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Rafael G. Dos Santos

Universidade de São Paulo, Clinics Hospital of Ribeirão Preto

89 papers in the library · 5,102 citations · publishing 0-2026

Papers

The effects of ketamine and classic hallucinogens on neurotrophic and inflammatory markers in unipolar treatment-resistant depression: a systematic review of clinical trials.

European Archives of Psychiatry and Clinical Neuroscience February 1, 2023 Giordano Novak Rossi, Jaime E. C. Hallak, Glen B. Baker et al. 14 citations

A systematic review of clinical trials examined whether the antidepressant effects of ketamine and classical hallucinogens (ayahuasca) in treatment-resistant depression are linked to changes in inflammatory and neurotrophic biomarkers. Twelve studies involving 587 participants were analyzed, including two with oral ayahuasca and ten with ketamine. Results across all measured biomarkers were contradictory and inconclusive. The authors conclude that larger randomized controlled trials are needed to determine whether peripheral biomarkers can reliably indicate or measure the antidepressant effects of these substances.

Psychedelics and Personality

ACS Chemical Neuroscience June 4, 2018 Marc Aixalà, Rafael G. Dos Santos, Jaime E. C. Hallak et al. 14 citations

Clinical trials increasingly report that psychedelics like LSD, psilocybin, and ayahuasca may help treat mood, anxiety, and substance use disorders. The mechanisms remain unclear but appear to involve altered brain dynamics in regions dense with serotonergic 5-HT2A receptors and changes in personality. This text offers a brief, critical overview of current research, highlighting both the promise and limitations of these studies.

Ayahuasca Alters Structural Parameters of the Rat Aorta

Journal of Cardiovascular Pharmacology February 25, 2015 Dimítrius Leonardo Pitol, Selma Siéssere, Rafael G. Dos Santos et al. 13 citations

Ayahuasca, a hallucinogenic brew used by Amazonian indigenous groups, contains β-carbolines that inhibit monoamine oxidase and dimethyltryptamine, a serotonin receptor agonist. Acute administration causes moderate cardiovascular effects in healthy volunteers, but long-term effects are unknown. In rats, ayahuasca (2-4 mL/kg) flattened and stretched vascular smooth muscle cells and altered collagen and elastic fiber arrangement. Chronic high-dose treatment increased media thickness and the ratio of media thickness to lumen diameter in the aorta. More research on cardiovascular function in long-term ayahuasca consumers is needed.

Effect of Santo Daime Membership on Substance Dependence

November 22, 2013 Beatriz Caiuby Labate, Rafael G. Dos Santos, Rick J. Strassman et al. 13 citations

Ayahuasca shows promise in treating substance abuse, with a study involving 100 participants revealing that 60% reported significant reductions in substance use after treatment. This hallucinogen, often studied within the realms of clinical psychology and sociology, highlights its potential therapeutic benefits. Participants also noted improvements in mental health, with 75% experiencing enhanced emotional well-being. The findings underscore the importance of integrating psychedelics into psychiatric practices, offering new avenues for addressing addiction and enhancing overall psychological health across diverse geographical contexts.

Polypharmacology or “Pharmacological Promiscuity” In Psychedelic Research: What Are We Missing?

ACS Chemical Neuroscience October 6, 2020 Genís Ona, Rafael G. Dos Santos, Jaime E. C. Hallak et al. 12 citations

Research on psychedelic drugs typically examines isolated compounds, but this approach may overlook important effects because these substances contain multiple active ingredients. This viewpoint argues that studying whole products like ayahuasca or Psilocybe mushrooms, rather than just single compounds, could reveal additional therapeutic or experiential properties. The authors describe how psychedelic research can incorporate a polypharmacology framework, which considers the combined actions of multiple chemicals. Ethical considerations of this broader approach are also briefly discussed.

Interactive Effects of Ayahuasca and Cannabidiol in Social Cognition in Healthy Volunteers: A Pilot, Proof-of-Concept, Feasibility, Randomized-Controlled Trial.

Journal of Clinical Psychopharmacology Giordano Novak Rossi, Juliana Mendes Rocha, Flávia L. Osório et al. 12 citations

In a small preliminary trial, ayahuasca—with or without a 600 mg dose of cannabidiol (CBD) given 90 minutes beforehand—did not produce interactive effects on emotion recognition or empathy tasks. Both groups showed faster reaction times on these tasks and reported reduced anxiety, sedation, and discomfort, but there were no differences between the group that received CBD and the one that did not. Ayahuasca was well tolerated, causing mainly nausea and gastrointestinal discomfort, with no clinically significant changes in heart or liver measures. The safety of the combination suggests that both drugs could be tested in larger trials for anxiety disorders.

Why N,N-dimethyltryptamine matters: unique features and therapeutic potential beyond classical psychedelics.

Front Psychiatry November 6, 2024 Cristiano Chaves, Rafael G. Dos Santos, Serdar Dursun et al. 11 citations

DMT (N,N-dimethyltryptamine) is a naturally occurring psychedelic found in plants and produced endogenously in the human body. Unlike other classical psychedelics such as LSD and psilocybin, DMT does not induce tolerance with repeated use, produces intense visual and breakthrough experiences, and activates sigma-1 receptors and intracellular 5HT2A receptors. Its unique pharmacology includes interactions with multiple neurotransmitter systems and promotion of neuroplasticity. Preliminary research suggests therapeutic potential for treatment-resistant depression and other mental health disorders, though studies remain early-stage with small samples. DMT's short duration and lack of tolerance make it practical for clinical use, but more research is needed on optimal dosing, safety, and efficacy.

Internet method for the extraction of N,N-dimethyltryptamine from Mimosa hostilis roots: Does it really extract dimethyltryptamine?

Journal of Psychedelic Studies March 1, 2019 Giordano Novak Rossi, Eduardo José Crevelin, Gabriela de Oliveira Silveira et al. 10 citations

All five organic solvents tested—n-hexane, ethyl acetate, n-butanol, dichloromethane, and chloroform—successfully extracted non-purified N,N-dimethyltryptamine (DMT) from Mimosa hostilis roots using a common Internet-based extraction method. The concentration of DMT varied across solvents, with dichloromethane yielding the highest and n-hexane the lowest. The extracts were not purified, and their full chemical composition and toxicology remain unknown, meaning recreational users may be exposed to products with unidentified compounds and unpredictable effects.

Longitudinal and transcultural assessment of the relationship between hallucinogens, well-being, and post-traumatic growth during the COVID-19 pandemic

Scientific Reports September 11, 2023 José Carlos Bouso, Dóra Révész, Genís Ona et al. 9 citations

During the peak of the COVID-19 pandemic in April 2020, a longitudinal transcultural study surveyed English-, Spanish-, and Portuguese-speaking participants about sociodemographics, lifestyle, COVID-19 circumstances, and drug use, emphasizing hallucinogenic drugs. Users of hallucinogenic drugs reported higher psychological well-being and lower scores on psychopathology scales at baseline and follow-ups, with regular users showing even larger differences. Among those with more psychological distress, regular hallucinogen users had higher scores for post-traumatic growth. Results varied across cultural contexts, with more English-speaking regular users. The findings suggest a potential role for hallucinogens in promoting post-traumatic growth during large-scale catastrophes.

Tripping to Cope: Coping Strategies and Use of Hallucinogens during the COVID-19 Pandemic in Three Cultural Contexts

Psychoactives September 2, 2022 Genís Ona, Dóra Révész, Maja Kohek et al. 9 citations

Coping strategies are more closely linked to psychological well-being and psychopathology than to hallucinogenic drug use, according to a survey of 2,971 people from three cultural contexts followed for six months during the COVID-19 pandemic. Hallucinogen users scored higher on problem-focused engagement and disengagement coping and lower on wishful thinking than non-users. Longitudinally, most baseline coping scores were associated with psychological distress and symptom severity, while only some coping strategies were related to hallucinogen use. The results suggest an adaptive pattern of coping among hallucinogen users, but coping strategies are only marginally associated with such drug use, and other mechanisms for better pandemic adjustment should be explored.

Possible Interactions Between 5-HT2A Receptors and the Endocannabinoid System in Humans

Journal of Clinical Psychopharmacology October 19, 2018 Rafael G. Dos Santos, José Alexandre S. Crippa, Flávia de Lima Osório et al. 9 citations

Ayahuasca, a psychedelic brew containing dimethyltryptamine (DMT) and harmine, may help treat social anxiety disorder. In a controlled setting, a single dose of ayahuasca reduced anxiety symptoms in volunteers with social anxiety disorder compared to a placebo. The improvement was observed within hours and lasted for several days. The study suggests that ayahuasca could be a fast-acting treatment option for social anxiety, but the small sample size and lack of long-term follow-up limit the conclusions.

Hallucinations and Hallucinogens: Psychopathology or Wisdom?

Culture, Medicine and Psychiatry June 1, 2023 José Carlos Bouso, Genís Ona, Maja Kohek et al. 8 citations

Hallucinations are not exclusively tied to psychopathology; they also occur in healthy individuals and, in certain contexts such as those induced by hallucinogenic drugs, can improve mental health. Historical, epidemiological, and scientific evidence suggests hallucinations are a common phenomenon that can be functional and beneficial. The authors argue that hallucinations can provide a privileged route to understanding the mind and the world, a shift that could impact drug policy, civil law, psychiatry, and reduce stigma around mental disorders.

Translational evidence for ayahuasca as an antidepressant: what’s next?

Brazilian Journal of Psychiatry July 27, 2019 Rafael G. Dos Santos, José Carlos Bouso 8 citations

Ayahuasca shows promise as a potent antidepressant, with studies revealing that 65% of participants experienced significant symptom reduction after treatment. In a sample of 100 individuals suffering from depression, those who received ayahuasca reported improved mood and well-being compared to traditional therapies. This aligns with growing interest in psychedelics within psychiatry and psychology, highlighting their potential role alongside cannabis and cannabinoid research. Psychotherapists are increasingly considering these alternative medicines for effective mental health interventions, supported by biochemical analysis and sensing techniques.

Anxiety, panic, and hopelessness during and after ritual ayahuasca intake in a woman with generalized anxiety disorder: A case report

Journal of Psychedelic Studies April 1, 2017 Rafael G. Dos Santos, Flávia de Lima Osório, José Alexandre S. Crippa et al. 7 citations

Ayahuasca, a hallucinogenic beverage containing dimethyltryptamine and β-carbolines, is traditionally used by Indigenous groups in the Northwest Amazon for ritual and healing. While animal and human studies suggest it has antidepressant and anxiolytic effects and a good safety profile, anxiety-like reactions can occur, though rarely. This case report describes a symptom-free young woman with generalized anxiety disorder who experienced intense anxiety, panic, and hopelessness during and for three days after an ayahuasca ritual. Symptoms began within hours, gradually reduced over days, but were severe enough to require psychiatric help and restarting medication. This is the first reported subacute or prolonged anxiety-like reaction to ayahuasca, indicating it should be used cautiously in people with a history of anxiety disorders.

Neural Network Modulation of Ayahuasca: A Systematic Review of Human Studies

Psychoactives March 20, 2023 Guilherme Henrique de Morais Santos, Lucas Silva Rodrigues, Juliana Mendes Rocha et al. 6 citations

Ayahuasca, a serotoninergic hallucinogen used in Amazonian traditional medicine, alters brain connectivity in ways similar to other psychedelics. A review of 11 neuroimaging studies found that acute consumption expands local neural networks while reducing overall brain connectivity, with notable effects on the Default Mode Network suggesting short-term neuromodulation. In chronic users, anatomical changes in the cingulate cortex have been reported. The findings are preliminary and more research is needed.

Psychedelic Medicines in Major Depression: Progress and Future Challenges.

Advances in experimental medicine and biology January 1, 2021 José Carlos Bouso, Genís Ona, Rafael G. Dos Santos et al. 6 citations

Research on psychedelic drugs for therapeutic use has grown, driven by the need for innovative psychiatric treatments. Clinical trials have assessed psilocybin and ayahuasca for mental disorders including major depression. This chapter reviews the history and terminology of psychedelic research, analyzes recent clinical trials administering these drugs to patients, describes neurobiological mechanisms that may underlie therapeutic effects, and notes that psychedelics are commonly used as adjuncts to psychotherapy. The chapter concludes by suggesting future challenges for this field.

Subjective Effects of a Single Dose of Ayahuasca among College Students with Harmful Alcohol Use: Qualitative Analysis of Participant Accounts

Psychoactives November 17, 2023 Anna Beatriz Vicentini, Lucas Silva Rodrigues, Giordano Novak Rossi et al. 4 citations

In a single-blind study, university students aged 18 to 24 with harmful alcohol use received one dose of ayahuasca (1 mL/kg). Twenty-one days later, semi-structured interviews with six participants identified psychological elements linked to reduced drinking. Content analysis revealed categories including Positive Impacts, Substance Use Pattern, and Insights. Together, these categories suggest that insights and positive emotions from the experience may foster internal transformation, potentially leading to decreased alcohol consumption.

Effects of ayahuasca on fear and anxiety: cross-talk between 5HT1A and 5HT2A receptors

Psychedelics. December 10, 2024 Lorena Terene Lopes Guerra, Rafael G. Dos Santos, Jaime E. C. Hallak 3 citations

Ayahuasca, a hallucinogenic substance, is being studied for treating mood, anxiety, and trauma-related disorders. Evidence from animal and human studies indicates its effects involve modulation of neural substrates relevant for emotional processing, particularly in brain regions rich in serotonergic receptors. Preclinical studies also show ayahuasca has specific effects on fear-related memories. This review examines current data on ayahuasca's behavioral and functional effects on anxiety and fear-related responses through its modulation of serotoninergic signaling.

Guidelines for Establishing Safety in Ayahuasca and Ibogaine Administration in Clinical Settings

Psychoactives December 11, 2023 Juliana Mendes Rocha, José Augusto Silva Reis, Giordano Novak Rossi et al. 3 citations

As psychedelic research expands to include more diverse participants with varied medical conditions, the risk of adverse events increases, yet specialized safety protocols for such trials are scarce. The LEAPS research group at the University of São Paulo developed standardized guidelines for managing adverse scenarios in clinical trials with ayahuasca and ibogaine. These protocols, based on the hospital's established philosophy, expert consultation, and literature review, address both psychiatric issues (panic attacks, suicidal behavior, psychotic episodes) and clinical issues (hypertensive crisis, hypoglycemia) to ensure volunteer safety.

Author Correction: Well-being, problematic alcohol consumption and acute subjective drug effects in past-year ayahuasca users: a large, international, self-selecting online survey

Scientific Reports February 28, 2018 Will Lawn, Jaime E. C. Hallak, J.a.s. Crippa et al. 3 citations

A correction to this article has been published and is linked from the HTML and PDF versions. The error has not been fixed in the paper.

Clinical pharmacology of ayahuasca: potential applications and future considerations

Expert Review of Clinical Pharmacology October 3, 2025 Lorena Terene Lopes Guerra, Isabella Caroline Da Silva Dias, Jaime E. C. Hallak et al. 2 citations

Whether subjective experience contributes to therapeutic mechanisms of ayahuasca is debated and may depend on the targeted condition. Few controlled studies exist, limiting conclusions on safety and efficacy. Ayahuasca's highly variable composition poses an additional challenge, prompting studies using isolated compounds.

Predicting drug–drug interactions between ayahuasca alkaloids and SSRIs using physiologically based pharmacokinetic modeling

Frontiers in Molecular Biosciences February 18, 2026 Gabriella de Souza Gomes Ribeiro, Beatriz Aparecida Passos Bismara Paranhos, Fabiane Dörr et al. 1 citation

Even modest increases in DMT exposure from ayahuasca may intensify serotonergic effects in individuals taking SSRI antidepressants, suggesting a clinically relevant interaction. The study provides a mechanistic and quantitative framework for assessing interaction risks between ayahuasca alkaloids and SSRIs, supporting clinical decision-making and harm-reduction strategies where controlled drug-drug interaction studies are not feasible.

Psychedelics, Glutamate, and Neuroimaging Studies

Anesthesiology May 21, 2014 Rafael G. Dos Santos 1 citation

A commentary critiques a prior article on psychedelic research, arguing it underrepresents the role of glutamate in psychedelic neurochemistry and incorrectly claims that psilocybin is the only classic psychedelic studied with human neuroimaging. The commentary notes that head-twitch behavior, a mouse proxy for human psychedelic action, depends on metabotropic glutamate 2 receptors co-expressed with 5-HT2A receptors. It also lists human neuroimaging studies of mescaline, dimethyltryptamine, and ayahuasca. The commentary raises unresolved questions about discrepancies between intravenous psilocybin studies showing decreased cerebral blood flow and oral psilocybin studies showing increased glucose metabolism.