This review presents recent advances in neuroscience research on psychedelic substances and their psychotherapeutic applications. Psilocybin, a 5-HT2A receptor agonist, has been linked to deactivation of the Default Mode Network, increased access to autobiographical memory, a positive emotional attentional bias, and reductions in anxiety and mood disorder symptoms. MDMA may significantly assist therapy for post-traumatic stress disorder by strengthening the therapeutic alliance and enabling reprocessing of traumatic memories with less avoidance, through oxytocin release and enhanced frontal regulation of the amygdala. Ayahuasca and ketamine have shown initial reductions in problematic use of cocaine, heroin, alcohol, and tobacco, as well as associated craving. Though modern research is recent, initial results encourage further investigation into risks, benefits, and mechanisms.
A 31-year-old woman developed serotonin syndrome after consuming ayahuasca for the first time during an indigenous ritual in Cachipay, Cundinamarca, over two consecutive days in an unknown quantity. Serotonin syndrome is a set of signs and symptoms caused by serotonergic hyperactivity, primarily affecting the central nervous system. The patient received treatment and her condition was adequately controlled. While multiple reports describe psychotic disorders from DMT in ayahuasca, prolonged psychotic symptoms beyond 48 hours are exceptional and have been described in patients with personal or family history of psychosis, mania, hypomania, or psychoactive substance abuse.