Beyond the Psychoactive Effects of Ayahuasca: Cultural and Pharmacological Relevance of Its Emetic and Purging Properties

Abstract

The herbal preparation ayahuasca has been an important part of ritual and healing practices, deployed to access invisible worlds in several indigenous groups in the Amazon basin and among mestizo populations of South America. The preparation is usually known to be composed of two main plants, Banisteriopsis caapi and Psychotria viridis, which produce both hallucinogenic and potent purging and emetic effects; currently, these are considered its major pharmacological activities. In recent decades, the psychoactive and visionary effect of ayahuasca has been highly sought after by the shamanic tourism community, which led to the popularization of ayahuasca use globally and to a cultural distancing from its traditional cosmological meanings, including that of purging and emesis. Further, the field of ethnobotany and ethnopharmacology has also produced relatively limited data linking the phytochemical diversity of ayahuasca with the different degrees of its purging and emetic versus psychoactive effects. Similarly, scientific interest has also principally addressed the psychological and mental health effects of ayahuasca, overlooking the cultural and pharmacological importance of the purging and emetic activity. The aim of this review is therefore to shed light on the understudied purging and emetic effect of ayahuasca herbal preparation. It firstly focuses on reviewing the cultural relevance of emesis and purging in the context of Amazonian traditions. Secondly, on the basis of the main known phytochemicals described in the ayahuasca formula, a comprehensive pharmacological evaluation of their emetic and purging properties is presented.

Ethnomedical uses of Yawar Panga (<i>Aristolochia didyma</i>) in a therapeutic community dedicated to the treatment of drug addiction in the Peruvian Amazon

“…Despite the well-known toxicity of Aristolochia alkaloids, such ethnopharmacological fieldwork testifies to the possibility of using Aristolochia species in a safe and effective way. It has already been specified elsewhere that, "The etymology of the word "pharmakon" from ancient Greek means at the same time "poison" and "drugs"; this remarks the subtle line between being a problem or a solution and the pharmacist ′ s ability to convert a potential poison into an effective drug" (Politi et al, 2021). This same concept, which represents one of the pillars of pharmacology, has also been noted previously (Politi et al, 2018).…”

“…As part of the therapeutic protocol of Takiwasi, several plants with emetic effects are offered to patients in order to provide physical cleansing, and to combine with this physical cleansing additional purported effects on an energetic or spiritual level. Herbal preparations with emetic activity are considered relevant therapeutic tools from both cultural and clinical perspectives within the context of Amazonian medical traditions (Fotiou & Gearin, 2019;Politi et al, 2021;Sanz-Biset & Cañigueral, 2013). One such major example is the liquid preparation of Tobacco, especially Nicotiana rustica L. .…”

Use of tobacco purge in a therapeutic community for the treatment of substance use disorders

“…The same ayahuasca brew that has gained popularity among a global audience in the past three decades is often referred to as the “purga” in the Peruvian Amazon because of its emetic, cleansing, and depurative effects (Politi et al. 2021). Purging, itself, is an important aspect of the ayahuasca experience and, in many cases, a variety of other purgative plants, including tobacco, are used to prepare the body of the individual who will later participate in an ayahuasca ceremony (Fotiou and Gearin 2019).…”

“…Plant remedies taken in purgas are aqueous extracts that, highly unpleasant to drink due to their bitter taste, act chiefly as irritants of the gastric and intestinal mucosa, which trigger nausea and emesis (Sanz-Biset and Cañigueral 2013;Fotiou and Gearin 2019). The same ayahuasca brew that has gained popularity among a global audience in the past three decades is often referred to as the "purga" in the Peruvian Amazon because of its emetic, cleansing, and depurative effects (Politi et al 2021). Purging, itself, is an important aspect of the ayahuasca experience and, in many cases, a variety of other purgative plants, including tobacco, are used to prepare the body of the individual who will later participate in an ayahuasca ceremony (Fotiou and Gearin 2019).…”

Cardiovascular safety of psychedelic medicine: current status and future directions

“…A range of symptoms, particularly those affecting the state of consciousness, caused by plants or plant-derived substances and fungi containing psychedelic substances, have led to their use for millennia in religious practices, tribal rituals, and also for the treatment of fever and rheumatic pain [4][5][6]. The modern era of psychedelic research did not begin with the synthesis of a new substance in this group, d-lysergic acid diethylamide (LSD) in 1938, but with the accidental discovery of its effects by Albert Hoffmann on 19 April, 1943, (known as Bike Day) [7].…”