Ayahuasca
Learn more about ayahuasca, the psychedelic tea used historically by indigenous populations.
This content is made in collaboration with Blossom.
Overview
Common Nicknames
Yagé, caapi, cipó, nixi pae, camalampi, uni
Drug Class
Psychedelic
Drug Form
Tea/Brew
Route of Administration
Oral
What is the science of Ayahuasca?
Ayahuasca is a psychedelic tea originating from the Upper Amazon in South America. It is typically prepared from two plants– Psycotra viridis, containing the psychedelic compound DMT (N,N-Dimethyltryptamine), and Banisteriopis Caapi (the ayahuasca vine) which contains monoamine oxidase inhibitors (MAOIs) that prevent DMT from being broken down in the gut and liver. This combination allows DMT to have psychoactive effects when taken orally, and prolongs the intense psychedelic experience.
DMT is an indole alkaloid and acts as an agonist at 5-HT2A receptors, the same receptor targeted by other classic psychedelics such as LSD, psilocybin and 5-MeO-DMT, producing strong visionary effects and other markers of altered consciousness. DMT also shows substantial partial activity at 5-HT2C receptors, along with some binding at 5-HT1A and sigma-1 receptors, suggesting its effects are shaped by more than a single receptor target.
Under normal circumstances, DMT is inactive when consumed orally, as it is denatured by an enzyme found in the stomach before it can take effect, which is why it is more commonly vaporised or, in some clinical research, given intravenously. In ayahuasca, the MAOI compounds (β-carboline compounds such as harmine, and harmaline), slow down this enzymatic breakdown, allowing the oral preparation to produce a profound and prolonged psychedelic experience, often called an "ayahuasca trip." Pharmacokinetic studies in healthy volunteers found that DMT levels in the blood typically peak around 75 minutes after drinking the brew. DMT itself clears the body quickly, but harmine lingers longer, and it is this slower clearing MAOI that stretches the experience out, compared with smoked or injected DMT, which comes on in seconds and fades within 15 to 30 minutes.
Brain imaging research shows ayahuasca reduces activity in the brain's default mode network, while altering activity in limbic and visual processing areas, a pattern broadly consistent with other classic psychedelics. In the hours after dosing, blood levels of BDNF, a protein linked to brain plasticity, rise significantly, and animal studies suggest DMT can stimulate the growth of new neurons and blood vessels in the hippocampus, pointing to a broader neurotrophic mechanism that may help explain its longer lasting psychological effects.
What are the risks?
Ayahuasca has a long history of use, with very few reported incidents of harm. Clinical studies, in both animals and humans, indicate it is extremely safe when appropriate dosage, setting and supervision are applied, and there is very little risk of toxicity, consistent with most classic psychedelics. In pooled data from over 100 clinical trial administrations, the most common adverse events were the kind of effects you'd expect from classical psychedelics: nausea, vomiting, diarrhoea, transient headaches, and mild to moderate increases in heart rate and blood pressure. Some participants experience acute anxiety, confusion or dysphoria at the peak of the experience, but there are no reports in this literature of lasting psychosis, cognitive problems, serious organ toxicity or fatalities. In the pivotal 2019 clinical trial in treatment-resistant depression, every participant vomited, but none suffered lasting harm and all reported feeling physically safe throughout.
The most frequently reported issue overall is simply an intense, emotionally challenging experience. Past trauma can resurface, and this is usually temporarily unpleasant rather than harmful. However, it is real and worth preparing for.
As with all substances, there is risk around the composition of the preparation. Toxicological studies of ayahuasca ‘brews’ have revealed that concentrations of both DMT and the β-carboline MAOIs vary substantially across preparations. Many different types of additional plant matter have been reported, some of which may pose risk of interaction or potentiation. Storage duration and transport conditions have also been shown to affect composition, with significant changes observed to the harmala alkaloids (present in the MAOI).
Judgement and awareness can be significantly altered during the experience, and the risk of sexual assault or accidental injury is higher wherever powerful psychoactive substances are involved, so the safety of the setting and the people around you matters enormously.
Although pharmacologically safe at typical doses, some pre-existing conditions and medications should rule out ayahuasca use, or at minimum require a conversation with a doctor first. These include other MAOIs (sometimes prescribed as antidepressants), antipsychotics, antihypertensives, and SSRIs, since combining SSRIs with the MAOIs already present in ayahuasca carries a real risk of serotonin syndrome. Lithium is another medication to avoid, given the elevated seizure risk that has been observed when it is combined with psychedelics generally. Some medications may also simply blunt the effects of ayahuasca if they act on the same receptors. Never stop a prescribed medication without first talking to your doctor.
Diagnoses such as schizophrenia, a personal history of psychosis, or bipolar disorder are treated as exclusion criteria in most clinical and retreat settings, as is uncontrolled cardiovascular disease and pregnancy.
Full or partial fasting beforehand is typically recommended. This reduces the chances of vomiting, promotes better absorption, and helps avoid dangerous food interactions, since foods high in tyramine, such as many cheeses and cured meats, are believed to interact with the beta-carboline alkaloids in ayahuasca.
How might the drug make you feel?
As with other 5-HT2A agonists (such as LSD, psilocybin, 5-MeO-DMT etc), a serotonergic response is observed. The subjective effects – which last approximately four hours – are highly variable and often difficult to describe, but can include:
Intense closed and open eye visuals
Re-experiencing of memorable events
Distortions in sense of time, place, and sometimes sense of self
Possible auditory and sensory hallucinations
A deep state of introspection
Profound spiritual experiences
Perceived contact and interaction with other entities
Temporary alterations in mood and emotion that can range from terror to euphoria.
‘Autobiographical’ elements of content are often reported by those experiencing ayahuasca-induced visuals. The resurgence of memories, and a ‘third person’ perspective on life events have frequently been reported.
The psychedelic effects may be preceded by nausea, vomiting, and sometimes diarrhoea. This emetic action is perceived of as a cathartic expulsion in traditional settings, and is welcomed as part of the overall experience.
Is Ayahuasca addictive, and what are the long-term effects?
Ayahuasca, like the other classical psychedelic drugs, is not addictive. Despite the documented (and further anecdotal) benefits, the trip process can be unpleasant and difficult, and therefore does not lend itself to regular use. Psychedelics in general also demonstrate a pharmacological mechanism of short-term reduced efficacy (tolerance) which inhibits their prolonged or frequent use. In fact, ayahuasca is valued for its anti-addictive properties and its potential role in supporting those with dependency on other substances is being explored.
Harm Reduction and Drug-Drug Interactions
If you've already decided to use ayahuasca, there are several precautions worth taking to reduce risk. Adequate supervision is strongly advised, ideally from someone who is both sober and experienced with the psychedelic state and can support you through any challenging moments. In a retreat setting, pay attention to screening processes, preparation, supervision arrangements, integration support, and independent reviews from previous participants where available. The setting itself should be as comfortable, secure and free of interruptions as possible. Any pre-existing conditions or medications should be discussed with a physician wherever possible.
Ayahuasca should not be combined with alcohol or other drugs. Amphetamines in particular should be avoided, since their hypertensive effect combined with the MAOIs in ayahuasca could in theory prove fatal, though this specific combination does not appear to be documented in the ayahuasca literature itself. More broadly, serotonergic medications and drugs, including SSRIs, tramadol and dextromethorphan, carry a documented risk of severe serotonin toxicity when combined with the MAOIs in ayahuasca, producing agitation, hyperreflexia and autonomic instability in reported cases; this combination should be avoided entirely. A standard low-tyramine diet is also generally recommended around the time of use, given ayahuasca's inherent MAOI content.
Ayahuasca is commonly used in traditional settings alongside other ethnobotanical or naturally derived psychoactive substances, including tobacco (as rapé or mapacho), kambo (from the kambo frog), 5-MeO-DMT (from the Bufo Alvarius toad), peyote (mescaline cactus), psilocybin mushrooms, and yopo seeds (which contain N,N-DMT, 5-MeO-DMT and bufotenine). Caution is warranted even where these are presented as a normal part of a retreat programme. While there is little anecdotal evidence of harm, few studies have examined the clinical implications of taking these substances in close proximity to one another.
Medical Uses
Emerging research into ayahuasca's effects on brain function points to some genuinely positive effects on mental wellbeing. Preliminary clinical observations suggest anxiolytic and antidepressant effects, alongside reductions in suicidality among people with treatment-resistant depression. A Brazilian Phase II randomised controlled trial in treatment-resistant depression found large antidepressant effects, and a separate placebo-controlled trial from Imperial College London using a single intravenous dose of synthetic DMT in moderate to severe depression, published in a major medical journal in 2026, reported a significantly larger drop in depression scores than placebo, with the effect persisting at three months and, for some participants, out to six months, and no serious treatment-related side effects. Separately, a first-in-human study testing DMT combined with oral harmine through the nose found this approach greatly reduced nausea while still producing consistent blood levels of the drug, a promising sign for future, gentler delivery methods.
Ayahuasca may also have a role in supporting addiction recovery. Clinical research has found improvements in hopefulness, empowerment, mindfulness, and overall quality of life among people with dependency on other substances, along with reductions in self-reported use of tobacco, alcohol and cocaine. Trials are now also being planned or run for PTSD, and observational, longer-term projects following outcomes after a year have looked specifically at ayahuasca's role in addiction treatment.
The therapeutic potential of ayahuasca has also been documented through its use in religious and ritual practice. It is consumed as a sacrament in several Brazilian syncretic churches, and studies comparing regular churchgoers who consume ayahuasca (typically around twice a month) with members of non-ayahuasca churches have consistently found higher wellbeing scores in the former group.
None of this amounts to an approved medical treatment. Every use of ayahuasca in a clinical or therapeutic sense today remains investigational, off-label or anecdotal, and no health authority has approved ayahuasca or DMT as a therapy for any condition.
Myths and Misconceptions
Ayahuasca is an all-round panacea for physical and mental health
While there are many interesting research avenues being/to be explored, it is dangerous to assume that any one substance can ‘cure’ ailments for which we do not (yet) have an evidence base for. This particularly applies to any choices one may make about rejecting or discontinuing mainstream medical accompaniment. Prescription medication should not be suspended to take part in, or as a result of, an ayahuasca experience without medical guidance.
Ayahuasca is a recreational drug, and ceremonies are "drug-fuelled" gatherings
On the contrary, the taking of ayahuasca is often referred to as trabajo (‘work’) in traditional contexts. From the nausea and vomiting, to the solitary introspection and the potentially challenging emotional experiences, it is not considered an easy or reliably pleasant activity. It is not therefore used as a recreational substance and is rarely taken at parties, festivals and nightclubs.
History, Research, and Legal Status
Ayahuasca's roots stretch back millennia among Amazonian tribes, but its chemistry only entered Western scientific awareness in the mid-20th century. Hungarian chemist Stephen Szára was the first to synthesise DMT, in 1956, and self-administered it himself, documenting its vivid effects. Ethnobotanists such as R. Evans Schultes brought wider academic attention to the brew from the 1940s onward, though traditional use remained largely undocumented in Western science for decades. DMT was placed under international Schedule I control in 1971, which significantly slowed research for years, even as the Santo Daime and União do Vegetal churches continued incorporating ayahuasca into syncretic religious ritual, and Brazil formally exempted ayahuasca for religious use in 1987.
Research picked back up gradually from the late 1990s, with early work establishing the safety of harmine in humans and clarifying how the MAOI interaction works, followed by controlled pharmacology and brain imaging studies in the early 2000s. A genuine research renaissance took hold through the 2010s, with open-label depression trials, the first placebo-controlled randomised trial in 2019, and, in 2026, the first controlled trial of a DMT infusion for depression, all contributing to a much more sophisticated evidence base than existed even a decade earlier. Legally, a landmark 2006 US Supreme Court ruling allowed the União do Vegetal church to use ayahuasca sacramentally, with a further injunction protecting the Santo Daime church in 2009.
Despite this growing research base, ayahuasca and DMT remain tightly restricted almost everywhere. In the UK, DMT is a Class A drug, making the ayahuasca brew illegal to possess, supply or produce. In the United States it is Schedule I, illegal outside the specific religious exemptions described above. Within the EU there is no single unified approach. Spain, for example, tolerates ceremonial ayahuasca use under religious exemption, while Germany and France enforce outright bans. Brazil remains the clearest exception, explicitly permitting ayahuasca in religious contexts since 1987. Australia and New Zealand both prohibit DMT outright, while Canada lists it as a controlled substance but granted a specific legal exemption to a Santo Daime church in 2017. No health authority anywhere has approved ayahuasca or DMT as a medical therapy, and any path toward that would likely require a standardised pharmaceutical formulation and a full late-stage clinical trial programme, none of which currently exists.
Ayahuasca has a long history of ceremonial use among indigenous populations across the region, in countries including Bolivia, Ecuador and Peru, where it is regarded as an important element of shamanic tradition and medicine, typically consumed under the guidance of a shaman sought out for healing physical, emotional and psychological issues. More recently, its psychedelic properties and therapeutic potential have drawn considerable attention in the West, alongside a fast-growing tourism sector built around ayahuasca retreats for international visitors. Ayahuasca is also increasingly used outside traditional retreats and ceremonies, partly due to the online availability of the plants involved. This shift has raised real concerns about the impact on traditional communities where these plants grow, and about the risks of unsupervised use outside a ceremonial or clinical context.
