What is Ayahuasca? (And Can it Cure Your Depression?)

If you’re like me then over the past few years you’ve seen a big influx on social media of people praising the benefits of a drug called ayahuasca. Reports from people taking the drug vary widely- some people describe a beautiful, traditional experience that helped them gain self-awareness and powerful insight, while others describe three hours filled with vomiting, diarrhea, and hallucinations so vivid that users of LSD would be jealous.

This article gives a basic overview of the traditional psychedelic tea, including what it actually contains, what it does to the body, whether it has potential as a therapeutic for mental health conditions, and whether it’s actually safe to consume.

What is Ayahuasca?

Typically, when one talks about ayahuasca they’re actually referring to a tea made from two different plants. These plants are:

Banisteriopsis caapi (also known as the soul vine). This vine is a native of the Amazon jungle and grows pretty, pink flowers. The leaves of the plant contain a class of compounds known as β-carboline alkaloids. These molecules are well-known to act as monoamine oxidase inhibitors, or MAOIs. MAOIs stop the degradation of neurotransmitters, like dopamine and serotonin. Many early antidepressants also have MAOI activity, including the drugs Marplan and Nardil.
Psychotria viridis, a leafy plant that produces bright red berries. As you can probably tell by the name psychotria, this is where the hallucinogenic effects of ayahuasca stem from. Psychotria virdis contains the compound DMT, which has a structure very similar to serotonin and can activate serotonin receptors in the brain. DMT usually isn’t orally bioavailable- meaning that it’s degraded by the digestive system and therefore needs to be injected directly into the bloodstream to have an effect.

The combination of these two plants gives a very interesting effect, pharmacologically speaking. The banisteriopsis caapi stops the body from degrading substances similar to serotonin , while the psychotria virdis provides a big hit of the serotonin-lookalike DMT. The result is that the DMT isn’t degraded in the usual way and can pass through the digestive system and into the bloodstream, where it activates serotonin receptors.

What Happens When You Take Ayahuasca?

Happily, we don’t have to rely on dodgy Instagram posts or podcasts to get a solid picture of what happens to someone when they take ayahuasca. The rise in popularity of the drug means that there are a good few studies published that examine the effects of it on users in a clinical setting.

These studies report the following:

After taking the ayahuasca tea, users experience a 30-minute delay before the onset of any effects
During this time, the high acidity of the tea can cause stomach pain, which often leads to vomiting
After 30 minutes, users may start to experience skin sensitivity, paired with hot and cold flushes
Approximately an hour after ingestion, the hallucinogenic properties of the DMT in the psychotria virdis begin to kick in. These hallucinations are described as being similar to lucid dreaming; the user generally remains aware that what they’re seeing isn’t real and it’s rare to hear voices or other auditory hallucinations. Instead, users report experiencing complex, movie-like visual hallucinations that often have a logical sequence and are generally spiritual in nature. This is coupled with heightened senses; for example, music may sound louder or more intense.
The maximum intensity of the hallucinations is typically around 1.5 to 2 hours after ingestion of the ayahuasca; after this, there’s a slow tapering off.

Photo by Renny Gamarra on Unsplash

Does Ayahuasca Cure Depression?

So, does ayahuasca cure depression? The answer is a resounding maybe.

To reiterate, the two compounds that give ayahuasca its potency are DMT and β-carboline alkaloids.

DMT is known to bind to serotonin receptors in the brain. More specifically, it mostly binds to the 5-HT2A receptor, which is already a known drug target for antidepressants (Trazadone and Mirtazapine, to name a few). There are several other psychotropic drugs that are being considered in the treatment of depression that act on this same receptor, including LSD and psilocybin.

β-carboline alkaloids, on the other hand, act as MAOI compounds, bearing similarities to early-generation antidepressants like Marplan and Nardil. The reason these drugs were eventually superseded by later antidepressants was due to the significant side effects that patients often experienced, but there’s no doubt that they do alleviate depression.

Aside from these two mechanisms, ayahuasca is also thought to have an effect on a structure in the brain called the sigma-1 receptor. This receptor hasn’t been studied nearly as extensively as the 5-HT2A receptor, but it’s been established that it’s involved in the process of neural plasticity — the process of physical changes occurring in the brain. Because of this, it’s been theorised that long-term use of ayahuasca leads to physical differences in the brain. However, again, this hasn’t been 100% confirmed.

So, it’s not a huge logical leap to assume that ayahuasca might cure depression. That being said, just because it makes sense that something might have a particular effect, doesn’t mean that it necessarily does. So what do the actual studies in humans say?

Well, the results have been mixed but generally positive. Of seven recent human trials conducted with ayahuasca that studied depression, all found either minor or moderate reductions in depressive symptoms. One study even reported a significant reduction in depression symptoms only 1 day after a single dose of ayahuasca. However, it’s important to note that all of these studies contained small sample sizes (the smallest actually only had nine participants!). To date, there hasn’t been a single study with a large enough population to convincingly argue that ayahuasca is therapeutically beneficial.

In sum, while the initial indications are positive for ayahuasca, there’s a very long way to go before we can say that it conclusively has an anti-depressant effect, and even longer before it becomes a commonly used treatment.

Photo by 五玄土 ORIENTO on Unsplash

Does Taking Ayahuasca Have Harmful Side Effects?

Ayahuasca definitely has some pretty intense side effects, some of which I’ve already mentioned. These include:

Nausea and vomiting, which can sometimes be severe
Raised blood cortisol levels
Raised blood pressure (although it should be noted that this elevation is far less than what a user of pure DMT would experience and that heart rate isn’t much affected)

While these may sound serious, ultimately properly brewed ayahuasca is very unlikely to actually endanger someone’s life. I emphasise properly brewed because when you’re putting something in your body that someone else has prepared, there’s never 100% certainty. If you’re planning on taking ayahuasca, make sure you properly vet the organisation or person who is preparing it and ensure that they’re experienced and have a good reputation.

Another thing to consider is whether the practitioner is going to offer ‘supplemental treatments’ or other experiences. In February of 2024, a man died in Australia following an ayahuasca ritual, in which he’d not only drunk the psychoactive tea but had also had a frog toxin extract called ‘kambo’ painted onto burns on his skin. Now, it’s not entirely clear whether the man died as a result of the frog toxin, the ayahuasca, a combination of the two, or an entirely unrelated health issue, but keep in mind that treatments offered in conjunction with ayahuasca aren’t necessarily safe.

Finally, ayahuasca absolutely shouldn’t be used in conjunction with prescription drugs, particularly drugs that modulate serotonin levels in the brain like antidepressants. As the ayahuasca itself elevates serotonin levels, it’s very dangerous to combine it with something that has the same effect — this could very easily lead to an overdose.

Conclusion

In conclusion, Ayahuasca is a complex brew with potential benefits and risks. Its effects on depression are promising but require more research. Always prioritize safety and consult professionals.

The information provided is intended for educational purposes only and does not constitute medical advice. Consult with a qualified healthcare professional before making any decisions about your health or treatment.

What is Ayahuasca? (And Can it Cure Your Depression?)