A new insight into ayahuasca's adverse effects: Reanalysis and perspectives on its mediating role in mental health from the Global Ayahuasca Survey (GAS).
Óscar Andión, José Carlos Bouso, Jerome Sarris, Luís Fernando Tófoli, Emérita Sátiro Opaleye, Daniel Perkins
PLOS mental health 2025 DOI: 10.1371/journal.pmen.0000097 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional survey Peer reviewed |
|---|---|
| Sample size | 10,836 |
| Population | Participants in the Global Ayahuasca Survey |
| Intervention | Ayahuasca |
| Duration | Data collected from March 1st, 2017, to December 31st, 2019 |
| Topics | Ayahuasca |
| Citations | 1 |
| Key findings | A history of anxiety or depression is associated with more adverse mental states after ayahuasca use, but some adverse-like experiences may contribute to long-term psychological benefits. |
Abstract
Ayahuasca is a decoction native to the Amazon, where it plays a central role in the traditional medicine of many local cultures and has expanded internationally over the last decades. Ayahuasca has also attracted the interest of scientists for its potential benefits on mental health, but its adverse effects are under-researched. We analyzed data from the Global Ayahuasca Survey, including 10,836 participants who rated predetermined adverse effects. Data were collected from March 1st, 2017, to December 31st, 2019, and accessed for analysis on November 30th, 2021. Only DP and JJS had access to identifiable participant data. Machine learning and statistical methods were used to examine the relationship between sample characteristics, post-ayahuasca adverse mental states, and mental health outcomes measured by the 12-Item Short Form Survey (SF-12). Among participants, 14.2% (767) had a prior anxiety disorder and 19.7% (1,064) a depressive disorder. Despite this, the median SF-12 score was 50.16, comparable to the general population. A history of anxiety or depression was associated with more adverse mental states after ayahuasca use. However, increased experiences of "visual distortions" and higher ayahuasca use correlated with better mental health. Women reported more adverse states but did not show worsened mental health. The classification of adverse mental states in psychedelic research should be reconsidered, as certain experiences traditionally labeled as negative may contribute to long-term psychological benefits. The context in which these experiences occur, along with individual factors, plays a crucial role in determining whether these states lead to positive or negative outcomes. Understanding these dynamics is essential for improving harm reduction strategies and maximizing therapeutic potential. Individuals with a history of depression require special attention, as they are more prone to experiencing post-ayahuasca adverse mental states and may benefit from additional psychological support.
Comparable studies
Other cross-sectional and survey studies on ayahuasca, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Survey of subjective "God encounter experiences": Comparisons among naturally occurring experiences and those occasioned by the classic psychedelics psilocybin, LSD, ayahuasca, or DMT Adults reporting a single most memorable God encounter experience, either nondrug or... | 2019 | Cross-sectional survey | n = 4,285 |
| Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey. Ayahuasca users from more than 50 countries who completed an online survey | 2022 | Cross-sectional survey | n = 10,836 |
| Ayahuasca in adolescence: a preliminary psychiatric assessment. Adolescents from a Brazilian ayahuasca sect and matched controls | 2005 | Controlled cross-sectional study | n = 80 |
| Psychological and neuropsychological assessment of regular hoasca users. Regular hoasca users from a U.S. branch of União do Vegetal and matched non-user controls | 2016 | Cross-sectional study | n = 57 |
| Indoleamine Hallucinogens in Cluster Headache: Results of the Clusterbusters Medication Use Survey People with cluster headache | 2015 | Cross-sectional survey | n = 496 |
Citations in the library
Cited by 2
- Adverse reactions to psychedelics in naturalistic settings are associated with current psychopathology and well-being: A correlational study Psychiatry Research October 1, 2026
- Symmetrical Global Mental Health (Sym-GMH): Ayahuasca and shipibo traditional medicine for lasting changes in personality and quality of life Psychedelics April 20, 2026
Cites 68
- Psilocybin occasioned mystical-type experiences: immediate and persisting dose-related effects. Psychopharmacology December 1, 2011
- Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial Psychological Medicine June 15, 2018
- The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects. ACS Pharmacology & Translational Science December 10, 2020
- Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors Journal of Psychopharmacology October 11, 2017
- Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report Brazilian Journal of Psychiatry March 1, 2015
and 63 more in the library