A Single Dose Of Ayahuasca Modulates Salivary Cortisol In Treatment-Resistant Depression
A single dose of ayahuasca acutely raised salivary cortisol and, 48 hours later, normalised the blunted awakening salivary cortisol response in treatment‑resistant depression patients to levels seen in healthy controls, without changing plasma cortisol.
Abstract
Major depression is a highly prevalent mood disorder, affecting about 350 million people, and around 30% of the patients are resistant to currently available antidepressant medications. Recent evidence from a randomized placebo-controlled trial supports the rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression. The aim of this study was to explore the effect of ayahuasca on plasma cortisol and awakening salivary cortisol response, in the same group of treatment-resistant patients and in healthy volunteers. Subjects received a single dose of ayahuasca or placebo, and both plasma and awakening salivary cortisol response were measured at baseline (before dosing) and 48h after the dosing session. Baseline assessment (D0) showed blunted awakening salivary cortisol response and hypocortisolemia in patients (DM), both with respect to healthy controls group (C). Salivary cortisol also was measured during dosing session and we observed a large increased for both C and DM that ingested ayahuasca, than placebo groups. After 48h of the dosing session (D2) with ayahuasca, awakening salivary cortisol response (for both sexes) of treated patients became similar to levels detected in controls. This was not observed in patients that ingested placebo. No changes in plasma cortisol were observed after 48 hours of ayahuasca or placebo ingestion for both groups and sexes. Therefore, these findings point to new evidence of modulation of ayahuasca on salivary cortisol levels, as cortisol acts in regulation of distinct physiological pathways, emotional and cognitive processes related to etiology of depression, this modulation could be an important part of the antidepressant effects observed with ayahuasca. Moreover, this study highlights the importance of psychedelics in the treatment of human mental disorders.
Research Summary of 'A Single Dose Of Ayahuasca Modulates Salivary Cortisol In Treatment-Resistant Depression'
Introduction
Major depressive disorder (MDD) is common and linked to dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, with studies reporting both hypercortisolism and hypocortisolism depending on factors such as depression subtype, severity, sex, illness duration and socioeconomic status. Cortisol measures, including the cortisol awakening response (CAR), have been used as biomarkers of depression and treatment response, though findings are heterogeneous. Psychedelics, and specifically ayahuasca, have recently shown rapid antidepressant effects in early clinical studies; ayahuasca contains N,N-dimethyltryptamine (N,N-DMT) plus β-carboline MAO inhibitors and has a long history of ritual medicinal use in Brazil and South America. Galvão and colleagues set out to examine how a single dose of ayahuasca affects cortisol physiology in people with treatment-resistant depression and in healthy volunteers. They tested two primary hypotheses: that patients and controls would differ at baseline in plasma cortisol and awakening salivary cortisol response (AUC), and that ayahuasca (but not placebo) would acutely raise cortisol during the dosing session and alter cortisol measures 48 hours after ingestion, with cortisol responses correlating with clinical improvement in depressive symptoms.
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Study Details
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de Menezes Galvão, A. C., de Almeida, R. N., dos Santos Silva, E. A., de Morais Freire, F. A., Palhano-Fontes, F., Onias, H., Arcoverdee, E., Maia-de-Oliveira, J. P., Araújo, D. B., Lobão-Soares, B., & Galvão-Coelho, N. L. (2018). A Single Dose Of Ayahuasca Modulates Salivary Cortisol In Treatment-Resistant Depression. https://doi.org/10.1101/257238
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