Antidepressant Effects of a Single Dose of Ayahuasca in... : Journal of Clinical Psychopharmacology (original) (raw)

Brief Reports

Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression

A SPECT Study

Sanches, Rafael Faria PhD*†; de Lima Osório, Flávia PhD*‡; dos Santos, Rafael G. PhD*; Macedo, Ligia R.H. MSc*; Maia-de-Oliveira, João Paulo PhD*‡§; Wichert-Ana, Lauro PhD*; de Araujo, Draulio Barros PhD∥¶; Riba, Jordi PhD†#**††; Crippa, José Alexandre S. PhD*‡; Hallak, Jaime E.C. PhD*‡

From the*Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil; †Centre d'Investigació de Medicaments, Servei de Farmacologia Clínica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.; ‡National Institute of Science and Technology, Translational Medicine, Ribeirão Preto; §Department of Clinical Medicine, ∥Onofre Lopes University Hospital, ¶Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil; #Human Experimental Neuropsychopharmacology, Institut de Recerca, Hospital de la Santa Creu i Sant Pau; **Departament de Farmacologia i Terapèutica, Universitat Autònoma de Barcelona; and ††Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Barcelona, Spain.

Received March 18, 2015; accepted after revision September 22, 2015.

Reprints: Rafael G. dos Santos, PhD, Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Hospital das Clínicas, Terceiro Andar, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, Brazil (e-mail: [email protected]).

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Abstract

Ayahuasca is an Amazonian botanical hallucinogenic brew which contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor. Our group recently reported that ayahuasca administration was associated with fast-acting antidepressive effects in 6 depressive patients. The objective of the present work was to assess the antidepressive potentials of ayahuasca in a bigger sample and to investigate its effects on regional cerebral blood flow. In an open-label trial conducted in an inpatient psychiatric unit, 17 patients with recurrent depression received an oral dose of ayahuasca (2.2 mL/kg) and were evaluated with the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale, the Brief Psychiatric Rating Scale, the Young Mania Rating Scale, and the Clinician Administered Dissociative States Scale during acute ayahuasca effects and 1, 7, 14, and 21 days after drug intake. Blood perfusion was assessed eight hours after drug administration by means of single photon emission tomography. Ayahuasca administration was associated with increased psychoactivity (Clinician Administered Dissociative States Scale) and significant score decreases in depression-related scales (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale) from 80 minutes to day 21. Increased blood perfusion in the left nucleus accumbens, right insula and left subgenual area, brain regions implicated in the regulation of mood and emotions, were observed after ayahuasca intake. Ayahuasca was well tolerated. Vomiting was the only adverse effect recorded, being reported by 47% of the volunteers. Our results suggest that ayahuasca may have fast-acting and sustained antidepressive properties. These results should be replicated in randomized, double-blind, placebo-controlled trials.