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The Impact of Ayahuasca on Suicidality: Results From a Randomized Controlled Trial

Richard J. Zeifman, Fernanda Palhano-Fontes, Jaime E. C. Hallak, Emerson Arcoverde, João Paulo Maia-Oliveira, Dráulio Barros de Araújo

Frontiers in Pharmacology November 19, 2019 DOI: 10.3389/fphar.2019.01325 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Randomized placebo-controlled trial Peer reviewed
Sample size 29
Population Adults with treatment-resistant depression
Intervention Ayahuasca
Dose one dose
Duration 7-day follow-up
Topics Ayahuasca
Keywords Placebo Depression economics Psychological intervention Randomized controlled trial Suicidal ideation Clinical psychology Mental health Poison control Suicide prevention Alternative medicine Medical emergency
Citations 79
Registration NCT02914769
Key findings Ayahuasca produced medium-to-large reductions in suicidality compared with placebo at one, two, and seven days after a single dose, although the group-by-time interaction was not statistically significant.

Abstract

Suicide is a major public health problem. Given increasing suicide rates and limitations surrounding current interventions, there is an urgent need for innovative interventions for suicidality. Although ayahuasca has been shown to target mental health concerns associated with suicidality (i.e., depression and hopelessness), research has not yet explored the impact of ayahuasca on suicidality. Therefore, we conducted secondary analyses of a randomized placebo-controlled trial in which individuals with treatment-resistant depression were administered one dose of ayahuasca (n = 14) or placebo (n = 15). Suicidality was assessed by a trained psychiatrist at baseline, as well as 1 day, 2 days, and 7 days after the intervention. A fixed-effects linear mixed model, as well as between and within-groups Cohen's d effect sizes were used to examine changes in suicidality. Controlling for baseline suicidality, we found a significant effect for time (p p = .088). At all time points, we found medium between-group effect sizes (i.e., ayahuasca vs. placebo; day 1 Cohen's d = 0.58; day 2 d = 0.56; day 7 d = 0.67), as well as large within-group (ayahuasca; day 1 Cohen's d = 1.33; day 2 d = 1.42; day 7 d = 1.19) effect sizes, for decreases in suicidality.

Conclusions: This research is the first to explore the impact of ayahuasca on suicidality. The findings suggest that ayahuasca may show potential as an intervention for suicidality. We highlight important limitations of the study, potential mechanisms, and future directions for research on ayahuasca as an intervention for suicidality. Clinical

Trial Registration: www.ClinicalTrials.gov, identifier NCT02914769.

Comparable studies

Other randomized controlled trials on ayahuasca, most cited first.

Study Year Design Participants
Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial Patients with treatment-resistant depression 2018 Randomized controlled trial n = 29
Human Pharmacology of Ayahuasca: Subjective and Cardiovascular Effects, Monoamine Metabolite Excretion, and Pharmacokinetics Volunteers with prior experience in the use of psychedelics 2003 Double-blind placebo-controlled clinical trial n = 18
Subjective effects and tolerability of the South American psychoactive beverage Ayahuasca in healthy volunteers Healthy male volunteers with prior experience using ayahuasca 2001 Single-blind crossover placebo-controlled clinical trial n = 6
Increased frontal and paralimbic activation following ayahuasca, the pan-amazonian inebriant Male volunteers with prior experience in the use of psychedelics 2006 Randomized controlled trial n = 15
Human brain effects of DMT assessed via EEG-fMRI. Healthy volunteers 2023 Within-subjects, placebo-controlled design n = 20

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