Ayahuasca and Dimethyltryptamine Adverse Events and Toxicity Analysis: A Systematic Thematic Review

Area of Science:

• Pharmacology and Toxicology
• Ethnobotany
• Clinical Research

Background:

• Ayahuasca, a psychoactive brew, and its alkaloids like DMT are used traditionally.
• Concerns exist regarding the safety and toxicity of ayahuasca and its constituents.

Purpose of the Study:

• To systematically review adverse events, safety, and toxicity of ayahuasca and its alkaloids.
• To discuss clinical considerations for ayahuasca use in controlled settings.

Main Methods:

• Systematic literature search of preclinical, clinical, epidemiological, and pharmacovigilance data.
• Searches included PubMed, Web of Science, PsycINFO, ClinicalTrials.gov, and Embase databases.
• Thematic analysis of 78 relevant articles.

Main Results:

• Ayahuasca and DMT are generally safe in humans, with rare serious adverse effects reported in healthy populations.
• Animal models indicate potential abortifacient and teratogenic effects at high doses.
• Harmala alkaloids, especially harmaline, showed potential toxicity in preclinical studies, particularly at higher doses or with drug co-administration.

Conclusions:

• Ayahuasca and DMT demonstrate an acceptable safety profile for traditional use in controlled settings.
• Preclinical findings on toxicity may not directly translate to human therapeutic use of plant extracts.
• Further rigorous clinical trials are needed to fully establish safety and efficacy.