Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years
This systematic review (1990–2015) found preliminary evidence from six small clinical trials that ayahuasca, psilocybin and LSD have antidepressive, anxiolytic and antiaddictive effects and were well tolerated, including in treatment‑resistant cases; however, many studies were open‑label and underpowered, so larger randomised, double‑blind, placebo‑controlled trials are needed to confirm efficacy.
Authors
- Jordi Riba
- Jamie Hallak
- Rafael dos Santos
Published
Abstract
To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings.
Research Summary of 'Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years'
Introduction
Ayahuasca is a traditional Amazonian botanical brew made from Banisteriopsis caapi and Psychotria viridis; the former supplies β-carbolines (harmine, tetrahydroharmine, harmaline) that inhibit monoamine oxidase A (MAO‑A) and thereby enable the orally inactive tryptamine N,N‑dimethyltryptamine (DMT) from P. viridis to reach the brain and activate 5‑HT1A/2A/2C receptors. Previous human and animal work, plus anecdotal and observational reports from ritual users, have suggested potential therapeutic effects of ayahuasca and its alkaloids for mood and anxiety disorders and for substance dependence, and pharmacological studies have indicated an acceptable acute safety profile in healthy volunteers. However, evidence remains fragmented across animal models, small experimental human studies and observational assessments, and clinical trials are scarce. Dos Santos and colleagues therefore performed a systematic review to collect and synthesise animal and human studies up to 3 April 2015 that examined anxiolytic or antidepressive effects of ayahuasca and its isolated alkaloids (DMT, harmine, THH, harmaline). The stated aim was to evaluate the preclinical and clinical evidence supporting anxiolytic, antidepressant and related effects and to identify gaps requiring further investigation; the work combined animal models, experimental human dosing studies, observational studies of long‑term users and available clinical trials.
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dos Santos, R. G., Osório, F. L., Crippa, J. A. S., Riba, J., Zuardi, A. W., & Hallak, J. E. C. (2016). Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years. Therapeutic Advances in Psychopharmacology, 6(3), 193-213. https://doi.org/10.1177/2045125316638008
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