The pharmacological interaction of compounds in ayahuasca: a systematic review

Ayahuasca, a South American psychoactive plant brew used in traditional spiritual and cultural rituals, has been studied primarily for the prevention of deamination of N,N-dimethyltryptamine (DMT) by monoamine oxidase inhibitors (MAOIs) in the brew. Two constituents, DMT and harmine, have received more research attention than secondary harmala alkaloids. Current evidence suggests that the pharmacological interactions in ayahuasca may act synergistically or additively to produce psychoactive effects, but the understanding of these synergistic mechanisms is limited and more complex processes may be involved. There is not yet enough data to determine any potential synergistic interaction between the known compounds, and increased pharmacological understanding is needed to avoid potential risks.

Study at a glance

Abstract

Ayahuasca is a South American psychoactive plant brew used as traditional medicine in spiritual and in cultural rituals. This is a review of the current understanding about the pharmacological mechanisms that may be interacting in ayahuasca. Searches were performed using PubMed, PsycINFO, and Web of Science databases and 16 papers were selected. As hypothesized, the primary narrative in existing research revolved around prevention of deamination of N,N-dimethyltryptamine (N,N-DMT, also referred to as DMT) by monoamine oxidase inhibitors (MAOIs) in ayahuasca. Two of the constituents, DMT and harmine, have been studied more than the secondary harmala alkaloids. At present, it is unclear whether the pharmacological interactions in ayahuasca act synergistically or additively to produce psychoactive drug effects. The included studies suggest that our current understanding of the preparation's synergistic mechanisms is limited and that more complex processes may be involved; there is not yet enough data to determine any potential synergistic interaction between the known compounds in ayahuasca. Our pharmacological understanding of its compounds must be increased to avoid the potential risks of ayahuasca use.