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Psychiatry
Drug-induced psychosis following use of Ayahuasca: a presentation to forensic psychiatric services
  1. Morven Rosemary Baker and
  2. Christopher Iain O'Shea
  1. Royal Edinburgh Hospital, Edinburgh, UK
  1. Correspondence to Dr Christopher Iain O'Shea; Chris.O'Shea{at}nhs.scot

Abstract

Ayahuasca is a plant-based psychoactive decoction, traditionally used by indigenous Amazonian peoples, which commonly contains the hallucinogen N,N-dimethyltryptamine (DMT). There is now growing interest across the Western world in psychedelics including Ayahuasca.

This case describes a previously well male with no risk factors for adverse psychiatric outcomes or forensic history. Following controlled Ayahuasca use, he developed an enduring psychotic episode, during which he significantly assaulted a relative and was admitted to a forensic psychiatric unit. He was treated with the antipsychotic aripiprazole, and his psychotic symptoms abated. 18 months following his admission, recovery has been sustained.

Previous case reports have described psychosis following Ayahuasca ingestion, but typically of short duration in patients with a personal or family history of psychiatric illness, or in those taking other substances. With the growing use of Ayahuasca, it is important to highlight that adverse effects may include more prolonged psychotic symptoms and the risk of psychotically mediated violence.

  • Psychotic disorders (incl schizophrenia)
  • Drugs misuse (including addiction)

https://doi.org/10.1136/bcr-2024-260648

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: MB and CO. The following authors gave final approval of the manuscript: MB and CO.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.