Wait what? A magical beverage?

vzuluagacuartas
Nov 28, 2019
8 min read

Updated: Dec 9, 2019

Hahaha I got you with the nice picture of Sangría. Unfortunately, this week's topic will not be about how magical a Sangría is...bad news, Sangría has no psychedelic effects....but Ayahuasca does!

This week's post will give a scientific crash course explaining this "magical"drink.

What is Ayahuasca?

Ayahuasca is a psychedelic drink that was originally used for religious purposes by native South American tribes in the Western Amazon Basin. This drink is made by boiling the stems of Banisteriopsis caapi (in South America it is known as yagé), along with the leaves of the shrub Psychotria viridis, which is commonly known as chacruna. The combination of both plants leads to a drink rich in a substance known as dimethyltryptamine (DMT), which is a powerful hallucinogenic substance (Malcolm & Lee, 2017).

In simple terms, DMT has very low bioavailability (it will not last long in the body) and enzymes called monoamine oxidases (MAOs) break down DMT very quickly. The addition of yagé in the drink blocks the ability of MAOs to break down DMT quickly, allowing DMT to last longer. When both plants are combined, they form a powerful psychedelic that affects the central nervous system and alters consciousness, creating hallucinations, out-of-body experiences, and euphoria (Malcolm & Lee, 2017).

It is important to notice that DMT works in the same way as psilocybin and LSD. It behaves like a non-selective serotonin agonist, acting on (5-HT)2A receptors (serotonin receptors). The effects of DMT take around 20 minutes to appear. The effects peak between 60 to 120 minutes after consumption and will last no longer than 5 hours. It's half life is around 1 hour (Marcolm & Lee, 2017).

How was it originally used?

Ayahuasca is still used in shemanic ceremonies by indigenous tribes in the Amazon, just like it always has been. These ceremonies are performed at night and take a lot of preparation. They are always led by a powerful shaman who guides and provide spiritual support. Because the consumption of Ayahuasca might lead to disturbed experiences, the shaman makes sure to set a baseline mindset and will control the physical environment where it is taken. This beverage is consumed by various indigenous tribes, as they believe in its healing and transforming effects.

I have many family members that practice these ceremonies. The shamans always recommended abstaining from cigarettes, heavy drugs, sex, alcohol, and caffeine. They are also very strict about following a healthy diet a week or two prior to the ceremony. The best diet is a vegan diet, with no consumption of cheese, fermented foods, pork, or any red meat.

During the first hour, individuals can experience disturbing symptoms such as vomiting, diarrhea, feelings of euphoria, strong visual and auditory hallucinations, mind-altering psychedelic effects, fear, and paranoia. The negative effects of vomiting and diarrhea are believed to be part of the cleaning process, where impurities are expelled by the body before the soul can heal. People who practice the ritual for many years find these processes to be positive and relieving.

Neuroscience:

Several studies have looked at the neurophysiological effects that DMT has on the brain. Head scans have shown that DMT decreases blood flow to frontal cortical structures, including the medial temporal lobe, amygdala, hippocampus, and the parahippocampal gyrus – which are involved in regulation of emotion and memory.

Moreover, the activation of the temporo-parieto-occipital junction is also shown to be activated. The activation of this structure results in synesthesia and other psychedelic phenomena.

Another important finding that the scans have revealed is that ayahuasca has increased cortical thickness in the anterior cingulate cortex (ACC) and thinning of the posterior cingulate cortex (PCC)

in at least 50 individuals over the past 2 years (Bouso, 2015). Both of these structures are involved with the default mode network (DMN), which helps to integrate environmental stimuli with cognitive and emotional processes.

The hyperactivity of the DMN has been shown to be related to depression, anxiety, ADHD, and schizophrenia (Gudayol-Ferré, Peró-Cebollero, González-Garrido, & Guàrdia-Olmos, 2015; Hamilton, Farmer, Fogelman, & Gotlib, 2015).

Research has shown that psilocybin and ayahuasca affect very similar structures. They both produce changes in the DMN activity. These changes are what scientists believe strongly affect the treatment of psychiatric illnesses. The present hypothesis is that changes of activation in the DMN is what underlies the benefits of psychedelics.

The Default Mode what...?

The DMN is known to be involved in different functions that are part of the neurological basis for the self. These include:

Emotion of one’s self
Autobiographical information
Thinking about others
Emotions of others
Good-bad attitude judgments about social conceptsSocial categories
Remembering the past and thinking about the future

Such mechanisms are known to be affected in patients with depression and anxiety. The DMN is part of many tasks that can become the source of rumination. It is not the DMN on its own that "causes" depression, but the highjacked relationship between the DMN and parts of the brain involved in emotional thinking (those mentioned above). This results in thoughts becoming entirely consumed with negative rumination (Hamilton, Farmer, Fogelman, & Gotlib, 2015).

Is taking Ayahuasca dangerous?

There have been several reported deaths, including an alleged homicide during a ceremony (you can find the reports here: https://chacruna.net/can-people-really-die-from-drinking-ayahuasca-as-announced-in-the-media/). There are unclear views regarding the safety of ayahuasca, but according to Dos Santos (2013), there has never been a death observed during a clinical study. Dos Santos stated that there is a lack of accurate forensic and toxicological information regarding the deaths.There is no clear evidence supporting that the deaths were due to traditional ayahuasca preparations.

The biggest danger that comes from taking ayahuasca is the risk of mixing this drink with other drugs that affect parts of the brain involved in serotonin production.

Some deaths have been caused by the dangerous hallucinations produced by DMT, but just as mentioned before, the risks of such fatalities are decreased when these drugs are taken in a controlled environment. The consumer needs to feel safe and have a responsible person nearby to take care of them. This is why experimentation with psychedelics is not recommended, unless performed in a safe and controlled environment.

Here is a really cool video explaining how ayahuasca tea is made. The video quality is not the best, but it highlights the whole ceremony experience!

Bouso, J. C., Palhano-Fontes, F., Rodríguez-Fornells, A., Ribeiro, S., Sanches, R., Crippa, J. A. S., ... & Riba, J. (2015). Long-term use of psychedelic drugs is associated with differences in brain structure and personality in humans. European Neuropsychopharmacology, 25(4), 483-492

Dos Santos, R. G. (2013). A critical evaluation of reports associating ayahuasca with life-threatening adverse reactions. Journal of Psychoactive Drugs, 45(2), 179-188.

Gudayol-Ferré, E., Peró-Cebollero, M., González-Garrido, A. A., & Guàrdia-Olmos, J. (2015). Changes in brain connectivity related to the treatment of depression measured through fMRI: A systematic review. Frontiers in human neuroscience, 9, 582.

Hamilton, J. P., Farmer, M., Fogelman, P., & Gotlib, I. H. (2015). Depressive rumination, the default-mode network, and the dark matter of clinical neuroscience. Biological psychiatry, 78(4), 224-230.

Malcolm, B. J., & Lee, K. C. (2018). Ayahuasca: An ancient sacrament for treatment of contemporary psychiatric illness?. The mental health clinician, 7(1), 39–45. doi:10.9740/mhc.2017.01.039.

Whitfield-Gabrieli, S., & Ford, J. M. (2012). Default mode network activity and connectivity in psychopathology. Annual review of clinical psychology, 8, 49-76.

Article Summary:

A meta-analysis performed by Malcolm and Lee (2018) described ayahuasca's pharmacology, potential drug interactions, and clinical data for the treatment of psychiatric illnesses.

Firstly the background chemistry of the drug was described. According to Malcolm and Lee (2018), psychedelic substances such as psilocybin, mescaline, peyote, and N-N-dimethyltryptamine (DMT) have been used for thousands of years as ritual sacraments. In modern times, psychedelics have been the focus of drug research for the treatment for psychiatric illnesses, including depression.

Moreover, Malcolm and Lee (2018) described the ways ayahuasca is used in shamanic ceremonies by indigenous peoples of the Amazon (the description of the ceremonies is mentioned in the blog).

The Santo Daime and União do Vegetal (UDV) are two of the largest modern-day ayahuasca churches.

N-N-dimethyltryptamine a schedule I controlled substance in the United States (Substances in this schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse) but ritual drinking of ayahuasca for members of the UDV has been upheld by the Supreme Court under the Religious Freedom Restoration Act.

Malcolm and Lee (2018) also commented on Ayahuasca's psychedelic activity, Ayahuasca is a tryptamine psychedelic that acts as a nonselective serotonin agonist in the 5-hydroxytryptamine (5-HT)2A receptors. Moreover, DMT is endogenously produced, structurally similar to serotonin. Subjective effects of ayahuasca correlate closely with DMT blood concentrations; onset occurs around 20 minutes, peaks between 60 and 120 minutes, and resolution around 240 to 300 minutes. The half-life is approximately 1 hour.

Randomized, placebo-controlled trials of acute administration of ayahuasca in humans have exchibited safe profiles for the consumption of ayahuasca. Doses of DMT administered ranged from 0.5 to 1 mg/kg. Doses of up to 3.4 mg/kg were tolerated. The estimated lethal dose of ayahuasca determined was almost 20 times the average amount consumed in ritual contexts. Therefore, there is a low therapeutic index with concentrated brew although propensity to induce vomiting may limit consumption.

Because of the MAO inhibition by the plants, ayahuasca carries a higher risk of drug interactions than other psychedelics. Ayahuasca has previously been recognized to have interaction potential with selective serotonin reuptake inhibitors such as SSRIs, trazodone, and St John's wort.Psychoactive drugs, such as phenylethylamines (mescaline, MDMA), methcathinones or “bath salts”, and tryptamines (LSD, and psilocybin) are high-risk combinations as fatalities have been reported when combined with harmala alkaloids in a recreational setting. Amazonian diets used in preparation of ritual ayahuasca involve bland foods that do not involve alcohol, cheese, or other fermented food items.

Malcolm and Lee (2018) state how Ayahuasca is not considered to be an addictive substance. The drug has not been observed to produce withdrawal in studies to date. Ayahuasca is not well tolerated physically causing nausea, vomiting, and diarrhea as well as other somatic symptoms known as purging or la purga.

According to indigenous cultures, these adverse effects are considered to be cleansing and normal. It is hypothesized that the aversive symptoms are related to mild serotonin toxicity. In addition, after the consumption of Ayahuasca there is an increase in cortisol and prolactin levels that persist for approximately 6 hours with consequent immunomodulatory change.

There have been many reports of death after the consumption of ayahuasca in people that have tried it for the first time. Accordingly, the explanations of the deaths are unclear. It is believed that some shamans add additional plants with increased toxicity.

It is important to note that there has never been a death observed during a clinical study. Moreover, Ayahuasca does not appear to increase the risk of schizophrenia but it is recommended that Ayahuasca is not taken by patients with a history of mania or psychosis.

The analysis of the data from the research was performed from research found in PubMed. Anecdotal clinician reports and naturalistic studies demonstrated that Ayahuasca had positive effects on substance use disorders. The explanation was due to potential mechanisms in substance use disorders that include the modulation of serotonergic and dopamine neurotransmission.

Other two studies investigated the antidepressant effects of Ayahausca in patients with recurrent moderate major depressive disorder.

The first study was conducted in six patients in a psychiatric hospital. After consumption of Ayahuasca, the patients exhibited a sustained reductions in the Hamilton Depression Rating (HAM-D) scale and Montgomery Asberg Depression Rating Scale (MADRS).

The second study assessed the impact of Ayahuasca in 17 patients with depressive symptoms. The patients also exhibited reductions of scales in HAM-D and MADRS. In addition to the scales,

neuroimaging analysis was also performed.