What Is Ayahuasca? Benefits, Side Effects And Retreats (2024)

Ayahuasca, derived from the bark of the Banisteriopsis caapi vine and leaves of the Psychotria viridis bush, is used for sacred rituals and magical ceremonies, as well as to address and offer insight into psychological and physical concerns of those who take it.

Amazonian cultures and shamans have used ayahuasca for over 3,000 years. In Quechua, the language indigenous to this Amazonian region, ayahuasca translates to “vine of the dead” or “vine of the soul.”

The earliest indigenous people of the Amazonian basin—the drainage basin for the Amazon River that currently includes the greater parts of Peru and Brazil, much of Colombia, Ecuador, Bolivia and a small portion of Venezuela—used ayahuasca administered by shamans for spirit communication, magical experiences, initiation rites and healing rituals.

Today, people travel to South America and Central America, where ayahuasca is legal in many countries, to take ayahuasca for introspection, spiritual enlightenment and relief from depression and anxiety symptoms. The hallucinogenic component of ayahuasca, N,N-dimethyltryptamine (DMT), is illegal in Canada and in most of the U.S. except for religious purposes in some states. DMT is also illegal in many European countries.

Thrill-seeking tourists are also drawn to the ayahuasca experience, according to Jeff McNairy, Psy.D., chief medical officer at Rythmia Life Advancement Center, an all-inclusive and medically-licensed luxury ayahuasca retreat in Guanacaste, Costa Rica.

People taking ayahuasca may hallucinate, often revisiting past traumas that shaped or still influence their lives and relationships. Many individuals also report experiencing a transcendental experience with extreme feelings of ecstasy and peace during and after taking ayahuasca, according to experts.

However, taking ayahuasca is not for the faint of heart. Ayahuasca sessions are intense and can be initially terrifying for those who revisit past trauma, says Cali Estes, Ph.D., a psychologist in the Miami-Fort Lauderdale, Florida area. Dr. Estes specializes in addiction recovery and treating severe trauma, including post-traumatic stress disorder (PTSD).

“While ayahuasca offers intriguing potential for mental health treatment, it’s a complex substance that requires careful consideration and guidance,” says Ryan Sultán, M.D., an assistant professor of clinical psychiatry at Columbia University Medical Center in New York City. “Research is still in the early phases, so it’s vital to approach its use cautiously, preferably under professional supervision.”

Further rigorous studies are needed to better understand ayahuasca’s safety, efficacy, and best practices for integration into mainstream therapy, says Dr. Sultán.

How Ayahuasca Works

Psychotria viridis leaves contain the hallucinogen DMT. Meanwhile, alkaloids in the bark of the Banisteriopsis caapi are naturally occuring monoamine oxidase inhibitors (MAOIs).

Pharmaceutical MAOIs are antidepressant drugs used to treat depression, social anxiety and panic disorders. The natural MAOIs in Banisteriopsis caapi keep the plant’s DMT from being inactivated by gut and liver enzymes. This combination of DMT and MAOIs gives ayahuasca tea its psychoactive effect, potentially altering an individual’s consciousness, perception, cognition, mood, mental state or emotions.

Ayahuasca taps into the amygdala and other parts of the brain’s limbic system, a cluster of brain components that regulate emotions and memory. The amygdala, one of those brain components, regulates fear conditioning, anxiety, aggression, emotional memory and social conditioning.

“[Taking ayahuasca is] kind of like being [in] a lucid dream,” says Dr. McNairy. “You’re witnessing things, maybe talking to people. Some people don’t have visuals, but information is coming to the person individually, like maybe an answer to a question they have or hints toward a choice they’re making.”

Mental blocks, resistance, fears and biases are often confronted and moved out of the way during an ayahuasca session (or multiple sessions), says Dr. McNairy.

Even though ayahuasca sessions are intense and can produce heightened anxiety or terror initially, many people also report experiencing a sense of peace, euphoria or out-of-body experiences, often with profound revelations that influence their life perspectives, says Dr. Estes.

Robust clinical research regarding the benefits of ayahuasca is limited. However, many people anecdotally report the following benefits:

• Improved or resolved depression and/or anxiety symptoms
• Alcohol and/or drug addiction recovery
• Greater self-knowledge
• Improved interpersonal relationships
• New perspectives on life
• Resolution of past trauma and trauma triggers

Ayahuasca use is prohibited in most of the U.S. except for administration under certain conditions for religious purposes. Dr. Estes says she can’t legally refer her patients to churches or ayahuasca retreats, but she informs them about ayahuasca options. If her patients choose to take ayahuasca, she helps them process their experience(s) afterward.

Dr. Estes adds that many of her clients tried medications and multiple therapies, including Eye Movement Desensitization and Reprocessing (EMDR) and neurofeedback for depression, anxiety, PTSD, substance abuse addictions and other mental health conditions before trying ayahuasca. “Nothing worked. But when some try ayahuasca, it works.” says Dr. Estes.

A person taking ayahuasca often becomes an observer of their traumatic experiences, acknowledging them and letting them pass, according to experts. “Ayahuasca neutralizes the trauma—it’s not positive or negative, it’s just an event,” explains Dr. Estes.

Dr. Estes discourages thrill-seekers hoping for a psychedelic trip from taking ayahuasca. “I wouldn’t recommend it for just anybody to try,” she says. “I would recommend it for people who want to get to the bottom of something.”

People taking antidepressant medications while using ayahuasca risk developing serotonin syndrome, a serious condition that can be deadly. “The symptoms of serotonin syndrome look a lot like the symptoms of an ayahuasca ceremony,” says Dr. McNairy. Both ayahuasca effects and serotonin syndrome symptoms include sweating, agitation, pacing, an elevated heart rate or nervousness. “Serotonin syndrome is hard to diagnose if [someone is] on ayahuasca, so that’s problematic and dangerous,” he says.

Rythmia requires guests to discontinue all antidepressants four weeks prior and benzodiazepines, such as clonazepam, 15 days prior to taking ayahuasca. Guests must also stop taking MAOI medications four weeks prior, says Dr. McNairy. However, it’s important to note that discontinuing antidepressant or other medications should always be done under the guidance of the prescribing physician.

Additional medications or substances that should be discontinued before ingesting ayahuasca include:

• Central nervous system depressants (barbiturates and benzodiazepines)
• Opiates
• Analgesics, including those in cold and flu medicines
• Many supplements and herbs, such as St. John’s wort and ginseng

People with the following medical conditions may also be at risk when taking ayahuasca

• Epilepsy or seizure disorders or a family history of epilepsy
• Psychosis or family history of mental illness
• Glaucoma
• Endocrine problems
• Fever
• Heart/cardiovascular conditions or high blood pressure

Side effects from taking ayahuasca are typically short term, and some are part of the “purging” or cleansing that frequently occurs after taking ayahuasca. In that respect, certain side effects, such as vomiting and diarrhea, are considered a beneficial part of the experience.

Potential side effects include:

• Nausea
• Vomiting
• Diarrhea
• Dizziness
• Agitation
• Changes in body perception
• Confusion
• Hypertension
• Rapid or irregular heartbeat

For those struggling with depression, anxiety, or PTSD, ayahuasca has been reported to offer some relief, acting as a form of psychedelic therapy, says Dr. Sultan

However, anecdotal reports should be weighed against potential risks, which can include significant emotional distress, physical harm and the exacerbation of existing psychiatric conditions, says Dr. Sultán.

“While ayahuasca offers intriguing potential for mental health treatment, it’s a complex substance that requires careful consideration and guidance,” says Dr. Sultán. “Research is still in the early phases, so it’s vital to approach its use cautiously, preferably under professional supervision.”

Further rigorous studies are needed to better understand ayahuasca’s safety, efficacy, and best practices for integration into mainstream therapy, says Dr. Sultán.

Depending on the ayahuasca retreat, facilitators may require potential attendees to complete a medication questionnaire and stop taking medications or supplements that can interact with ayahuasca in advance of the sessions. Individuals may also be required to pass psychological and medical screenings before they’re allowed to participate.

In addition to several of the medical conditions listed above, Rythmia mental health care providers screen for bipolar I, bipolar II and borderline personality disorders.

“While individuals with bipolar II and borderline personality disorder may often be cleared for participation, those with a bipolar I diagnosis are prohibited from consuming ayahuasca due to the risk of triggering a manic episode,” says Dr. McNairy.

Some retreats require abstaining from alcohol and sex and indulging in only “clean” eating, such as eliminating red meat, spicy foods, fermented foods or large amounts of sugar, for a certain amount of time prior to the ayahuasca retreat.

During ayahuasca ceremonies, the medicine is brewed into a tea and then prepared and administered by trained shamans. Shaman helpers, who are typically trained, often for years, by shamans, may also be present to assist participants with restroom access, basic shamanic healing practices and supervision. Medical or mental health clinicians may also be present. Ayahuasca ceremonies may take place over three or four nighttime sessions, each lasting several hours.

Ayahuasca ceremonies typically take place in a group setting in a building or a hut. Participants usually have a bed or mattress in a group setting with buckets for purging and may have rolls of toilet paper to wipe their eyes and noses when crying or to use after having a bowel movement. (Rythmia retreat settings have eight restrooms guests can use).

The medicine, administered in an amount about the size of a 1-ounce shot glass, takes effect after about 40 minutes. Ayahuasca’s short-term effects typically peak two to three hours after drinking the tea and start to dissipate after four hours.

Rythmia, a luxury retreat offering yoga and many other wellness amenities, costs around $8,000 for a week-long, all-inclusive stay, which is on the high end of retreat prices. The average week-long, all-inclusive ayahuasca retreat in Central America typically costs between $1,050 (for a shared room or dorm) and $2,800 (for a private, luxury suite), according to Chelsea Westman with the data insights team at BookRetreats.com. Some retreats are more expensive.

It’s important to note that Rythmia is a well-known retreat that has both highly positive and scathingly negative online reviews. The same holds true for some other ayahuasca retreats. Also important to note is published reports exist of deaths, sexual assault and violent attacks by other participants during ayahuasca ceremonies at some ayahuasca retreats.

Before booking an ayahuasca retreat, research the facility and ask questions about the retreat’s ethics, such as whether the retreat has:

• A robust medical and psychological screening process
• A head shaman (if not indigenous) with three to five years training under an indigenous shaman. Indigenous shamans should hail from indigenous tribes that have ethically utilized ayahuasca for generations.
• An ethically cultivated brew neither stolen nor harvested without sustainable farming and replanting practices
• Supervision by a medical doctor, emergency medical technician or paramedic, with registered nurses available and easy access to an emergency hospital
• Written safety measures and protocols for participants’ review

Reading online reviews can also help inform one’s decision. It’s also important to ensure the facility is medically licensed in the country where it’s located before booking.