Symptom specificity of ayahuasca’s effect on depressive symptoms

This retrospective survey study (n=120) found that ayahuasca improved specific depressive symptoms (CESD-10) namely hope, depressed mood, and happiness, more than other symptoms such as cognitive, interpersonal, sleep, loneliness, and focusing.

Abstract

“Background Ayahuasca’s effects on symptoms of depression have generated considerable optimism. Clients frequently report more concern about some symptoms than others, and available treatments alter symptoms differentially. Few studies address the symptom specificity of this psychoactive brew.

Aims We examined self-reported effects of ayahuasca on the individual symptoms of depression assessed by the 10-item short-form of Center for Epidemiological Studies of Depression (CESD-10).

Methods We asked over 120 participants to complete a retrospective assessment of CESD-10 symptoms one month before and one month after using ayahuasca.

Results Participants indicated that ayahuasca had a larger influence on affective symptoms like hope, depressed mood, and happiness, than cognitive, interpersonal, and somatic symptoms like restless sleep, loneliness, and difficulty focusing.

Conclusions Potential clients might appreciate identifying if different treatments provide more relief for some depressive symptoms than others. We examined retrospective reports of ayahuasca’s potential for differential impact. Those eager to alter hope, happiness, and other affective symptoms will likely find ayahuasca more helpful than those who want an intervention for restless sleep, loneliness, or trouble focusing. This symptom specificity parallels the effects of serotonergic antidepressant medications, suggesting that psychedelic-assisted psychotherapy using ayahuasca might have considerable appeal for those who seek comparable relief but would rather not use prescription serotonergic medications. Jumpstarting psychotherapy with the rapid onset of ayahuasca-induced relief also appears to have potential.“

Authors: Cody S. Gilbert, Mitch Earleywine, Maha N. Mian & Brianna R. Altman

Notes

Participants had on average used ayahuasca 40 times, were between 30-50 (52%), Caucasian (87%), and had at least a bachelors degree (61%).

The participants recalled their symptoms one month before, and one month after their last trip.

Summary

Ayahuasca’s effects on symptoms of depression were examined in a retrospective study of over 120 participants. The study found that ayahuasca had a larger influence on affective symptoms like hope, depressed mood, and happiness, than cognitive, interpersonal, and somatic symptoms like restless sleep, loneliness, and difficulty focusing.

INTRODUCTION

Major Depressive Disorder is a common and costly problem, often with chronic and recurring episodes. Pharmacological and psychological interventions have shown promise, but leave many affected individuals unimproved.

Available treatments for depression have serious drawbacks. Antidepressant medications frequently create aversive side-effects, and psychotherapy lacks side-effects and withdrawal, but can require considerable time, effort, and expense.

Research into which treatments alter which aspects of the disorder might prove beneficial, especially when considering that clients often view some symptoms as more distressing than others. Standard serotonergic antidepressants also do not address hallmark decreases in pleasure, interest, energy, and positive affect.

This symptom specificity raises a problem related to the status of the diagnostic category of clinical depression. Interventions might be more effective for people who experience specific symptoms rather than those who qualify for a full-blown diagnostic category.

Ayahuasca’s effects on the serotonin system differ from those of standard antidepressants, but acute responses can be challenging and can include nausea, vomiting, frightening thoughts, delusions, and hallucinations. Long-term negative consequences are rare.

With these caveats in mind, a study was conducted to identify the symptom specificity of ayahuasca’s impact on the CESD-10. The study found that ayahuasca decreased some symptoms of depression but not others, and prevented onset in those experiencing only a few symptoms.

Participants

Participants responded to a survey online via SurveyMonkey about several demographic variables, and symptoms of depression before and after ayahuasca use.

RESULTS

We used paired t-tests to compare pre-post differences across 10 symptoms, and dropped 7 participants because they had standardized change scores > 3.0 on at least one symptom.

DISCUSSION

Clinical depression is expensive, ubiquitous, and severe, and it leaves at least 35% of clients unimproved. Psychotherapy and standard antidepressant medications are time-consuming, effortful, pricey, and inaccessible, and they rarely offer relief from symptoms in the first few weeks of treatment.

The drawbacks of available therapies inspired clinical trials of psychedelic-assisted treatments, including work with ayahuasca, a plant-based medicine originally concocted by natives of the Amazon Basin. Ayahuasca alleviates relevant symptoms at rates comparable to standard treatments, often with a very rapid onset, few side effects, and no withdrawal.

The current sample reported that ayahuasca’s impact on affective symptoms (like hopelessness and happiness) exceeded changes in somatic and cognitive symptoms (like sleep disturbances and impaired focus). However, the smaller improvements on perceived motivation and energy seem comparable to the drawbacks also attributed to the serotonergic drugs.

Although a huge randomized clinical trial can answer the relevant questions definitively, ayahuasca might enhance happiness and hope enough to encourage consistent attendance in psychotherapy, which might in turn create novel improvements in energy and motivation after a few sessions.

The limitations of the current sample emphasize the need for continued work on ayahuasca’s effect on depressive symptoms, including placebo controls, extensive assessments, huge and diverse samples, and longitudinal follow-up. Nevertheless, further research on the symptom-specificity of treatments could benefit many.