Ayahuasca-Induced Serotonin Syndrome: Risks, Mechanisms, and Clinical Considerations
Pharmaceutical science. August 1, 2025 DOI: 10.5772/intechopen.1011742 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Ayahuasca Serotonin |
| Keywords | Serotonin syndrome Ecology |
| Key findings | Argues that ayahuasca shows potential therapeutic benefits including antidepressant, anxiolytic, anti-inflammatory, and neuroplastic effects, but requires controlled clinical research to establish safety and efficacy. |
Abstract
Ayahuasca is a traditional Amazonian brew composed primarily of Banisteriopsis caapi and Psychotria viridis, drawing increasing interest for its psychedelic effects and potential therapeutic applications. Its pharmacological action is based on the synergistic combination of β-carbolines (harmine, tetrahydroharmine, and harmaline), which act as reversible inhibitors of monoamine oxidase A (MAO-A), and N,N-dimethyltryptamine (DMT), a serotonergic agonist at 5-HT2A, 5-HT2C, and 5-HT1A receptors. This interaction enables DMT to reach active levels in the central nervous system by preventing gastrointestinal degradation. Preclinical studies and early clinical trials suggest antidepressant, anxiolytic, anti-inflammatory, and neuroplastic benefits, with no evidence of dependence or significant tolerance. Nonetheless, risks remain, including psychotic episodes, hazardous interactions with SSRIs, and the potential for serotonin syndrome. Adverse events such as nausea, vomiting, and cardiovascular changes must be considered. Although the current data are promising, controlled clinical research is essential to establish the safety, efficacy, and toxicological profile of ayahuasca in therapeutic contexts.