Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies
This review (2021; s=9) of ayahuasca for substance use disorders (SUDs; e.g. alcoholism) found improvements in both rodents and humans who were suffering from SUDs (also on scores of anxiety and depression). The human studies were observational (vs RCTs) thus lacking the power to (confidently) infer causality.
Authors
- Jamie Hallak
- Rafael dos Santos
- Felipe Osório
Published
Abstract
Ayahuasca is a hallucinogenic/psychedelic traditionally used for ritual and therapeutic purposes. One such therapeutic use is related to Substance Use Disorders (SUDs). A previous systematic review of preclinical and human studies published until 2016 suggested that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. To conduct an update of this previous review. A systematic review of quantitative studies which analyzed the effects of ayahuasca and its alkaloids on drug use (primary outcome) and other measures (secondary outcomes) related to SUDs was conducted, including articles from 2016 to 2020. Nine studies (four preclinical, five observational) were included in the review. Preclinical studies in rodents reported reductions in amphetamine self-administration and anxiety, and in alcohol- and methylphenidate-induced conditioned place preference. Observational studies among healthy ritual ayahuasca users and patients with SUDs reported reductions in drug use, anxiety, and depression, and increases in quality of life and well-being. We replicated the findings of the previous review suggesting that ayahuasca and its alkaloids have therapeutic effects in the treatment of SUDs. However, translation of preclinical data to humans is limited, observational studies do not allow us to infer causality, and there is a lack of standardization on ayahuasca doses. Although promising, randomized, controlled trials are needed to better elucidate these results.
Research Summary of 'Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies'
Introduction
Substance use disorders (SUDs) are common, chronic psychiatric conditions marked by relapse, compulsive seeking and consumption, impaired control, and negative emotional states such as irritability and dysphoria. Current pharmacological treatments (for example, nicotine replacement, methadone/buprenorphine, naltrexone/acamprosate/disulfiram) are only partially effective and there are no approved drugs for some substances such as cannabis and cocaine. Consequently, there is ongoing interest in alternative therapeutic approaches. Classic serotonergic psychedelics (including ayahuasca, DMT, psilocybin, and LSD) act primarily via cortical 5-HT2A receptor agonism and have been associated with increased neuroplasticity in regions involved in emotion, introspection, and social cognition; these neurobiological effects are hypothesised to underlie their therapeutic potential for SUDs and comorbid mood and anxiety disorders. This paper updates an earlier systematic review by assessing quantitative preclinical and human studies published between 2016 and 2020 that examined the effects of ayahuasca and its principal alkaloids on drug use (primary outcome) and related psychological and cognitive measures (secondary outcomes). Rodrigues and colleagues aimed to synthesise evidence from animal experiments and observational human studies to determine whether more recent data replicate earlier signals that ayahuasca or its constituents may reduce substance use and improve related symptoms, while also evaluating study quality and gaps that remain for clinical translation.
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Rodrigues, L. S., Rossi, G. N., Rocha, J. M., L Osório, F., Bouso, J. C., Hallak, J. E. C., & dos Santos, R. G. (2022). Effects of ayahuasca and its alkaloids on substance use disorders: an updated (2016-2020) systematic review of preclinical and human studies. European Archives of Psychiatry and Clinical Neuroscience, 272(4), 541-556. https://doi.org/10.1007/s00406-021-01267-7
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