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 Peer reviewed DOI: 10.1007/s00213-020-05692-9 via PubMed
Summary
Ayahuasca may lead to significant reductions in suicidality among individuals with major depressive disorder (MDD). In a study with 17 participants, those who were suicidal at baseline showed large decreases in suicidality both acutely and post-acutely, with the most substantial effect observed 21 days after treatment. Effect sizes ranged from 1.31 to 1.75, indicating strong improvements over time.
Study at a glance
| Design | open-label trial |
|---|---|
| Sample size | 17 |
| Population | individuals with recurrent major depressive disorder |
| Key finding | Ayahuasca administration resulted in significant acute and sustained reductions in suicidality among individuals with major depressive disorder. |
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.