Ayahuasca-Induced Serotonin Syndrome: Risks, Mechanisms, and Clinical Considerations
Pharmaceutical science. August 1, 2025 Melissa Ortega
Ayahuasca, a traditional Amazonian brew combining Banisteriopsis caapi and Psychotria viridis, produces psychedelic effects through a synergistic pharmacological action: β-carbolines (harmine, tetrahydroharmine, and harmaline) inhibit monoamine oxidase A, allowing N,N-dimethyltryptamine (DMT) to reach active levels in the central nervous system and act as a serotonergic agonist at 5-HT2A, 5-HT2C, and 5-HT1A receptors. Preclinical studies and early clinical trials suggest antidepressant, anxiolytic, anti-inflammatory, and neuroplastic benefits, with no evidence of dependence or significant tolerance. Risks include psychotic episodes, hazardous interactions with SSRIs, potential serotonin syndrome, nausea, vomiting, and cardiovascular changes. The authors argue that controlled clinical research is essential to establish safety, efficacy, and toxicological profile.