Anxiety, panic, and hopelessness during and after ritual ayahuasca intake in a woman with generalized anxiety disorder: A case report

Abstract

Background and aims: Ayahuasca is a dimethyltryptamine- and β-carboline-rich hallucinogenic beverage traditionally\rused by indigenous groups of Northwest Amazonian for ritual and therapeutic purposes. Animal and human\rstudies suggest that ayahuasca has antidepressant and anxiolytic potentials and has a good safety profile. However,\ranxiety-like reactions may also occur after ayahuasca intake, although they are rare. Methods: Case report.\rResults: Here, we describe a case of a non-medicated, symptom-free young female with generalized anxiety\rdisorder, who experienced intense anxiety, panic, and hopelessness during and for 3 days after participating in an\rayahuasca ritual. The symptoms appeared in the first hours after ayahuasca intake and were gradually reducing in the\rfollowing hours/days, but were intense enough to cause significant suffering to her, who needed to seek psychiatric\rhelp and restarted pharmacological treatment. Conclusions: Although “bad/horror trips” with anxiety features may\roccur during the acute effects of ayahuasca and other hallucinogens, to the best of our knowledge, this is the first\rreport of a subacute/prolonged anxiety-like reaction to this substance. Ayahuasca should be used with caution in\rpeople with a history of anxiety disorders.\rKeywords: hallucinogens, ayahuasca, dimethyltryptamine, anxiety disorders