Entre o ritual e o risco: uma revisão integrativa sobre a biossegurança in vivo da ayahuasca e da DMT

Abstract

Ayahuasca is a beverage commonly used for medicinal, ritualistic, and recreational purposes by native populations of the Amazon Basin. It is obtained from the plants Banisteriopsis caapi and Psychotria viridis, with B. caapi being rich in β-carbolines (harmine, harmaline, and tetrahydroharmine) and P. viridis containing N,N- dimethyltryptamine, also called DMT. Recognition of the importance of this beverage for religious cults resulted in the legalization of its use in Brazil; however, its therapeutic use in the country is still not permitted and is subject to sanctions. Along with legalization came concerns regarding the additive potential of interactions between the components present in Ayahuasca, as well as its toxic and adverse effects on the human organism. The objective of this work was to evaluate basic research studies, clinical trials in humans, and case reports involving the use of Ayahuasca and/or DMT, reporting the adverse effects and toxicity they may bring to the organism. 531 articles were found using the chosen keywords, of which 38 were selected as they met the inclusion criteria. 10 articles addressed toxicity and adverse effects in animals, 14 articles addressed toxicity and adverse effects in clinical trials conducted in humans, and 14 articles consisted of case reports involving the use of Ayahuasca and/or DMT. Most of the described effects consisted of fetal malformations, behavioral changes, auditory and visual hallucinations, as well as symptoms similar to those found in serotonin syndrome. Despite considerable embryotoxicity based on what was reported, the number of basic research studies in pregnant females is relatively low, which highlights the importance of conducting more studies involving females. It is also possible to observe how the demand for Ayahuasca and DMT consumption has increased over the years, emphasizing the importance of using such substances safely in order to avoid adverse effects.