Skip to content

Rafael G Dos Santos

Departamento de Neurociências e Comportamento, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.

14 papers in the library · 287 citations · publishing 0-2026

Papers

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.

Psychopharmacology February 1, 2021 Richard J Zeifman, Nikhita Singhal, Rafael G Dos Santos et al. 79 citations

Suicidality is a major public health problem with few treatment options. In an open-label trial, 17 adults with recurrent major depressive disorder received a single dose of ayahuasca. Among the 15 who had suicidality at baseline, suicidality decreased acutely (within 40 to 180 minutes after administration) and remained lower at 1, 7, 14, and 21 days afterward. Post-acute effect sizes were large (Hedges' g = 1.31–1.75), with the largest effect at 21 days (g = 1.75). When administered in an appropriate context, ayahuasca may produce rapid and sustained reductions in suicidality. The authors call for randomized, double-blind studies with larger samples to confirm these early findings.

Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies.

European archives of psychiatry and clinical neuroscience June 1, 2022 Lucas Silva Rodrigues, Giordano Novak Rossi, Juliana Mendes Rocha et al. 48 citations

Ayahuasca and its alkaloids show therapeutic potential for substance use disorders, according to an updated systematic review of nine studies (four preclinical, five observational) published between 2016 and 2020. Preclinical rodent studies found reductions in amphetamine self-administration, anxiety, and conditioned place preference for alcohol and methylphenidate. Observational studies in healthy ritual ayahuasca users and patients with substance use disorders reported decreased drug use, anxiety, and depression, along with improved quality of life and well-being. The review replicates earlier findings but notes limited translation from animal studies, inability to infer causality from observational designs, and lack of dose standardization. Randomized controlled trials are needed.

The adverse events of ibogaine in humans: an updated systematic review of the literature (2015-2020).

Psychopharmacology June 1, 2022 Genís Ona, Juliana Mendes Rocha, José Carlos Bouso et al. 41 citations

Ibogaine, a hallucinogenic and psychostimulant alkaloid from the African shrub Tabernanthe iboga, is known for its anti-addictive properties, but its use is associated with serious adverse events and fatalities. A systematic review of 18 studies from 2015 to 2020 found highly heterogeneous results regarding the product used and dosages. Adverse events were classified as acute effects (within 24 hours) and persistent cardiac, psychiatric, and neurological alterations. The review highlights the need for phase I clinical trials to establish safety for standardized ibogaine products, and for research to identify vulnerable populations and develop effective screening and clinical procedures.

Ayahuasca-enhanced extinction of fear behaviour: Role of infralimbic cortex 5-HT2A and 5-HT1A receptors.

British journal of pharmacology June 1, 2024 Isabel Werle, Laura M M Nascimento, Aymee L A Dos Santos et al. 21 citations

A single oral dose of ayahuasca containing 0.3 mg/kg of DMT increased within-session extinction of contextual freezing behavior in rats without affecting recall; two consecutive daily doses enhanced extinction recall. These effects occurred for both 1- and 21-day-old memories in males and females, independent of changes in anxiety or general exploratory activity. Blocking 5-HT2A receptors in the infralimbic cortex prevented within-session extinction, while blocking 5-HT1A receptors prevented between-session extinction. The findings highlight complementary mechanisms by which ayahuasca facilitates behavioral suppression of aversive memories, suggesting potential benefits for stress-related disorders.

Identifying setting factors associated with improved ibogaine safety: a systematic review of clinical studies.

European archives of psychiatry and clinical neuroscience October 1, 2023 Juliana Mendes Rocha, José A S Reis, José Carlos Bouso et al. 21 citations

Ibogaine, a psychoactive alkaloid from the west-African shrub Tabernanthe iboga, is increasingly sought in Western cultures for its claimed anti-addictive properties, though evidence remains preliminary. Its use often occurs without medical supervision in uncontrolled settings and has been linked to severe adverse events. This systematic review evaluated clinical studies of ibogaine, focusing on administration settings to identify criteria promoting safer use. Following PRISMA guidelines, searches in PubMed, Scielo, ClinicalTrials.gov, and Core.ac.uk retrieved clinical studies published through November 17, 2022; 12 sources were synthesized. The review concludes that controlled settings with trained professionals and equipment for rigorous medical, psychiatric, and cardiac monitoring are essential for patient safety.

Main targets of ibogaine and noribogaine associated with its putative anti-addictive effects: A mechanistic overview.

Journal of psychopharmacology (Oxford, England) December 1, 2023 Genís Ona, Ingrid Reverte, Giordano N Rossi et al. 20 citations

Ibogaine and its main metabolite, noribogaine, modulate several brain targets associated with substance use disorders. Rather than having a single key mechanism, their anti-addictive action appears to arise from a complex modulation of multiple receptor systems, creating potential beneficial synergies. This understanding comes from a review of theoretical and experimental studies published up to July 2022. The authors suggest that future research should apply polypharmacology approaches to better describe the multifaceted patterns of this multi-target drug, which could guide both mechanistic and therapeutic studies.

Underground ibogaine use for the treatment of substance use disorders: A qualitative analysis of subjective experiences.

Drug and alcohol review February 1, 2023 Borja J Rodríguez-cano, Maja Kohek, Genís Ona et al. 17 citations

Ibogaine, a psychoactive alkaloid from the Tabernanthe iboga plant traditionally used in Bwiti culture, has been used experimentally to treat substance use disorders (SUD) since 1962. Interviews with 13 people who self-treated their SUD with ibogaine revealed that the drug's therapeutic benefits arise not only from its pharmacology but also from the subjective experience it induces. Participants reported that ibogaine evoked interpersonal and transpersonal experiences, autobiographical memories, and personal insights. These effects, along with preparation, integration, and motivation for lifestyle change, appear to help individuals cope with their SUD, particularly given limited alternative treatment options.

The effects of ketamine and classic hallucinogens on neurotrophic and inflammatory markers in unipolar treatment-resistant depression: a systematic review of clinical trials.

European archives of psychiatry and clinical neuroscience February 1, 2023 Giordano Novak Rossi, Jaime E C Hallak, Glen Baker et al. 14 citations

A systematic review of clinical trials examined whether the antidepressant effects of ketamine and classical hallucinogens (ayahuasca) in treatment-resistant depression are linked to changes in inflammatory and neurotrophic biomarkers. Twelve studies involving 587 participants were analyzed, including two with oral ayahuasca and ten with ketamine. Results across all measured biomarkers were contradictory and inconclusive. The authors conclude that larger randomized controlled trials are needed to determine whether peripheral biomarkers can reliably indicate or measure the antidepressant effects of these substances.

Interactive Effects of Ayahuasca and Cannabidiol in Social Cognition in Healthy Volunteers: A Pilot, Proof-of-Concept, Feasibility, Randomized-Controlled Trial.

Journal of clinical psychopharmacology Giordano Novak Rossi, Juliana Mendes Rocha, Flávia L Osório et al. 12 citations

In a small preliminary trial, ayahuasca—with or without a 600 mg dose of cannabidiol (CBD) given 90 minutes beforehand—did not produce interactive effects on emotion recognition or empathy tasks. Both groups showed faster reaction times on these tasks and reported reduced anxiety, sedation, and discomfort, but there were no differences between the group that received CBD and the one that did not. Ayahuasca was well tolerated, causing mainly nausea and gastrointestinal discomfort, with no clinically significant changes in heart or liver measures. The safety of the combination suggests that both drugs could be tested in larger trials for anxiety disorders.

Hallucinations and Hallucinogens: Psychopathology or Wisdom?

Culture, medicine and psychiatry June 1, 2023 José Carlos Bouso, Genís Ona, Maja Kohek et al. 8 citations

Hallucinations are not exclusively tied to psychopathology; they also occur in healthy individuals and, in certain contexts such as those induced by hallucinogenic drugs, can improve mental health. Historical, epidemiological, and scientific evidence suggests hallucinations are a common phenomenon that can be functional and beneficial. The authors argue that hallucinations can provide a privileged route to understanding the mind and the world, a shift that could impact drug policy, civil law, psychiatry, and reduce stigma around mental disorders.

Psychedelic Medicines in Major Depression: Progress and Future Challenges.

Advances in experimental medicine and biology January 1, 2021 Jose Carlos Bouso, Genís Ona, Rafael G Dos Santos et al. 6 citations

Research on psychedelic drugs for therapeutic use has grown, driven by the need for innovative psychiatric treatments. Clinical trials have assessed psilocybin and ayahuasca for mental disorders including major depression. This chapter reviews the history and terminology of psychedelic research, analyzes recent clinical trials administering these drugs to patients, describes neurobiological mechanisms that may underlie therapeutic effects, and notes that psychedelics are commonly used as adjuncts to psychotherapy. The chapter concludes by suggesting future challenges for this field.

Classic psychedelics and personality: An updated systematic review.

Journal of psychopharmacology (Oxford, England) May 31, 2026 Anna Beatriz Vicentini, Caio César De Paula, José Augusto Silva Reis et al.

A systematic review of 48 studies (14 experimental, 34 observational) covering 2016–2024 found that classic psychedelics—such as psilocybin and ayahuasca—most consistently increase the personality trait Openness and reduce Neuroticism. Changes in Extraversion, Agreeableness, and Conscientiousness were more variable. Microdosing was linked to modest reductions in Neuroticism and higher Absorption. Most studies used the Five-Factor Model. The findings suggest psychedelics can promote lasting personality changes, but contradictory results remain, and future research should combine experimental and naturalistic designs with longer follow-ups.

Effects of ayahuasca on neuropsychological performance and social cognition: A systematic review.

Journal of psychopharmacology (Oxford, England) March 9, 2026 Caio César De Paula, Anna Beatriz Vicentini, Lorena Terene Lopes Guerra et al.

A systematic review of 16 studies found that ayahuasca has distinct short- and long-term cognitive effects. In the short term, improvements in working memory and cognitive flexibility were observed, linked to neurochemical modulation of cortical networks. Observational studies reported increased empathy and emotion recognition, while experimental studies only found reduced reaction times in social cognition tasks. Long-term studies generally found no neuropsychological deficits, with some reporting improved memory and executive function. The review notes methodological limitations including small sample sizes, varied protocols, and potential learning effects, calling for more controlled, randomized studies.

Ayahuasca modulation of traumatic-like fear memories requires infralimbic cortex BDNF-dependent mechanisms in rats.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology February 1, 2026 Isabel Werle, Francisco S Guimarães, Rafael G Dos Santos et al.

Ayahuasca, a brew containing the psychedelic DMT, helps rodents overcome persistent and generalized fear memories by boosting brain-derived neurotrophic factor (BDNF) signaling in the infralimbic (IL) region of the medial prefrontal cortex. In rats exposed to stress or high-intensity fear conditioning, repeated ayahuasca (0.3 mg/kg DMT) enhanced extinction learning and its retention, and reduced fear generalization. These effects were blocked by infusing an anti-BDNF antibody or a TrkB receptor antagonist into the IL cortex. The reduction in fear generalization depended on BDNF in females but not males. The findings suggest psychedelics may aid in treating difficult-to-extinguish trauma memories, such as those in PTSD.