Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression

Abstract

Ayahuasca is an Amazonian botanical hallucinogenic brew which contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor. Our group recently reported that ayahuasca administration was associated with fast-acting antidepressive effects in 6 depressive patients. The objective of the present work was to assess the antidepressive potentials of ayahuasca in a bigger sample and to investigate its effects on regional cerebral blood flow. In an open-label trial conducted in an inpatient psychiatric unit, 17 patients with recurrent depression received an oral dose of ayahuasca (2.2 mL/kg) and were evaluated with the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale, the Brief Psychiatric Rating Scale, the Young Mania Rating Scale, and the Clinician Administered Dissociative States Scale during acute ayahuasca effects and 1, 7, 14, and 21 days after drug intake. Blood perfusion was assessed eight hours after drug administration by means of single photon emission tomography. Ayahuasca administration was associated with increased psychoactivity (Clinician Administered Dissociative States Scale) and significant score decreases in depression-related scales (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale) from 80 minutes to day 21. Increased blood perfusion in the left nucleus accumbens, right insula and left subgenual area, brain regions implicated in the regulation of mood and emotions, were observed after ayahuasca intake. Ayahuasca was well tolerated. Vomiting was the only adverse effect recorded, being reported by 47% of the volunteers. Our results suggest that ayahuasca may have fast-acting and sustained antidepressive properties. These results should be replicated in randomized, double-blind, placebo-controlled trials.

Psychiatry & the psychedelic drugs. Past, present & future

“…Flavia de Lima Osorio and colleagues (Osorio et al, 2015) and Rafael Sanches and colleagues (Sanches et al, 2016), both working in Sao Paulo, Brazil, reported studies where a single dose of ayahuasca to patients with recurrent depression. In Osorio's pilot study, 6 medication and ayahuasca naive participants (4 women) were given 2.2 ml/kg of a standardised preparation of ayahuasca containing 0.8 mg/ml DMT and 0.21 mg/ml of harmine.…”

“…Three pilot studies using psychedelics in major depressive disorder have been published to date in the modern literature (Carhart-Harris et al, 2017, 2016aOsorio et al, 2015;Sanches et al, 2016). Our own open-label pilot study gave 2 doses of psilocybin (a 10 mg "test" dose and a 25 mg therapeutic dose) 1 week apart with psychological support before and after the experience to 20 patients with treatment resistant depression who were moderately to severely depressed, but without psychotic features (Carhart-Harris et al, 2017, 2016a.…”

Ayahuasca: what mental health professionals need to know

“…Regarding anxiolytic and antidepressive effects in humans, a double-blind, placebo-controlled studies with nine experienced ayahuasca users showed that a single ayahuasca dose was associated with less panic symptoms and reduced hopelessness 41 . An open-label study by our group showed that a single ayahuasca dose was associated with rapid and sustained reductions in anxiety and depressive symptoms in 17 patients with treatment-resistant major depressive disorder 42 . The anxiolytic and antidepressive effects were observed already in the first hours after ayahuasca intake and remained significant for 21 days.…”

“…Evidence from uncontrolled studies 42,48,49 Anxiolytic Antidepressive Antiaddictive Evidence from controlled studies 41,43 Anxiolytic Antidepressive…”

Off label Administration of Buprenorphine in the Treatment of Major Depression

“…Ayahuasca is an Amazonian botanical hallucinogenic cook. It contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor [10,11] As a partial agonist of mu opioid receptor, buprenorphine can diminish the level of depression and suicidal thoughts rapidly [12,13].…”