Ayahuasca, a traditional plant-based psychedelic brew, has gained attention for its healing properties. This Amazonian tisane typically combines the Banisteriopsis caapi vine and Psychotria viridis leaves, containing compounds like N,N-dimethyltryptamine (DMT) and monoamine oxidase inhibitors (MAOIs). While many seek it for spiritual or therapeutic experiences, in rare instances, ayahuasca use can lead to a serious adverse reaction known as “ayahuasca psychosis.” This article explores this condition and how to address it.
What is Ayahuasca Psychosis?
Psychosis refers to a mental state characterized by a significant break from reality, often involving hallucinations, delusions, and disorganized thought patterns. Normal ayahuasca experiences induce altered states of consciousness, including vivid visual imagery and intensified emotions. However, these effects are temporary, and individuals typically maintain a connection to reality during the experience.
Ayahuasca psychosis differs from these transient psychedelic effects. It involves a persistent, distressing, and disruptive loss of reality testing that extends beyond the acute effects of the brew. This condition can significantly impair daily functioning. The compounds in ayahuasca, such as DMT, interact with serotonin 5-HT2A receptors in the brain. MAOIs prevent DMT breakdown, allowing it to remain active. In susceptible individuals, these interactions can trigger persistent alterations in brain chemistry, leading to psychotic symptoms.
Who is at Risk for Ayahuasca Psychosis?
Individuals with a pre-existing personal or family history of psychotic disorders, such as schizophrenia or bipolar disorder with psychotic features, face a heightened risk of developing ayahuasca-induced psychosis. Those with ongoing manic or psychotic symptoms should also avoid ayahuasca.
The concurrent use of certain medications, particularly antidepressants or antipsychotics, can lead to dangerous drug interactions due to the MAOIs present in ayahuasca. For instance, combining MAOIs with certain antidepressants can risk serotonin syndrome, a potentially life-threatening condition. Lack of proper screening and preparation is another contributing factor, as it may lead to individuals with underlying vulnerabilities using it without adequate safeguards. High doses or frequent use of ayahuasca can also increase the likelihood of experiencing adverse psychological effects, including psychosis.
Recognizing the Signs of Ayahuasca Psychosis
Ayahuasca-induced psychosis manifests through specific symptoms that persist beyond the acute effects of the substance. Individuals may experience persistent hallucinations, which can be visual or auditory, such as seeing things that are not there or hearing voices. Delusions, false, fixed beliefs not based in reality, are another common sign.
Disorganized thinking and speech are also indicative, where thoughts may seem incoherent or jump between unrelated topics. Paranoia, characterized by intense suspicion or distrust of others, along with extreme anxiety or agitation, can be prominent. Significant changes in behavior or personality, such as uncharacteristic aggression or withdrawal, may also be observed. A concerning sign is the loss of insight, meaning the individual is unaware that their experiences are not real. These symptoms can persist for days, weeks, or even months after ayahuasca consumption.
What to Do About Ayahuasca Psychosis
If someone exhibits signs of ayahuasca psychosis, immediate professional medical and psychiatric help is necessary. This is a medical emergency, and contacting an emergency room or a mental health crisis line without delay is recommended. Timely intervention can significantly impact recovery.
Ensuring the person is in a safe, calm, and supportive environment, free from further triggers, is also important. This involves removing them from any chaotic or overstimulating situations that might exacerbate their distress. Professional treatment typically involves hospitalization to stabilize the individual and manage acute symptoms. Antipsychotic medications, such as paliperidone or quetiapine, have been used with reported success in managing ayahuasca-associated psychosis, helping to alleviate hallucinations and delusions.
Psychotherapy, such as cognitive behavioral therapy for psychosis, can also be beneficial in the long term to help individuals process their experiences and develop coping strategies. Ongoing mental health support is important for recovery, which can vary in duration from weeks to months. Avoiding further psychedelic use is advised to prevent recurrence or worsening of symptoms.