Therapeutic efficacy of ayahuasca in patients with mental disorders based on clinical studies: an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i4.27182

Keywords:

Ayahuasca; Clinical studies; Psychic disorders; Therapy.

Abstract

Objective: To investigate therapeutic evidence of Ayahuasca, which is a psychoactive drink obtained from the decoction of two plants of Amazonian origin: Banisteriospsis caapi (Miri vine) and Psychotria viridis (Chacrona), proven in controlled clinical studies in patients with psychiatric disorders. Methodology: This is an integrative literature review focused on clinical trials available in the electronic databases MEDLINE (Pubmed-AdvancedSearch), Trip data base and Lilacs using the descriptors “Ayahuasca, treatment”; “Ayahuasca, clinical study”; “Ayahuasca, psychiatric treatment”. Results: Eight articles published between 2015 and 2021 were selected. Six studies evaluated the use of Ayahuasca in the treatment of recurrent depressive disorder, and two investigated the relationship between Ayahuasca and reduced risk of suicide in patients with recurrent depression. The drink showed rapid and sustained antidepressant effects, improving symptoms of depression, linked or not to suicidal thoughts. Final Considerations: Considering the side effects and the time required for symptom remission of current treatments, it is necessary to consider the potential of alternative and innovative treatments for patients who do not adapt to conventional methods. The results demonstrated in this research need to be replicated in larger studies, and with longer-term follow-up, to assess the long-term efficacy and safety of the substance.

Author Biographies

Alexandre Machado de Moura, Faculdade Santíssima Trindade

Farmacêutico pela Faculdade Santíssima Trindade (FAST), Nazaré da Mata – PE.

Marcela Barboza de Melo Aragão, Faculdade Santíssima Trindade

Farmacêutica pela Faculdade Santíssima Trindade (FAST), Nazaré da Mata – PE.

Dario César de Oliveira Conceição, Faculdade Santíssima Trindade

Graduado e Mestre em Química pela Universidade Federal Rural de Pernambuco (UFRPE), Doutorando em Ciências de Materiais pela Universidade Federal de Pernambuco (UFPE). Atualmente é Professor Formador na Gerência Regional de Educação (GRE Mata Norte) e Professor dos cursos de Farmácia e Enfermagem da Faculdade Santíssima Trindade (FAST - Nazaré da Mata – PE).

Karoline Belém Seixas, Faculdade Santíssima Trindade

Graduada em Ciências Farmacêuticas pela Universidade Federal de Pernambuco (UFPE), com graduação na modalidade sanduíche realizada na Massachusets College of Pharmacy and Heathy Science (MCPHS- Boston/EUA) como bolsista financiada pela CAPES através do programa Ciências Sem Fronteiras. Possui mestrado em ciências farmacêuticas pela UFPE e atualmente é estudante de doutorado em Ciências Farmacêuticas pela Universidade Federal de Pernambuco (PPGCF/UFPE) na área de produção e controle de medicamentos. Atua como professora no ensino superior no curso de Farmácia e como servidora na Secretária de Saúde do Estado de Pernambuco como farmacêutica na assistente em saúde. 

References

Adell, A., Biggs, T. A., & Myers, R. D. (1996). Action of harman (1-methyl-beta-carboline) on the brain: body temperature and in vivo efflux of 5-HT from hippocampus of the rat. Neuropharmacology, 35(8), 1101–1107. https://doi.org/10.1016/s0028-3908(96)00043-3

Almeida, R. N., Galvão, A., da Silva, F. S., Silva, E., Palhano-Fontes, F., Maia-de-Oliveira, J. P., de Araújo, L. B., Lobão-Soares, B., & Galvão-Coelho, N. L. (2019). Modulation of Serum Brain-Derived Neurotrophic Factor by a Single Dose of Ayahuasca: Observation From a Randomized Controlled Trial. Frontiers in psychology, 10, 1234. https://doi.org/10.3389/fpsyg.2019.01234

Andreatini, R. (2000). Uso de fitoterápicos em psiquiatria. Revista Brasileira de Psiquiatria, 22(3), 104–105.

Balon, R. (2002) Managingcompliance. Psychiatric Times, 19 (5), 1-2.

Brasil. Ministério da Saúde (MS) (2006). Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Política nacional de práticas integrativas e complementares no SUS. Brasília,. 92.

Bouso, J. C., González, D., Fondevila, S., Cutchet, M., Fernández, X., Ribeiro Barbosa, P. C., Alcázar-Córcoles, M. Á., Araújo, W. S., Barbanoj, M. J., Fábregas, J. M., & Riba, J. (2012). Personality, psychopathology, life attitudes and neuropsychological performance among ritual users of Ayahuasca: a longitudinal study. PloS one, 7(8), e42421. https://doi.org/10.1371/journal.pone.0042421

Callaway, J. C. (2005). Various alkaloid profiles in decoctions of Banisteriopsis caapi. Journal of psychoactive drugs, 37(2), 151–155. https://doi.org/10.1080/02791072.2005.10399796

Carlini, E. A. (2003). Plants and the central nervous system. Pharmacology, biochemistry, and behavior, 75(3), 501–512. https://doi.org/10.1016/s0091-3057(03)00112-6

Coutinho, T. (2013). Curando através de imagens. Ponto Urbe, (13). https://doi.org/10.4000/pontourbe.652

Del-Ben, C. M., Sponholz-Junior, A., Mantovani, C., Faleiros, M. C. D. M., Oliveira, G. E. C. d., Guapo, V. G., & Marques, J. M. D. A. (2017). Psychiatric emergencies: psychomotor agitation management and suicide risk assessment. Medicina (Ribeirao Preto. Online), 50(supl1.), 98. https://doi.org/10.11606/issn.2176-7262.v50isupl1.p98-112

Dubovsky, S. L. (2018). What Is New about New Antidepressants? Psychotherapy and Psychosomatics, 87(3), 129–139. https://doi.org/10.1159/000488945

Fleck, M. P., Berlim, M. T., Lafer, B., Sougey, E. B., Porto, J. A. D., Brasil, M. A., Juruena, M. F., & Hetem, L. A. (2009). Revisão das diretrizes da Associação Médica Brasileira para o tratamento da depressão (Versão integral). Revista Brasileira de Psiquiatria, 31(suppl 1), S7—S17. https://doi.org/10.1590/s1516-44462009000500003

Fortunato, J. J., Réus, G. Z., Kirsch, T. R., Stringari, R. B., Fries, G. R., Kapczinski, F., Hallak, J. E., Zuardi, A. W., Crippa, J. A., & Quevedo, J. (2010). Effects of β-carboline harmine on behavioral and physiological parameters observed in the chronic mild stress model: Further evidence of antidepressant properties. Brain Research Bulletin, 81(4-5), 491–496. https://doi.org/10.1016/j.brainresbull.2009.09.008

Frecska, E., Bokor, P., & Winkelman, M. (2016). The Therapeutic Potentials of Ayahuasca: Possible Effects against Various Diseases of Civilization. Frontiers in Pharmacology, 7. https://doi.org/10.3389/fphar.2016.00035

Galvão, A. C. d. M., de Almeida, R. N., Silva, E. A. d. S., Freire, F. A. M., Palhano-Fontes, F., Onias, H., Arcoverde, E., Maia-de-Oliveira, J. P., de Araújo, D. B., Lobão-Soares, B., & Galvão-Coelho, N. L. (2018). Cortisol Modulation by Ayahuasca in Patients With Treatment Resistant Depression and Healthy Controls. Frontiers in Psychiatry, 9. https://doi.org/10.3389/fpsyt.2018.00185

Galvão-Coelho, N. L., de Menezes Galvão, A. C., de Almeida, R. N., Palhano-Fontes, F., Campos Braga, I., Lobão Soares, B., Maia-de-Oliveira, J. P., Perkins, D., Sarris, J., & de Araujo, D. B. (2020). Changes in inflammatory biomarkers are related to the antidepressant effects of Ayahuasca. Journal of Psychopharmacology, 34(10), 1125–1133. https://doi.org/10.1177/0269881120936486

Gartlehner, G., Hansen, R. A., Morgan, L. C., Thaler, K., Lux, L., Van Noord, M., Mager, U., Thieda, P., Gaynes, B. N., Wilkins, T., Strobelberger, M., Lloyd, S., Reichenpfader, U., & Lohr, K. N. (2011). Comparative benefits and harms of second-generation antidepressants for treating major depressive disorder: an updated meta-analysis. Annals of internal medicine, 155(11), 772–785. https://doi.org/10.7326/0003-4819-155-11-201112060-00009

Glennon, R. A., Dukat, M., Grella, B., Hong, S.-S., Costantino, L., Teitler, M., Smith, C., Egan, C., Davis, K., & Mattson, M. V. (2000). Binding of β-carbolines and related agents at serotonin (5-HT2 and 5-HT1A), dopamine (D2) and benzodiazepine receptors. Drug and Alcohol Dependence, 60(2), 121–132. https://doi.org/10.1016/s0376-8716(99)00148-9

Hoge, C. W., Lesikar, S. E., Guevara, R., Lange, J., Brundage, J. F., Engel, C. C., Jr, Messer, S. C., & Orman, D. T. (2002). Mental disorders among U.S. military personnel in the 1990s: association with high levels of health care utilization and early military attrition. The American journal of psychiatry, 159(9), 1576–1583. https://doi.org/10.1176/appi.ajp.159.9.1576

Ioannides-Demos, L. L., Piccenna, L., & McNeil, J. J. (2011). Pharmacotherapies for Obesity: Past, Current, and Future Therapies. Journal of Obesity, 2011, 1–18. https://doi.org/10.1155/2011/179674

Karasu, T. B. et. al. (2000). Practice Guidline for the Treatment of Patients With Major Depressive Disorder. 2. ed.: American Psychiatric Association

Labate, B., & Jungaberle, H. (orgs). (2011). The internationalization of Ayahuasca. Zurique: Lit Verlag. 446 p.

Labate, B., Dos Santos, R., Anderson, B., Mercante, M. & Barbosa, P. C. R. (2009). Considerações sobre o tratamento da dependência por meio da ayahuasca. Núcleo de Estudos Interdisciplinares sobre Psicoativos – NEIP.

Linden, M., Gothe, H., Dittmann, R. W., & Schaaf, B. (2000). Early Termination of Antidepressant Drug Treatment. Journal of Clinical Psychopharmacology, 20(5), 523–530. https://doi.org/10.1097/00004714-200010000-00005

Machado-Vieira, R., Baumann, J., Wheeler-Castillo, C., Latov, D., Henter, I. D., Salvadore, G., & Zarate, C. A. (2010). The Timing of Antidepressant Effects: A Comparison of Diverse Pharmacological and Somatic Treatments. Pharmaceuticals (Basel, Switzerland), 3(1), 19–41. https://doi.org/10.3390/ph3010019

McKenna, D. J. (2004). Clinical investigations of the therapeutic potential of ayahuasca: rationale and regulatory challenges. Pharmacology & therapeutics, 102(2), 111–129. https://doi.org/10.1016/j.pharmthera.2004.03.002

Mckenna, D.J., Callaway, J. C., & Grob, C. S. (1998). The scientific investigation of ayahuasca: a review of past and current research. The Heffter Review of Psychodelic Research, 1, 65-76.

Mendes, K.D.S., Silveira, R.C.C.P, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 2008 out-dez; 17(4):758-64.

Newall, C.A et. al (2002). Plantas Medicinas: Guia para profissional de saúde. [S.L.]: Premier. 308 p.

Newall, C. A., Phillipson, J. D. & Anderson, L. A. (2002). Plantas medicinais: guia para pro¿ ssional de Saúde. São Paulo: Premier,. 308 p

Newman, D. J., & Cragg, G. M. (2016). Natural Products as Sources of New Drugs from 1981 to 2014. Journal of natural products, 79(3), 629–661. https://doi.org/10.1021/acs.jnatprod.5b01055

Osório, F., Sanches, R. F., Macedo, L. R., Santos, R. G., Maia-de-Oliveira, J. P., Wichert-Ana, L., Araujo, D. B., Riba, J., Crippa, J. A., & Hallak, J. E. (2015). Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 37(1), 13–20. https://doi.org/10.1590/1516-4446-2014-1496

Palhano-Fontes, F. et al. (2019). Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychological medicine, 49(4), 655–663. https://doi.org/10.1017/S0033291718001356

Patten, S. B., Williams, J. V., Lavorato, D. H., Modgill, G., Jetté, N., & Eliasziw, M. (2008). Major depression as a risk factor for chronic disease incidence: longitudinal analyses in a general population cohort. General hospital psychiatry, 30(5), 407–413. https://doi.org/10.1016/j.genhosppsych.2008.05.001

Petrovick, P.R.; González, O. G.; & Bassani, V.L. (1997). From a medicinal plant to a pharmaceutical dosage form. A (still) long way for the Brazilian medicinal plants. Ciencia e Cultura. Journal of the Brazilian Association for the Advancement of Science. 49 (5/6), 364-369.

Pilkington, K. (2018). Current research on complementary and alternative medicine (CAM) in the treatment of depression: evidence-based review. In Y-K. Kim (Ed.), Understanding Depression: Volume 2. Clinical Manifestations, Diagnosis and Treatment (Vol. 2, pp. 311-322). Springer Singapore. https://doi.org/10.1007/978-981-10-6577-4_23

Riba, J., Valle, M., Urbano, G., Yritia, M., Morte, A., & Barbanoj, M. J. (2003). Human pharmacology of ayahuasca: subjective and cardiovascular effects, monoamine metabolite excretion, and pharmacokinetics. The Journal of pharmacology and experimental therapeutics, 306(1), 73–83. https://doi.org/10.1124/jpet.103.049882.

Riba, J., Rodríguez-Fornells, A., Urbano, G., Morte, A., Antonijoan, R., Montero, M., Callaway, J. C., & Barbanoj, M. J. (2001). Subjective effects and tolerability of the South American psychoactive beverage Ayahuasca in healthy volunteers. Psychopharmacology, 154(1), 85–95. https://doi.org/10.1007/s002130000606.

Richardson, W. N., & Henderson, L. (2007). The safety of kava: a regulatory perspective. British journal of clinical pharmacology, 64(4), 418–420. https://doi.org/10.1111/j.1365-2125.2007.02933.x

Sadock, B. J. (2007) Compêndio de psiquiatria: ciência do comportamento e psiquiatria clínica. 9. ed. Porto Alegre: Artmed.

Sanches, R. F., de Lima Osório, F., Dos Santos, R. G., Macedo, L. R., Maia-de-Oliveira, J. P., Wichert-Ana, L., de Araujo, D. B., Riba, J., Crippa, J. A., & Hallak, J. E. (2016). Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression: A SPECT Study. Journal of clinical psychopharmacology, 36(1), 77–81. https://doi.org/10.1097/JCP.0000000000000436

Santos, R. G., Osório, F. L., Crippa, J. A., & Hallak, J. E. (2016). Antidepressive and anxiolytic effects of ayahuasca: a systematic literature review of animal and human studies. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999), 38(1), 65–72. https://doi.org/10.1590/1516-4446-2015-1701

Santos R. G. (2013). Safety and side effects of ayahuasca in humans--an overview focusing on developmental toxicology. Journal of psychoactive drugs, 45(1), 68–78. https://doi.org/10.1080/02791072.2013.763564

Dos Santos, R. G., Valle, M., Bouso, J. C., Nomdedéu, J. F., Rodríguez-Espinosa, J., McIlhenny, E. H., Barker, S. A., Barbanoj, M. J., & Riba, J. (2011). Autonomic, neuroendocrine, and immunological effects of ayahuasca: a comparative study with d-amphetamine. Journal of clinical psychopharmacology, 31(6), 717–726. https://doi.org/10.1097/JCP.0b013e31823607f6

Dos Santos, R. G., Grasa, E., Valle, M., Ballester, M. R., Bouso, J. C., Nomdedéu, J. F., Homs, R., Barbanoj, M. J., & Riba, J. (2012). Pharmacology of ayahuasca administered in two repeated doses. Psychopharmacology, 219(4), 1039–1053. https://doi.org/10.1007/s00213-011-2434-x

Santos, R. G., Landeira-Fernandez, J., Strassman, R. J., Motta, V., & Cruz, A. P. (2007). Effects of ayahuasca on psychometric measures of anxiety, panic-like and hopelessness in Santo Daime members. Journal of ethnopharmacology, 112(3), 507–513. https://doi.org/10.1016/j.jep.2007.04.012

Skodol, A. E., Grilo, C. M., Keyes, K. M., Geier, T., Grant, B. F., & Hasin, D. S. (2011). Relationship of personality disorders to the course of major depressive disorder in a nationally representative sample. The American journal of psychiatry, 168(3), 257–264. https://doi.org/10.1176/appi.ajp.2010.10050695

Thomas, G., Lucas, P., Capler, N. R., Tupper, K. W., & Martin, G. (2013). Ayahuasca-assisted therapy for addiction: results from a preliminary observational study in Canada. Current drug abuse reviews, 6(1), 30–42. https://doi.org/10.2174/1573399811309999000

Tupper K. W. (2008). The globalization of ayahuasca: harm reduction or benefit maximization?. The International journal on drug policy, 19(4), 297–303. https://doi.org/10.1016/j.drugpo.2006.11.001

Uthaug, M. V., van Oorsouw, K., Kuypers, K., van Boxtel, M., Broers, N. J., Mason, N. L., Toennes, S. W., Riba, J., & Ramaekers, J. G. (2018). Sub-acute and long-term effects of ayahuasca on affect and cognitive thinking style and their association with ego dissolution. Psychopharmacology, 235(10), 2979–2989. https://doi.org/10.1007/s00213-018-4988-3

VAN GOOL, C. H. et al. (2003). Relationship between changes in depressive symptoms and unhealthy lifestyles in late middle aged and older persons: results from the longitudinal aging study amsterdam. Age And Ageing. 32 (1), 81-87.

Vollenweider, F. X., & Kometer, M. (2010). The neurobiology of psychedelic drugs: implications for the treatment of mood disorders. Nature reviews. Neuroscience, 11(9), 642–651. https://doi.org/10.1038/nrn2884.

WAISELFISZ, Julio Jacobo et al. (2011). Mapa da Violência 2011: os jovens do brasil. São Paulo/Brasília: Instituto Sangari/Ministério da Justiça. 163 p. Mapa da violência 2011 : os jovens no Brasil /Julio Jacobo Waiselfisz. -- São Paulo : Instituto Sangari ; Brasília, DF : Ministério da Justiça.

Witkin, J. M., Knutson, D. E., Rodriguez, G. J., & Shi, S. (2018). Rapid-Acting Antidepressants. Current pharmaceutical design, 24(22), 2556–2563. https://doi.org/10.2174/1381612824666180730104707

World Health Organization. Preventing Suicide:A Global Imperative. Geneva, 2014. 89 p.

World Health Organization. Suicide worldwide in 2019: global health estimates. Geneva, 2021. 35p.

Zajecka J. M. (2000). Clinical issues in long-term treatment with antidepressants. The Journal of clinical psychiatry, 61 Suppl 2, 20–25.

Zeifman, R. J., Singhal, N., Dos Santos, R. G., Sanches, R. F., de Lima Osório, F., Hallak, J., & Weissman, C. R. (2021). Rapid and sustained decreases in suicidality following a single dose of ayahuasca among individuals with recurrent major depressive disorder: results from an open-label trial. Psychopharmacology, 238(2), 453–459. https://doi.org/10.1007/s00213-020-05692-9

Zeifman, R. J., Palhano-Fontes, F., Hallak, J., Arcoverde, E., Maia-Oliveira, J. P., & Araujo, D. B. (2019). The Impact of Ayahuasca on Suicidality: Results From a Randomized Controlled Trial. Frontiers in pharmacology, 10, 1325. https://doi.org/10.3389/fphar.2019.01325

Downloads

Published

16/03/2022

How to Cite

MOURA, A. M. de .; ARAGÃO, M. B. de M. .; CONCEIÇÃO, D. C. de O.; SEIXAS, K. B. . Therapeutic efficacy of ayahuasca in patients with mental disorders based on clinical studies: an integrative review. Research, Society and Development, [S. l.], v. 11, n. 4, p. e22211427182, 2022. DOI: 10.33448/rsd-v11i4.27182. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/27182. Acesso em: 28 apr. 2024.

Issue

Vol. 11 No. 4

Section

Agrarian and Biological Sciences

License

Copyright (c) 2022 Alexandre Machado de Moura; Marcela Barboza de Melo Aragão; Dario César de Oliveira Conceição; Karoline Belém Seixas

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.