I wrote this review during my Master in Neuroscience. It is rather long but if you are interesting in the effect of Aya and depression, it might be worth the time! Enjoy!!!
Ayahuasca: An Alternative for the Treatment of Depression?
This review aims to provide an overview of the most important and latest findings on Ayahuasca and offer insights into practical work with this plant medicine. Additionally, I will attempt to provide a better translation of clinical studies and present my own opinion, considering that the research field is still relatively young, although the therapeutic use of Ayahuasca dates back thousands of years.
With the start of 2020, discussions about alternative treatment methods, particularly in the field of therapeutic medicine, have become increasingly prominent. As early as the 1960s, substances such as LSD, ketamine, and MDMA showed promising results; unfortunately, many experiments were discontinued and forgotten. However, in the past decade, there has been a resurgence of interest in psychedelic medicine. These substances are making a comeback, and their range of applications is expanding.
At this juncture, the return to natural remedies, especially in some countries where therapeutic applications of psychedelic mushrooms and Ayahuasca already exist, seems timely. South American medicine has been used by indigenous shamans for thousands of years and made its way to Europe in the early 19th century. The Ayahuasca tea is derived from various plant parts and prepared through a specific brewing process. Originally, this medicine was administered in a guided ceremony deep in the jungle. Today, it has reached modern cultures.
Ayahuasca – the new, ancient medicine
In recent years, serious clinical investigations have been conducted on the potential application of Ayahuasca in the treatment of depression. Studies comparing the mental health of Ayahuasca consumers to non-consumers have demonstrated an increase in cognitive functionality, higher well-being, and a reduction in anxiety and depressive symptoms. Furthermore, even a single dose of Ayahuasca, combined with meditation practices, can induce antidepressant effects.
However, how did we arrive at a point in the modern world where we are making renewed efforts to give ancient natural medicine another chance? This question is primarily a matter for philosophy and cannot be easily answered. As a neuroscientist, I work with numerous numbers and studies, aiming to compare the facts about different mental illnesses and draw conclusions. Throughout this process, I have become aware that mental disorders are becoming increasingly prevalent, and the demand for treatments is steadily growing.
Ayahuasca as an Antidepressant
The World Health Organization (WHO, 2017) has classified Major Depressive Disorder (MDD) as one of the most significant psychiatric conditions, affecting over 300 million people worldwide. That is equivalent to the entire population of the United States. To date, the exact cause and accompanying molecular changes remain unclear, making proper treatment and the design of new medications challenging.
Therefore, studies on alternative treatment methods are all the more important, such as the Spanish study conducted in 2019 by José Carlos Bouso: “Ayahuasca and Public Health: Health Status, Psychosocial Well-Being, Lifestyle, and Coping Strategies in a Large Sample of Ritual Ayahuasca Users.” Bouso’s lab focused on the overall well-being of Ayahuasca users and recruited 380 participants. Relevant data on mental and physical conditions were collected and compared with publicly available data from the population health index (2014-2018). This is a common approach in studies, and the questionnaire targeted the following domains: physical health, mental health, social relationships, and the environment.
In Bouso’s study, Ayahuasca users demonstrated significantly more positive attitudes, including a reduction in alcohol and drug consumption, as well as a clear improvement in social skills and mental dysfunctions. The study is also of great importance because practitioners of the Santo Daime Church were allowed to participate. They have been using Ayahuasca as a sacred relic for decades. Although the application differs slightly from the full ceremonial origin and resembles microdosing, researchers were able to include a group in the study that regularly and frequently (more than 100 times) consumes the South American medicine. This group showed a significant increase in satisfaction with their personal lives and their environment, even over an extended period
Rapid Antidepressant Effects of Ayahuasca in the Treatment of Resistant Depression
Major Depressive Disorder (MDD) is a prevalent psychiatric illness affecting millions worldwide, yet the etiology and underlying molecular changes remain poorly understood, limiting the development of effective treatments. Consequently, there is a need for exploration of alternative therapeutic approaches. This review focuses on the potential of Ayahuasca as a novel intervention for depression, with a particular emphasis on the pioneering work conducted by Fernanda Palhano-Fontes.
Ayahuasca and Psychosocial Well-being:
Palhano-Fontes conducted the first study investigating the long-term effects of Ayahuasca on treatment-resistant depression. The participants included individuals who had suffered from severe depression for over 20 years. Despite the small sample size, the study revealed significant improvements in comparison to the placebo group. Participants demonstrated a notably more positive outlook and increased openness towards their future. Remarkably, the Ayahuasca experience was described as a transformative event, leading participants to perceive their previous experiences as distinct from their present reality. Furthermore, the study identified molecular changes induced by Ayahuasca that parallel the effects of conventional antidepressant medications. It is worth noting that while conventional medications require weeks to exhibit therapeutic effects, a single Ayahuasca session demonstrated similar outcomes. In addition to the observed physiological changes, Ayahuasca significantly reduced the elevated activity of the Default Mode Network (DMN), commonly associated with depression, even several days following the ceremony.
Promoting a Positive Outlook for the Future:
Suicidality is a distressing concern often associated with depression and frequently observed in individuals with MDD and borderline personality disorder. Suicide poses a significant public health problem, accounting for a substantial number of premature deaths, with an annual global toll of nearly one million lives (World Health Organization, 2014). For every completed suicide, there are estimated to be 20 to 30 suicide attempts. Alarmingly, suicide rates continue to rise worldwide. These disconcerting statistics highlight the urgent need for effective suicide interventions and further investigation.
Zeifman and Araujo conducted a small-scale study titled “The Impact of Ayahuasca on Suicidality: Results From a Randomized Controlled Trial,” revealing a significant reduction in suicidal ideation among participants following a single Ayahuasca treatment compared to the placebo group. This positive trend aligns with the findings of Palhano-Fontes’ study. The experience with this natural medicine appears to have a motivating effect on both the body and mind. However, the specific molecular changes responsible for such a remarkable outcome are not yet fully understood. Nevertheless, these promising findings lay the groundwork for potential long-term studies to assess the enduring effects of Ayahuasca. Preliminary unpublished data suggest that the immediate psychological improvements associated with a single Ayahuasca session may contribute to a more positive global mood, ultimately reducing the suicide rate.
It is crucial to acknowledge the limitations and potential side effects associated with Ayahuasca studies. It is by no means appropriate to perceive Ayahuasca as a panacea for all depression-related concerns. Although no serious adverse effects were observed during or following Ayahuasca administration, the possibility of long-term adverse effects cannot be completely ruled out. While 100% of the patients reported feeling safe during the Ayahuasca session, it should be noted that the experience was not necessarily pleasant. Some patients even reported experiencing psychological distress. The most commonly reported physical side effects included nausea and vomiting, although the latter is traditionally viewed not as a side effect of Ayahuasca itself but rather as part of a cleansing process (Tafur, 2017).
Ineffability and Personal Transformation: Ayahuasca’s Potential as an Adjunctive Treatment for Depression
Depression remains a complex psychiatric disorder for which conventional therapeutic approaches often prove insufficient. As such, exploring alternative interventions becomes increasingly important. This article examines the groundbreaking research conducted by Fernanda Palhano-Fontes, focusing on the potential of Ayahuasca as an adjunctive treatment for depression.
Ayahuasca and Psychosocial Well-being:
Palhano-Fontes conducted the first long-term study investigating the effects of Ayahuasca on treatment-resistant depression. Participants, who had experienced severe depression for over two decades, exhibited significant improvements compared to the placebo group. Notably, participants reported transformative experiences during Ayahuasca ceremonies, which led to a reevaluation of their past experiences in relation to their present reality. Furthermore, molecular changes observed after Ayahuasca administration resembled those associated with conventional antidepressant medications. Importantly, Ayahuasca induced rapid therapeutic effects, contrasting the delayed onset typically seen with conventional medications. Additionally, Ayahuasca effectively reduced the hyperactivity of the Default Mode Network (DMN), a neural network implicated in depression, with effects persisting for several days post-ceremony.
Facilitating Acceptance and Ego Decentralization:
Following Ayahuasca ceremonies, individuals often reported a heightened sense of inner acceptance and a phenomenon commonly referred to as “ego decentralization.” These aspects pose complex challenges for description and warrant further investigation. Ayahuasca provides a unique opportunity for participants to engage in a process of self-exploration, gaining profound insights into their own identities and consciously accessing their subconscious. The role of visionary experiences in Ayahuasca’s therapeutic effects is believed to be significant, as they allow for increased introspection and a deeper understanding of the underlying reasons behind one’s thought patterns. This process helps individuals clarify their true priorities and prevents generalizations. Consequently, this aspect of Ayahuasca treatment holds promise for therapeutic application. Modern medicine remains limited in terms of offering personalized treatment approaches, making it difficult for patients to truly understand the needs of their own bodies and minds, as they are often compared to general population norms. Ayahuasca serves as an internal mirror, enabling individuals to find their own answers and gain clarity on their life paths.
Based on my own experience, Ayahuasca participants often enter ceremonies burdened by deep-seated and analytical questions accumulated over many years. Frequently, these questions arise from comparisons with their social environment (friends, family, job, hobbies) and their own personality. Interestingly, these questions either cease to arise during the ceremony or can be swiftly addressed. The inner journey frequently revolves around long-forgotten events and experiences. Engaging with one’s own subconscious can be challenging and perplexing, as it surpasses the boundaries of what modern science can fully explain. I can also personally attest that individuals with depression often rediscover a renewed zest for life through Ayahuasca. Engaging in self-reflection and confronting one’s own reflection requires considerable courage. Approaching a guide and exploring alternative healing modalities can also be challenging. However, the transformative power of such inner journeys is unparalleled, fundamentally reshaping our understanding of the material world.
Immediate Effects and Potential Benefits:
Another notable advantage, particularly in our fast-paced society, is the immediate effect of Ayahuasca ceremonies. While complete healing may not be instantaneous, these experiences can bridge the gap during the often lengthy wait for conventional therapy placements. This enables individuals to approach life with a more positive and curious outlook, potentially alleviating some of the burdens associated with waiting for treatment. Furthermore, the delayed onset commonly associated with selective serotonin reuptake inhibitors (SSRIs) is not observed with Ayahuasca.
In summary, an increasing body of research demonstrates the positive outcomes of alternative treatment methods for depression. Ayahuasca, the South American healing brew, has shown promising effects in alleviating depressive symptoms. Specifically, Ayahuasca has been found to have a positive impact on cognitive processes, enhancing concentration, fostering a renewed sense of purpose, and facilitating reintegration into social environments. As the evidence base continues to grow, it is hoped that further studies will emerge, paving the way for the availability of Ayahuasca therapy as a natural medicine option.
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, 655–663. https://doi.org/10.1017/S0033291718001356
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The Impact of Ayahuasca on Suicidality: Results From a Randomized Controlled Trial Richard J. Zeifman1, Fernanda Palhano-Fontes2,3, Jaime Hallak4, Emerson Arcoverde3, João Paulo Maia-Oliveira3 and Draulio B. Araujo2,3*
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Transforming Lives, Enhancing Communities — Innovations in Global Mental Health Vikram Patel, F.Med.Sci., and Shekhar Saxena, M.D.