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.
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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.
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 |
Citations in the library
Cited by 76
- Default Mode Network Modulation by Psychedelics: A Systematic Review The International Journal of Neuropsychopharmacology October 21, 2022
- Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms Pharmacological Reviews December 16, 2020
- Acute and Sustained Reductions in Loss of Meaning and Suicidal Ideation Following Psilocybin-Assisted Psychotherapy for Psychiatric and Existential Distress in Life-Threatening Cancer ACS Pharmacology & Translational Science March 18, 2021
- Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta-analysis. Psychiatry Research May 1, 2024
- Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model Frontiers in Psychology June 2, 2022
and 71 more in the library
Cites 21
- Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Journal of Psychopharmacology November 30, 2016
- REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics Pharmacological Reviews June 20, 2019
- Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology November 8, 2017
- Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial Psychological Medicine June 15, 2018
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
and 16 more in the library