Ayahuasca and Dimethyltryptamine Adverse Events and Toxicity Analysis: A Systematic Thematic Review.
Eleanor White, Tom Kennedy, Simon Ruffell, Daniel Perkins, Jerome Sarris
International journal of toxicology 2024 DOI: 10.1177/10915818241230916 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic thematic review Randomized Peer reviewed |
|---|---|
| Sample size | 78 |
| Population | Human, animal models |
| Topics | Ayahuasca DMT 5-MeO-DMT |
| Keywords | Adverse events Hallucinogens Ayahuasca safety: ayahuasca Good safety profile Acceptable safety Traditional use Psychedelic toxicology: psychedelic Positive toxicology findings Serious issues DMT Research: Dimethyltryptamine |
| Citations | 13 |
| Key findings | Ayahuasca and DMT are generally safe in controlled settings, with serious adverse effects rarely reported in healthy populations, though higher doses in animal models show potential toxicity. |
Abstract
The objective of this paper is to conduct a systematic thematic review of adverse events, safety, and toxicity of traditional ayahuasca plant preparations and its main psychoactive alkaloids (dimethyltryptamine [DMT], harmine, harmaline, and tetrahydroharmine), including discussing clinical considerations (within clinical trials or approved settings). A systematic literature search of preclinical, clinical, epidemiological, and pharmacovigilance data (as well as pertinent reviews and case studies) was conducted for articles using the electronic databases of PubMed and Web of Science (to 6 July 2023) and PsycINFO, ClinicalTrials.gov, and Embase (to 21 September 2022) and included articles in English in peer-reviewed journals. Additionally, reference lists were searched. Due to the breadth of the area covered, we presented the relevant data in a thematic format. Our searches revealed 78 relevant articles. Data showed that ayahuasca or DMT is generally safe; however, some adverse human events have been reported. Animal models using higher doses of ayahuasca have shown abortifacient and teratogenic effects. Isolated harmala alkaloid studies have also revealed evidence of potential toxicity at higher doses, which may increase with co-administration with certain medications. Harmaline revealed the most issues in preclinical models. Nevertheless, animal models involving higher-dose synthetic isolates may not necessarily be able to be extrapolated to human use of therapeutic doses of plant-based extracts. Serious adverse effects are rarely reported within healthy populations, indicating an acceptable safety profile for the traditional use of ayahuasca and DMT in controlled settings. Further randomized, controlled trials with judicious blinding, larger samples, and longer duration are needed.
Comparable studies
Other narrative reviews on 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 | |
| Pharmahuasca: Human Pharmacology of Oral DMT Plus Harmine Human self-experimenters | 1999 | Review | n = 8 |
| The psychedelic model of schizophrenia: the case of N,N- dimethyltryptamine | 1976 | Review |
Citations in the library
Cited by 12
- Ayahuasca-assisted meaning reconstruction therapy as an early resource for bereavement: a non-randomized clinical trial. Scientific Reports September 1, 2025
- DMT and harmala alkaloids: an exploratory study of oral Acacia based formulations in healthy volunteers. Frontiers in Psychiatry August 15, 2025
- Fatalities following DMT use: Two case reports and a review of the literature. Journal of Analytical Toxicology July 9, 2025
- Opinion Mining of Erowid's Experience Reports on LSD and Psilocybin-Containing Mushrooms. Drug safety May 1, 2025
- A new insight into ayahuasca's adverse effects: Reanalysis and perspectives on its mediating role in mental health from the Global Ayahuasca Survey (GAS). PLOS mental health 2025
and 7 more in the library
Cites 54
- Causal association between cannabis and psychosis: examination of the evidence The British Journal of Psychiatry January 30, 2004
- The Hallucinogen N,N -Dimethyltryptamine (DMT) Is an Endogenous Sigma-1 Receptor Regulator Science February 13, 2009
- Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression Journal of Clinical Psychopharmacology December 11, 2015
- Monoamine oxidase inhibitors in South American hallucinogenic plants: Tryptamine and β-carboline constituents of Ayahuasca Journal of Ethnopharmacology April 1, 1984
- Human Pharmacology of Ayahuasca: Subjective and Cardiovascular Effects, Monoamine Metabolite Excretion, and Pharmacokinetics Journal of Pharmacology and Experimental Therapeutics June 18, 2003
and 49 more in the library