A 51-year-old woman with no personal psychiatric history and no reported substance use developed a manic episode of about two months' duration that worsened in the week before admission. Her husband found her locked inside her destroyed hair salon, and the previous night she had nearly set the house on fire by ritually burning objects. Over the past three years she had regular contact with a seer and had been invited to at least three Ayahuasca healing rituals, which coincided in time with two psychotic episodes—one in her son and one in her own. She denied participating in the rituals, but her husband confirmed she attended the most recent one on the weekend before admission and had visited the seer every Monday for three years.
A 33-year-old British man with no personal or family history of mental illness consumed ayahuasca during a spiritual retreat seeking emotional relief. He developed severe anxiety leading to a psychotic episode with hallucinations, delusions, and disorganization, requiring involuntary hospitalization. Treatment with olanzapine 10 mg daily resolved symptoms within days. The authors conclude ayahuasca is a highly dangerous psychoactive beverage with notable cognitive and psychiatric effects, warranting extreme caution.