidence ⁷	Ask a pharmacist; not verified here.

Who should check first 6

Situation	Advice	Evidence
Taking antidepressants or other serotonin-raising medicines	A critical review of reported severe cases concluded current use of serotonergic medicines is a contraindication. Talk with the prescriber; do not change medicines on your own.	Narrative review ^{46 8 33}
Psychosis, bipolar disorder or a family history of them	Reported psychotic episodes often involved a personal or family history, and trials screen for psychiatric history. See psychosis vulnerability and mania guides.	Systematic review ^{11 39 4}
Heart or liver disease	The critical review lists previous cardiac and hepatic pathologies as contraindications; trials exclude people with heart conditions and a cardiovascular review says evidence is insufficient for people with heart disease.	Narrative review ^{46 44 39}
Pregnancy and breastfeeding	No human pregnancy studies of ayahuasca were found; the authors of a scoping review say absence of data is not evidence of safety. Rats given high amounts had embryo deaths and fetal anomalies, and animal studies in a systematic review showed abortifacient and teratogenic effects. Breastfeeding: no source read.	Animal research ^{1 45 42}
Dehydration, long travel or kidney problems	One reported case of severe muscle breakdown and kidney injury followed ayahuasca and prolonged travel; the authors think dehydration contributed.	Case report ²³
Driving, working with machinery, childcare	Not covered by a source we read. Strong mind-altering effects make these unsafe.	Gap

Overdose, product quality and regulators

Summary. Toxicity is mainly described through case reports: serotonin syndrome, psychosis, rhabdomyolysis with kidney injury, delirium with other drugs, and rare deaths. Controlled trials in screened volunteers reported no serious adverse events.

Amounts. Not covered; no amounts are given on this page.

Onset and course. Not established in the sources read, except that the serotonin syndrome case improved over days with intensive care.

Repeated use. Long-term data come from observational studies; a systematic review reported subsets of people with persisting psychiatric complications. Animal studies at high amounts showed organ injury.

Animal data. Pregnant rats given much more than a human ritual amount died in large numbers and survivors had kidney injury; a systematic review reports abortifacient and teratogenic effects in animal models.

Toxic parts. Not applicable; this is a mix of plants. The brew's compounds are DMT and the beta-carbolines harmine, harmaline and tetrahydroharmine.

Not read. Poison-centre case counts for ayahuasca; coroner series; LiverTox; any regulator toxicology summary; Brazilian health agency documents.

No regulator source on contents of ayahuasca sold or served outside research was found. Two lab studies show that content varies and that one pair of samples had no adulterants.

Variation in strength. A study of 176 Brazilian lianas and 33 brew samples found very large variation in beta-carboline content, so two servings of the same-named brew can differ a lot. ³⁶

Two Uruguayan samples. Chemical analysis of samples from a neo-shamanic and a Santo Daime group found a typical alkaloid composition and no adulterants. This covers only those two samples. ³

Other drugs in users. In a poisoning case, blood contained cannabis, amphetamine and cocaine-related compounds as well as ayahuasca compounds, so the cause could not be assigned to ayahuasca alone. ¹⁴

Unusual extracts. One fatal case involved herbal extracts containing a high level of 5-MeO-DMT. ³⁸

Body	Action	Date
International Narcotics Control Board (INCB) (International)	In its 2010 report the INCB states that no plants are controlled under the 1971 or 1988 UN conventions, even where some active ingredients are, and that preparations such as decoctions made from them are also not under international control; it names ayahuasca (mainly Banisteriopsis caapi and Psychotria viridis) as an example. It also notes Brazil's CONAD adopted a resolution on religious use of ayahuasca in January 2010. This is the INCB's statement; each country sets its own laws. source	2010
US Drug Enforcement Administration (via Code of Federal Regulations) (United States)	21 CFR 1308.11 (Schedule I) lists dimethyltryptamine (DMT, code 7435), 5-methoxy-N,N-dimethyltryptamine and bufotenine. A keyword search of the section found no entry for ayahuasca, Banisteriopsis caapi, Psychotria viridis, harmine or harmaline. How other US law treats the brew or religious use was not verified here. source	2026-10-20 (version read)

When to get medical help

If someone has collapsed, has a seizure, has trouble breathing or cannot be awakened, call emergency services now. US: 911. UK: 999.
For poison advice in the US call Poison Help at 1-800-222-1222 (free and confidential). For other countries see our poison help by country page.
Warning signs after ayahuasca or after mixing it with medicines include severe agitation or confusion, trouble breathing, very deep drowsiness or stupor, severe muscle pain with dark urine, and psychotic symptoms that do not settle (from the case reports).
Tell emergency staff what was taken and every medicine, including over-the-counter products. Do not wait to see if symptoms pass.

If someone may be poisoned or in a crisis, contact a clinician or emergency service straight away. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

Is ayahuasca dangerous with antidepressants?

Yes, it can be. Ayahuasca contains compounds that block the enzyme MAO, so serotonin-raising medicines can build up to dangerous levels. A 1998 paper warned of serotonin syndrome with SSRIs, and a 2026 model predicts that fluoxetine and paroxetine raise exposure to ayahuasca's compounds. Never stop or change a prescribed medicine on your own; talk with the prescriber.

^{8 33 46}

Can it be dangerous with cough or cold medicines?

Yes. A 2026 case report describes severe serotonin syndrome with respiratory failure after ayahuasca followed by dextromethorphan and diphenhydramine. The man needed a breathing tube and intensive care and recovered. Check every product, even over-the-counter ones, with a pharmacist or doctor.

³⁰

What are the most common side effects?

Vomiting is the most common. In a large online survey, 69.9% reported acute physical effects, mainly vomiting, and 2.3% needed later medical attention. In screened trials, nausea, vomiting, headache and short rises in blood pressure or heart rate were common.

^{6 34}

Can ayahuasca cause psychosis?

It has been reported. A systematic review found rare psychotic episodes after ayahuasca, often in people with a personal or family history of psychosis or mania, but some without. A 2024 case describes a long psychotic episode with violence in a man with no known risk factors. People with these conditions are excluded from trials.

^{11 4 39}

Can people die from ayahuasca?

Rarely, but deaths are reported. One death followed an extract that contained a large amount of 5-MeO-DMT. A review of DMT deaths found three earlier cases, two in ayahuasca ceremonies and judged accidental. Many reported cases involved other drugs, so the cause is often uncertain, and no count of how often it happens was found.

^{38 32 46}

Is ayahuasca the same as DMT?

No. DMT is one compound in the brew. Swallowed alone, DMT is nearly inactive because the body breaks it down quickly. The beta-carbolines in ayahuasca block that breakdown, and they are also the reason for the medicine-interaction risk. Our DMT page covers the compound itself.

^{13 7 43}

Does ayahuasca treat depression?

It has not been shown to. One small randomized trial of 29 adults with treatment-resistant depression found lower depression scores than placebo up to seven days after one dose, and a six-person open trial pointed the same way. Follow-up was very short and no large trial was found. Ayahuasca is not an approved medicine for any condition in the sources we read.

^{31 29 10}

Are retreats safe, and are they regulated?

We did not find a regulator that tests or licenses retreats. Physical adverse effects in the survey were linked to non-supervised settings, and content varies a great deal between plant samples and brews. A retreat leader may not know your medicines or health history. See our guide to evaluating retreat claims. This is not advice to attend or to avoid.

^{6 36 3}

Who should not take ayahuasca?

A critical review of severe cases lists current use of serotonin-raising medicines and previous heart or liver disease as contraindications. Trials exclude people with psychosis, bipolar disorder and heart conditions. No pregnancy data for people were found, and the authors of a scoping review say that is not evidence of safety. Talk with a doctor first.

^{46 39 1 44}

Whose tradition is ayahuasca?

It belongs to the traditions of Amazonian Indigenous peoples. Sources read for this page name the Shipibo people of Peru, and describe use in Brazil, Peru, Colombia and Ecuador. Santo Daime and the UDV are Brazilian religions that also use it. Indigenous scholars raise concerns about appropriation, patents and consent, and have published ethical principles for outsiders.

^{12 18 5 9 37}

Is ayahuasca legal?

It depends on the country and on the activity, and laws change. The INCB says plants and preparations such as this brew are not under international control. In the US, the federal Schedule I list names DMT but our search of the text did not find ayahuasca or the plants named. We did not verify other countries. This is not legal advice.

^{22 40 24}

What should I do if someone feels very unwell?

Call emergency services now if the person collapses, has a seizure, has trouble breathing or cannot be awakened (US 911, UK 999). In the US, Poison Help is 1-800-222-1222. Tell staff what was taken and every medicine. For other countries see our poison help by country page.

^{28 27}

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Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records and regulator pages.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-25
Last substantive update: 2026-10-25
How we research: We searched PubMed and read the abstracts of 38 papers, read the INCB 2010 report paragraphs, the US eCFR Schedule I text, NIDA, Poison Control and NHS pages, and checked plant names in GBIF and chemical identifiers in PubChem. Where a statement came second-hand it is marked as unverified in our notes.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown, and none will be added for ayahuasca. This page gives no dose, preparation, ceremony, growing or sourcing advice.

Sources 46

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

Albert OM, Arthur A. Psychedelic exposure in pregnancy: a scoping review to inform perinatal drug safety and clinical counseling.. Ther Adv Drug Saf. 2026. PMID 41930230. DOI 10.1177/20420986261436104. (abstract)
Andión Ó, Bouso JC, Sarris JJ, Tófoli LF, Opaleye ES, Perkins D. A new insight into ayahuasca's adverse effects: Reanalysis and perspectives on its mediating role in mental health from the Global Ayahuasca Survey (GAS).. PLOS Ment Health. 2025. PMID 41661937. DOI 10.1371/journal.pmen.0000097. (abstract)
Apud I, Scuro J, Rodríguez L, Hernandez G, Carrera I, Lozano F et al. Ayahuasca, Personality and Acute Psychological Effects in Neo-Shamanic and Religious Settings in Uruguay.. J Psychoactive Drugs. 2023. PMID 37750012. DOI 10.1080/02791072.2023.2261017. (abstract)
Baker MR, O'Shea CI. Drug-induced psychosis following use of Ayahuasca: a presentation to forensic psychiatric services.. BMJ Case Rep. 2024. PMID 39142841. DOI 10.1136/bcr-2024-260648. (abstract)
Blainey MG. Forbidden therapies: Santo Daime, ayahuasca, and the prohibition of entheogens in Western society.. J Relig Health. 2015. PMID 24477460. DOI 10.1007/s10943-014-9826-2. (abstract)
Bouso JC, Andión Ó, Sarris JJ, Scheidegger M, Tófoli LF, Opaleye ES et al. Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey.. PLOS Glob Public Health. 2022. PMID 36962494. DOI 10.1371/journal.pgph.0000438. (abstract)
Brierley DI, Davidson C. Developments in harmine pharmacology--implications for ayahuasca use and drug-dependence treatment.. Prog Neuropsychopharmacol Biol Psychiatry. 2012. PMID 22691716. DOI 10.1016/j.pnpbp.2012.06.001. (abstract)
Callaway JC, Grob CS. Ayahuasca preparations and serotonin reuptake inhibitors: a potential combination for severe adverse interactions.. J Psychoactive Drugs. 1998. PMID 9924842. DOI 10.1080/02791072.1998.10399712. (abstract)
Celidwen Y, Redvers N, Githaiga C, Calambás J, Añaños K, Chindoy ME et al. Ethical principles of traditional Indigenous medicine to guide western psychedelic research and practice.. Lancet Reg Health Am. 2023. PMID 36844020. DOI 10.1016/j.lana.2022.100410. (abstract)
Civardi SC, Besana F, Durbano F, Toscano MOM, Raffone F, Dell'Osso BM et al. Psilocybin and ayahuasca in treatment-resistant depression: clinical evidence, methodological constraints and ethical challenges: a narrative review.. Front Psychiatry. 2026. PMID 42812990. DOI 10.3389/fpsyt.2026.1858319. (abstract)
Dos Santos RG, Bouso JC, Hallak JEC. Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies.. Ther Adv Psychopharmacol. 2017. PMID 28540034. DOI 10.1177/2045125316689030. (abstract)
Dos Santos RG, Hallak JEC. Ayahuasca: pharmacology, safety, and therapeutic effects.. CNS Spectr. 2024. PMID 39564645. DOI 10.1017/S109285292400213X. (abstract)
Egger K, Aicher HD, Cumming P, Scheidegger M. Neurobiological research on N,N-dimethyltryptamine (DMT) and its potentiation by monoamine oxidase (MAO) inhibition: from ayahuasca to synthetic combinations of DMT and MAO inhibitors.. Cell Mol Life Sci. 2024. PMID 39254764. DOI 10.1007/s00018-024-05353-6. (abstract)
Estrella-Parra EA, Avila-Acevedo JG, García-Bores AM, Rivera-Cabrera JC, Alarcón-Villaseñor EF, Alejandre-García I et al. Intoxication Associated with Ayahuasca Consumption, Characterization, and Comparative Analysis of the Beverage's Components: A Case Report.. Rev Colomb Psiquiatr (Engl Ed). 2025. PMID 41213743. DOI 10.1016/j.rcpeng.2025.10.009. (abstract)
GBIF. GBIF Backbone Taxonomy species match: Banisteriopsis caapi, Psychotria viridis, Diplopterys cabrerana. . 2026. (GBIF API species match (read 2026-10-25))
Gattuso JJ, Perkins D, Ruffell S, Lawrence AJ, Hoyer D, Jacobson LH et al. Default Mode Network Modulation by Psychedelics: A Systematic Review.. Int J Neuropsychopharmacol. 2023. PMID 36272145. DOI 10.1093/ijnp/pyac074. (abstract)
Gearin AK. Healing with Ayahuasca the Plant Teacher: Psychedelic Metaphoricity and Polyontologies.. Med Anthropol. 2024. PMID 39374048. DOI 10.1080/01459740.2024.2410969. (abstract)
Gonzalez D, Cantillo J, Perez I, Carvalho M, Aronovich A, Farre M et al. The Shipibo Ceremonial Use of Ayahuasca to Promote Well-Being: An Observational Study.. Front Pharmacol. 2021. PMID 34025402. DOI 10.3389/fphar.2021.623923. (abstract)
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Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.