LIBRO COMUNICACIONES
January 1, 2021
Ayahuasca, a brew containing β-carbolines from Banisteriopsis caapi and DMT from Psychotria viridis, shows anxiolytic and antidepressant properties with minimal risk of abuse or dependence. An open-label clinical trial reported therapeutic benefits in patients with major depression after a single dose. An observational study found significant decreases in depressive symptoms in both first-time and regular users, with improvements lasting six months; regular users scored better on depression scales than naive users. A volunteer study associated ayahuasca with reduced abuse of other substances. Adverse reactions include nausea, vomiting, anxiety, and a reported case of induced psychotic episode. More research is needed to clarify mechanisms, benefits, and risks for therapeutic use.
LIBRO COMUNICACIONES
January 1, 2021
Ayahuasca, a traditional Amazonian decoction containing the psychedelic DMT, can trigger psychotic episodes and serotonin syndrome, especially in individuals with a family history of psychosis. A 32-year-old woman with no prior psychiatric history but a first-degree relative with paranoid schizophrenia presented to the emergency department with vomiting, diarrhea, dilated pupils, ataxia, sweating, and tremor—symptoms consistent with serotonin syndrome—along with mystical-religious delusions and visual hallucinations. She denied substance use, and urine toxicology was negative. Only through a family member was it discovered she had been taking ayahuasca since a trip to Brazil. Published case series report ayahuasca-induced psychotic episodes predominantly in subjects with relatives affected by psychotic disorders, though cases in unaffected individuals have also been described.
LIBRO COMUNICACIONES
January 1, 2021
A 44-year-old man with a 20-year history of schizophrenia, treated with injectable paliperidone and using cannabis regularly with sporadic MDMA, was hospitalized for psychotic decompensation (mystical delusions and auditory hallucinations) after MDMA use. Symptoms resolved with treatment adjustment and abstinence. After discharge, a relapse in MDMA use triggered another episode. He later stopped MDMA but continued cannabis and remained stable. Although MDMA is most often linked to anxiety and depression, psychotic symptoms can occur in people with or without prior psychiatric disorders. The possible additive effect of cannabis and MDMA is noted, and more research is needed on short- and long-term MDMA effects.
LIBRO COMUNICACIONES
January 1, 2021
A 30-year-old woman with a history of depressive syndrome and psychotic symptoms from substance use was brought to the emergency room after being found walking on a road. She had consumed an unknown amount of ayahuasca during a spiritual retreat 48 hours earlier and had remained awake, fearing she would die if she closed her eyes. She was agitated, behaviorally disinhibited, and grabbed her neck in distress. Clinical examination revealed mydriasis, gait ataxia, hyperthymia, loose associations, persecutory delusions of alien capture, and pseudo-auditory hallucinations of her own voice singing. CT, X-ray, and lab results were normal. The diagnosis was a psychotic episode from hallucinogenic substance use.