4.3. Ayahuasca
Ayahuasca is a psychoactive substance, usually ingested as a beverage,
decocted from Banisteriopsis caapi and Psychotria viridisplants. They are rich in DMT, a partial 5-HT serotonergic receptor
agonist and have direct monoamine-oxidase A (MAO-A) inhibiting
properties. Through both mechanisms, ayahuasca has psychedelic
effects.84 Ayahuasca has been historically and
culturally used by those in several countries in Central and South
America, however, it has recently been more widely used, particularly in
religious and spiritual contexts.85
So far, no studies have investigated the role of ayahuasca in the
management of pain as a primary outcome. One recent study included the
Medical Outcomes Study 36-Item Short-Form (SF-36) as a secondary
measurement including a subcomponent rating of participant’s bodily
pain.86 In this report, the authors conducted two
observational sub-studies: (1) one with first-time ayahuasca users (n =
40), and (2) adding a comparison group of long-term ayahuasca users (n =
23). Reported improvements in depression rates for first-time ayahuasca
users and lower depression scores among long-term ayahuasca users were
found. However, there were no significant changes in bodily pain for
first-time ayahuasca users. In a similar study with 23 first-time
ayahuasca users showed similar findings but with significant reductions
in the bodily pain component of the SF-36 for a subgroup of participants
(n = 8).87 Despite the mechanistic plausibility of
ayahuasca for pain treatment given its serotonergic and other relevant
mechanisms of action, the literature on the topic is underdeveloped and
the little available evidence is conflicting.