Sub-acute and long-term effects of ayahuasca on affect and cognitive thinking style and their association with ego dissolution

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Abstract

Rationale

Ayahuasca is a psychotropic plant tea from South America used for religious purposes by indigenous people of the Amazon . Increasing evidence indicates that ayahuasca may have therapeutic potential in the treatment of mental health disorders and can enhance mindfulness-related capacities. Most research so far has focused on acute and sub-acute effects of ayahuasca on mental health-related parameters and less on long-term effects.

Objectives

The present study aimed to assess sub-acute and long-term effects of ayahuasca on well-being and cognitive thinking style. The second objective was to assess whether sub-acute and long-term effects of ayahuasca depend on the degree of ego dissolution that was experienced after consumption of ayahuasca.

Results

Ayahuasca ceremony attendants ( N = 57) in the Netherlands and Colombia were assessed before, the day after, and 4 weeks following the ritual. Relative to baseline, ratings of depression and stress significantly decreased after the ayahuasca ceremony and these changes persisted for 4 weeks. Likewise, convergent thinking improved post-ayahuasca ceremony up until the 4 weeks follow-up. Satisfaction with life and several aspects of mindfulness increased the day after the ceremony, but these changes failed to reach significance 4 weeks after. Changes in affect, satisfaction with life, and mindfulness were significantly correlated to the level of ego dissolution experienced during the ayahuasca ceremony and were unrelated to previous experience with ayahuasca.

Conclusion

It is concluded that ayahuasca produces sub-acute and long-term improvements in affect and cognitive thinking style in non-pathological users. These data highlight the therapeutic potential of ayahuasca in the treatment of mental health disorders, such as depression.

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Most cited references 19

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Synaptic dysfunction in depression: potential therapeutic targets.

Ronald S. Duman, George Aghajanian (2012)

Basic and clinical studies demonstrate that depression is associated with reduced size of brain regions that regulate mood and cognition, including the prefrontal cortex and the hippocampus, and decreased neuronal synapses in these areas. Antidepressants can block or reverse these neuronal deficits, although typical antidepressants have limited efficacy and delayed response times of weeks to months. A notable recent discovery shows that ketamine, a N-methyl-D-aspartate receptor antagonist, produces rapid (within hours) antidepressant responses in patients who are resistant to typical antidepressants. Basic studies show that ketamine rapidly induces synaptogenesis and reverses the synaptic deficits caused by chronic stress. These findings highlight the central importance of homeostatic control of mood circuit connections and form the basis of a synaptogenic hypothesis of depression and treatment response.

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Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression

Leor Roseman, David J Nutt, Robin Carhart-Harris (2018)

Introduction: It is a basic principle of the “psychedelic” treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD). In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN) (sharing features with mystical-type experience) and Dread of Ego Dissolution (DED) (similar to anxiety) would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value. Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin). The Altered States of Consciousness (ASC) questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR) at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable), with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest. Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable), the main effect and the effects at each time point compared to baseline were all significant (p = 0.002 and p = 0.003, respectively, for main effects), confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks) was specific compared to perceptual dimensions of the ASC (p < 0.05). Discussion: This report further bolsters the view that the quality of the acute psychedelic experience is a key mediator of long-term changes in mental health. Future therapeutic work with psychedelics should recognize the essential importance of quality of experience in determining treatment efficacy and consider ways of enhancing mystical-type experiences and reducing anxiety. Trial Registration: ISRCTN, number ISRCTN14426797, http://www.isrctn.com/ISRCTN14426797

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Inhibitors of MAO-A and MAO-B in Psychiatry and Neurology

John P. M. Finberg, Jose Rabey (2016)

Inhibitors of MAO-A and MAO-B are in clinical use for the treatment of psychiatric and neurological disorders respectively. Elucidation of the molecular structure of the active sites of the enzymes has enabled a precise determination of the way in which substrates and inhibitor molecules are metabolized, or inhibit metabolism of substrates, respectively. Despite the knowledge of the strong antidepressant efficacy of irreversible MAO inhibitors, their clinical use has been limited by their side effect of potentiation of the cardiovascular effects of dietary amines (“cheese effect”). A number of reversible MAO-A inhibitors which are devoid of cheese effect have been described in the literature, but only one, moclobemide, is currently in clinical use. The irreversible inhibitors of MAO-B, selegiline and rasagiline, are used clinically in treatment of Parkinson's disease, and a recently introduced reversible MAO-B inhibitor, safinamide, has also been found efficacious. Modification of the pharmacokinetic characteristics of selegiline by transdermal administration has led to the development of a new drug form for treatment of depression. The clinical potential of MAO inhibitors together with detailed knowledge of the enzyme's binding site structure should lead to future developments with these drugs.

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Author and article information

Contributors

M. V. Uthaug:

ORCID: http://orcid.org/0000-0001-7903-1325

malin.uthaug@maastrichtuniversity.nl

J. G. Ramaekers: j.ramaekers@maastrichtuniversity.nl

Journal

Journal ID (nlm-ta): Psychopharmacology (Berl)

Journal ID (iso-abbrev): Psychopharmacology (Berl.)

Title: Psychopharmacology

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 0033-3158

ISSN (Electronic): 1432-2072

Publication date (Electronic): 13 August 2018

Publication date PMC-release: 13 August 2018

Publication date (Print): 2018

Volume: 235

Issue: 10

Pages: 2979-2989

Affiliations

[1 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, , Maastricht University, ; Maastricht, The Netherlands

[2 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, Department of Clinical Sciences, Faculty of Psychology and Neuroscience, , Maastricht University, ; Maastricht, The Netherlands

[3 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, Department of Psychiatry and Psychology, Faculty of Health, Medicine and Life Sciences, , Maastricht University, ; Maastricht, The Netherlands

[4 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, Department of Methodology and Statistics, Faculty of Psychology and Neuroscience, , Maastricht University, ; Maastricht, The Netherlands

[5 ]ISNI 0000 0004 1936 9721, GRID grid.7839.5, Institute of Legal Medicine, , Goethe University of Frankfurt, ; Frankfurt, Germany

Author information

M. V. Uthaug http://orcid.org/0000-0001-7903-1325

Article

Publisher ID: 4988

DOI: 10.1007/s00213-018-4988-3

PMC ID: 6182612

PubMed ID: 30105399

SO-VID: c3925e2a-b72e-4728-9215-018f77542c63

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 15 May 2018

Date accepted : 24 July 2018

Funding

Funded by: Maastricht University

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ScienceOpen disciplines: Pharmacology & Pharmaceutical medicine

Keywords: ayahuasca,field study,creative thinking,affect,long-term effects,mindfulness

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ScienceOpen disciplines: Pharmacology & Pharmaceutical medicine

Keywords: ayahuasca, field study, creative thinking, affect, long-term effects, mindfulness

Sub-acute and long-term effects of ayahuasca on affect and cognitive thinking style and their association with ego dissolution

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Karger: Endocrinology

Most cited references 19

Synaptic dysfunction in depression: potential therapeutic targets.

Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression

Inhibitors of MAO-A and MAO-B in Psychiatry and Neurology

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