The diagnosis of substance-induced mental disorder lacks specificity. Understanding how ayahuasca acts on the brain—its pharmacodynamic properties—enables a more physiology-based approach to diagnosing a patient's condition.
Classic psychedelics such as LSD, psilocybin, mescaline, and ayahuasca are being studied again for treating unipolar and bipolar depression. They alter sensory perception, emotion, and self-processing by stimulating serotonin 2A receptors in the brain. Psychedelic-assisted psychotherapy integrates a safe psychedelic experience into ongoing therapy. Early randomized trials with psilocybin show promising results for unipolar depression, but classic psychedelics may also trigger mania. Atypical psychedelics like MDMA and ketamine work through different mechanisms; esketamine is approved for treatment-resistant unipolar depression, and ketamine shows early evidence for bipolar depression. Larger trials and careful legal frameworks will determine their broader clinical use.
A flavonoid-rich fraction from red onion husk extract, an agricultural waste product, shows a favorable safety profile in mice and rats and counteracts manic-like symptoms in a ketamine-induced model of mania in Wistar rats. The extract contains 17 bioactive compounds, including five-methyl-2-phenylindolizine, methadone N-oxide, and 3-phenylthiane, S-oxide. Ketamine administration increased oxidative stress markers and suppressed antioxidant enzymes in the cerebral cortex and hippocampus. Pre-treatment with the fraction (25 mg/kg) reduced oxidative stress, partially restored antioxidant enzyme activities, and significantly increased catalase activity, suggesting a compensatory mechanism. It also counteracted ketamine-elevated acetylcholinesterase activity, indicating neuroprotection. The findings suggest potential as a complementary therapy for manic episodes in bipolar disorder, pending further research.