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October 2021

Psychedelics as Medicine: Ayahuasca & Iboga Pique Consumer Interest

Interest in traditional psychedelic medicines such as ayahuasca and iboga has been growing for some time. Questions about their use for mental health and addiction keep coming up. Stay on top of the current research so that you can competently discuss this with patients.

You might get questions about ayahuasca. It’s an herbal psychotropic drink that’s used in religious rituals throughout many countries in the Amazon, including Brazil and Peru. It’s often made from the plants Banisteriopsis caapi and Psychotria viridis, which contain the hallucinogen dimethyltryptamine (DMT). But the contents of the drink vary depending on the plants used and how they are prepared – there’s no standardized dosing. If patients ask you about ayahuasca, explain that research on mental health, particularly depression, is picking up. Several small clinical trials, conducted in highly controlled settings, show that taking a single dose of ayahuasca improves depression. But at this point, studies are still too small – and reports of safety concerns and serious side effects, including hallucinations, high blood pressure, vomiting and many others, are fairly well-documented. Until more is known, tell patients to steer clear.

You might also hear about iboga. This shrub grows throughout many countries in Africa, including Gabon, Cameroon and Guinea. Like ayahuasca, it’s commonly used in ceremonial practices. The root bark of the plant contains a chemical called ibogaine. Ibogaine has hallucinogenic and euphoric effects and is a schedule I substance in the US. Some low-quality studies show that it might help reduce opioid withdrawal symptoms and relapse. But ibogaine has been linked to serious side effects, including irregular heartbeat, neurological complications such as confusion and ataxia, and death. Safety data on using the whole iboga plant is limited. For now, safety concerns outweigh any potential benefits.

The number of patients seeking care with these ingredients at treatment clinics in Mexico is picking up. Emphasize that these ingredients can cause serious side effects, and it’s not clear if they will provide any benefits. There are also issues with conducting high-quality research on these substances - it’s difficult to introduce a truly blinded placebo control. There are also concerns that participants might be eager to report the “benefits” of these substances after traveling to exotic locations, with the main goal of feeling better. Reported improvements might not be directly related to the actual effects from the psychedelics themselves. Check out our recently updated monographs on ayahuasca and iboga to learn more. 

The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2021 Natural Medicines Inc. Commercial distribution or reproduction prohibited. Natural Medicines is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.