Drug-induced psychosis following use of Ayahuasca: a presentation to forensic psychiatric services.

A man with no prior psychiatric risk factors or criminal history developed a lasting psychotic episode after using ayahuasca, a plant-based psychedelic containing DMT. During the episode he seriously assaulted a relative and was admitted to a forensic psychiatric unit. Treatment with the antipsychotic aripiprazole resolved his psychotic symptoms, and recovery was sustained 18 months after admission. Previous case reports described psychosis after ayahuasca use but typically brief and in people with personal or family psychiatric history or other substance use. This case highlights that ayahuasca can trigger prolonged psychosis and risk of violence even in low-risk individuals.

Study at a glance

Abstract

Ayahuasca is a plant-based psychoactive decoction, traditionally used by indigenous Amazonian peoples, which commonly contains the hallucinogen N,N-dimethyltryptamine (DMT). There is now growing interest across the Western world in psychedelics including Ayahuasca.This case describes a previously well male with no risk factors for adverse psychiatric outcomes or forensic history. Following controlled Ayahuasca use, he developed an enduring psychotic episode, during which he significantly assaulted a relative and was admitted to a forensic psychiatric unit. He was treated with the antipsychotic aripiprazole, and his psychotic symptoms abated. 18 months following his admission, recovery has been sustained.Previous case reports have described psychosis following Ayahuasca ingestion, but typically of short duration in patients with a personal or family history of psychiatric illness, or in those taking other substances. With the growing use of Ayahuasca, it is important to highlight that adverse effects may include more prolonged psychotic symptoms and the risk of psychotically mediated violence.