This page respects the original work's rights terms and independently introduces its bibliography, abstract, main results, and limitations. It is not a full translation.
About this resource
This page introduces a 2024 review that systematically collected different forms of evidence on adverse events and toxicity associated with ayahuasca and DMT. Its 78 included reports comprised preclinical experiments, clinical studies, epidemiological research, pharmacovigilance, existing reviews, and case reports. By mapping evidence with a focus on risks rather than benefits, the paper provides a safety foundation for this research library.
Study design
The authors searched databases and organized reported physical, psychiatric, developmental, and reproductive events after exposure to ayahuasca or DMT by theme. Controlled studies in screened healthy adults, case reports with unknown composition or co-exposures, and animal experiments using high exposures to isolated compounds carry different meanings as evidence. Rather than converting them collectively into a single incidence rate, the review classifies where signals have appeared.
Content
The review summarizes serious adverse events as rare in controlled clinical settings with screened healthy participants. Nausea, vomiting, changes in blood pressure and heart rate, anxiety, and acute psychological distress are nevertheless reported. Case reports include psychosis-like symptoms, manic states, seizures, and suspected serious interactions, but individual cases cannot establish frequency or causation.
Animal studies addressed signals of reproductive and developmental toxicity under high-exposure conditions. These findings do not directly show that the same effects occur with ordinary ceremonial exposure in humans, but they provide a reason not to assume safety during pregnancy. The pharmacology also differs among isolated DMT, isolated harmala alkaloids, and mixed brews.
Results
The authors conclude that serious events have not been found to be common among appropriately screened healthy adults in controlled settings, but the quantity and quality of evidence are insufficient to exclude long-term or rare risks. Variation among brews, missing exposure information, concomitant medication, prior history, and reporting bias make evaluation difficult.
The review did not conclude that toxicity is absent. Instead, it identifies psychiatric, cardiovascular, and interaction-related problems that may be infrequent but serious, along with uncertainty concerning pregnancy and development, and calls for standardized reporting.
Limitations
The evidence types are highly heterogeneous. Case reports have no denominator, while observational studies are subject to self-selection and underreporting. Some reports do not verify the botanical identity, chemical composition, contaminants, or co-used substances in the product. Results from animals exposed to high levels of isolated compounds also cannot be converted directly to brews consumed by humans.
Safety
Particular caution concerns interactions between β-carbolines that affect monoamine oxidase and other drugs or medications. A history of psychotic disorders or mania, cardiovascular disease, and pregnancy also require individualized risk assessment. With products of unknown composition, contamination and concentration variation beyond the known constituents must be considered.
This page introduces risk information and does not guide self-directed use, discontinuation, or combinations. Even when acute altered consciousness or vomiting is interpreted as part of a cultural practice, it must be distinguished from medical assessment of severity.
Source and rights
Original source: White E, Kennedy T, Ruffell S, Perkins D, Sarris J. Ayahuasca and Dimethyltryptamine Adverse Events and Toxicity Analysis: A Systematic Thematic Review. International Journal of Toxicology. 2024;43(3):327–339. DOI: 10.1177/10915818241230916.
The original article is published under a Creative Commons license that includes a noncommercial condition. This page is a detailed introduction that reconstructs bibliographic information and key points to provide a path to the original; it is not a full translation or a republication of figures and tables.