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Rapid and sustained decreases in suicidality following a single dose of ayahuasca among individuals with recurrent major depressive disorder: results from an open-label trial.

Richard J. Zeifman, Nikhita Singhal, Rafael G. Dos Santos, Rafael F Sanches, Flávia de Lima Osório, Jaime E. C. Hallak, Cory R. Weissman

Psychopharmacology February 1, 2021 DOI: 10.1007/s00213-020-05692-9 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Open-label trial (secondary analysis) Randomized Double-blind Peer reviewed
Sample size 17
Population Individuals with recurrent major depressive disorder
Intervention Ayahuasca
Dose single dose
Duration 21-day follow-up
Topics Ayahuasca Depression
Keywords Intervention Suicidality
Citations 79
Key findings Among individuals with suicidality at baseline, a single dose of ayahuasca was associated with rapid and sustained decreases in suicidality over 21 days, with large effect sizes.

Abstract

Suicidality is a major public health concern with limited treatment options. Accordingly, there is a need for innovative interventions for suicidality. Preliminary evidence indicates that treatment with the psychedelic ayahuasca may lead to decreases in depressive symptoms among individuals with major depressive disorder (MDD). However, there remains limited understanding of whether ayahuasca also leads to reductions in suicidality. To examine the acute and post-acute effect of ayahuasca on suicidality among individuals with MDD. We conducted a secondary analysis of an open-label trial in which individuals with recurrent MDD received a single dose of ayahuasca (N = 17). Suicidality was assessed at baseline; during the intervention; and 1, 7, 14, and 21 days after the intervention. Among individuals with suicidality at baseline (n = 15), there were significant acute (i.e., 40, 80, 140, and 180 min after administration) and post-acute (1, 7, 14, and 21 days after administration) decreases in suicidality following administration of ayahuasca. Post-acute effect sizes for decreases in suicidality were large (Hedges' g = 1.31-1.75), with the largest effect size 21 days after the intervention (g = 1.75). When administered in the appropriate context, ayahuasca may lead to rapid and sustained reductions in suicidality among individuals with MDD. Randomized, double-blind studies with larger sample sizes are needed to confirm this early finding.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

  • Among individuals with baseline suicidality, a single dose of ayahuasca was associated with rapid and sustained decreases in suicidality over 21 days, with large effect sizes (Hedges' g = 1.31-1.75).

    Synthesized

Comparable studies

Other non-randomized and open-label trials on ayahuasca for depression, most cited first.

Study Year Design Participants
Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression Patients with recurrent depression 2015 Open-label trial n = 17
Pilot Evaluation of a Residential Drug Addiction Treatment Combining Traditional Amazonian Medicine, Ayahuasca and Psychotherapy on Depression and Anxiety Male patients in an inpatient addiction treatment program 2020 Pre-post observational study n = 31
Long-term effects of ayahuasca in patients with recurrent depression: a 5-year qualitative follow-up Patients with treatment-resistant major depressive disorder who had participated in an... 2018 Long-term follow-up of an open-label trial n = 8
A quantitative textual analysis of the subjective effects of ayahuasca in naïve users with and without depression. Nine patients with treatment-resistant depression and twenty healthy individuals 2023 Qualitative study with quantitative textual analysis of open-ended responses from a previous clinical trial n = 29

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