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Psychedelic Therapy: A Primer for Primary Care Clinicians-N,N-Dimethyltryptamine and Ayahuasca.

Kenneth Shinozuka, Burton J. Tabaac, Alejandro Arenas, Bryce D. Beutler, Kirsten Cherian, Viviana D. Evans, Chelsey Fasano, Owen S. Muir

American Journal of Therapeutics DOI: 10.1097/mjt.0000000000001725 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Review Randomized Double-blind Peer reviewed
Interventions Ayahuasca DMT
Topics 5-MeO-DMT Ayahuasca DMT Psychedelic-assisted therapy
Keywords Traditional medicine Psychedelics Mental health Alternative medicine
Citations 12
Key findings Preliminary evidence indicates that ayahuasca and DMT may be more effective than existing antidepressants for treating major depressive disorder and treatment-resistant depression.

Abstract

N,N-dimethyltryptamine (DMT) is a naturally occurring serotonergic psychedelic found in natural plants around the globe. As the main psychoactive component in ayahuasca, which also contains monoamine oxidase inhibitors, DMT has been consumed as plant-based brew by indigenous peoples for centuries. Further research is required to delineate the therapeutic utility of DMT. Although previous research has shown that DMT is synthesized endogenously, it may not be produced at physiologically relevant concentrations. Additionally, the phenomenological similarities between the DMT-induced state and near-death experiences led to the popular hypothesis that endogenous DMT is released during the dying process. However, this hypothesis continues to be debated. Generally, DMT and ayahuasca seem to be physiologically and psychiatrically safe, although ayahuasca is known to cause transient vomiting. A double-blind, randomized controlled trial showed that, within 1 week, ayahuasca causes remission in 36% of patients with treatment-resistant depression. According to top-line results from a recent phase IIa trial, 57% of patients with major depressive disorder experienced remission 12 weeks after receiving a single intravenous dose of DMT. There has only been a single published double-blind randomized controlled trial on ayahuasca and 2 on DMT. All clinical trials have had small sample sizes (≤34 participants). DMT requires further research to understand its therapeutic and clinical potential as a psychedelic. Preliminary evidence indicates that ayahuasca and DMT may be more effective than existing antidepressants for treating major depressive disorder and treatment-resistant depression.

Comparable studies

Other narrative reviews on 5-MeO-DMT, most cited first.

Study Year Design Participants
Neuropharmacology of N,N-dimethyltryptamine 2016 Review
N, N-Dimethyltryptamine (DMT), an Endogenous Hallucinogen: Past, Present, and Future Research to Determine Its Role and Function Humans and animals (general) 2018 Review
Psychedelic 5-methoxy-N,N-dimethyltryptamine: metabolism, pharmacokinetics, drug interactions, and pharmacological actions. Humans (pharmacokinetics) 2010 Review
Dark Classics in Chemical Neuroscience:N,N-Dimethyltryptamine (DMT) 2018 Review
A possibly sigma-1 receptor mediated role of dimethyltryptamine in tissue protection, regeneration, and immunity. 2013 Review

Citations in the library

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5-MeO-DMT Ayahuasca DMT Psychedelic-assisted therapy Depression Near-death experience Philosophy of mind Serotonin