AYAHUASCA & PHARMAHUASCA

Ayahuasca is a psychoactive brew that has been used for centuries by indigenous peoples in the Amazon rainforest for spiritual and medicinal purposes. The brew is typically prepared by combining the ayahuasca vine (Banisteriopsis caapi) with leaves from the chacruna plant (Psychotria viridis), which contains the potent psychedelic compound dimethyltryptamine (DMT). The ayahuasca vine contains monoamine oxidase inhibitors (MAOIs) which prevent the breakdown of DMT in the body, allowing it to be absorbed and produce its effects when ingested orally.

Pharmahuasca is a term used to describe a mix of synthetic or laboratory-produced substances that contain DMT and MAOIs to achieve similar effects as ayahuasca. The mix often contains synthetic DMT and pharmaceutical MAOIs.

Effects

Potential positive effects include feelings of joy, feeling a greater understanding of things, extrasensory perception, feeling at peace, euphoria, experiencing revelations, spiritual enhancement and feelings of unity and interconnectedness.
Potential neutral effects include intense visual geometrical hallucinations, heightened senses, feeling separated from the body, encountering deceased/ religious spirits, increased speed of thoughts, encountering mystical beings and experiencing altered time perception and altered depth perception.(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6107838/) (https://maps.org/research-archive/w3pb/1994/1994_Strassman_22714_1.pdf)
Potential negative effects include anxiety, disorientation, perceiving objects as malevolent, being unable to function physically and uneasy and gloomy feelings. (https://maps.org/research-archive/w3pb/1994/1994_Strassman_22714_1.pdf)
People may experience physical effects including increased heart rate, increased blood pressure, pupil dilatation, dizziness, nystagmus (rapid rhythmic movements of the eyes), chest pain/ feelings of tightness; agitation, dehydration, large doses may cause seizures and respiratory arrest (very rare); nausea vomiting and diarrhoea

Dosage

As the concentration of psychoactive compounds in ayahuasca varies widely between different mixtures, there are no general guidelines for ayahuasca dosing. However, one report stated the average dose of DMT in the mixture is around 27mg.
In ayahuasca ceremonies, doses are often determined by the ceremony leaders, who tend to offer participants a small, medium, or large cup, depending on their preference. More cups of ayahuasca may be offered as the ceremony progresses if participants feel they want to increase their dose.
For pharmahuasca, online forum users report using around 150-200mg of harmine for their MAOI and around 50-60 mg of DMT.

Duration

Onset: 30 minutes- 1 hour
Duration: 4-5 hours
Aftereffects: 1-8 hours

Dangers

What not to mix with: (Originally published at Temple of the Way of Light)

Drugs that lower seizure threshold: Some evidence suggests psychedelics could increase the risk of seizures, especially for those with a personal or family history of epilepsy. Using psychedelics alongside other drugs that may also increase the risk for seizure, such as tramadol, could further increase this risk. You can learn more about medications associated with increased seizure risk here.
Stimulants: Taking ayahuasca/pharmahuasca with stimulants such as cocaines and amphetamines may increase anxiety and intensity feelings of fear. DMT causes increased heart rate and blood pressure when combined with stimulant drugs so taking stimulants and DMT together increase risk of dangerous cardiovascular problems, such as a heart attack.
Antidepressants: Both MAOIs and antidepressants increase the concentration of serotonin in the nervous system, potentially increasing the chance of toxicity from too much serotonin, otherwise known as serotonin syndrome.
Painkillers and sedatives: As DMT has a sedating effect on the body, combining ayahuasca/pharahuascha with drugs that also have a sedating effect, such as opioids and benzodiazepines, may increase the risk of respiratory depression (stopping breathing) and could result in coma.
Tyramine-containing foods: Tyramine is a molecule that is normally broken down by monoamine-oxidase enzymes. However, when MAOIs are taken in an ayahuasca or phamacuascha mix, eating foods which contain tyramine cause tyramine levels to increase and not get broken down by the enzyme. Excessive tyramine in the body can cause stroke, brain hemorrhage and death. The risk of tyramine-overdose is greatly increased with a pharacuhascha mix containing the irreversible MAOI isocarboxazid (Marplan) and has been known to cause deaths. A guide to foods to be avoided with MAOIs can be found here.
Alcohol: Alcohol increases the sedative effect of ayahuasca and can lead to chest pain and headaches. Furthermore alcohol is a diuretic (it increases the amount somebody wees) so mixing alcohol and ayahuasca/ pharmacuascha can cause a severe drop in blood pressure (5).
Dextromethorphan (cough suppressant): Dextromethorphan in combination with MAOIs can lead to excitement, high blood pressure, fever, and brief periods of psychosis.
Antihistamines: This combination can lead to dangerous side-effects.
Diet pills/ appetite suppressants: This combination can lead to dangerous side-effects.
Parkinson’s disease medication: This combination can lead to dangerous side-effects.

What are the dangers?

Fatality: One study found the deadly ayahuasca dose was 50x greater than the standard amount taken in ceremonies. However, there have been reports of travellers going overseas for an ayahuasca ceremony and dying due to drinking an ayahuasca brew containing toxic plants or plants poisonous when in combination with other ingredients of the brew. In addition, though the risk may be rare, serotonin syndrome from combining ayahuasca/pharmahuasca ingredients with other drugs could have fatal consequences.
Ceremony malpractice: Ayahuasca brewed with the wrong ingredients and doses could have fatal consequences, so it’s essential you look for a well-attended ceremony led by experienced guides. Cases of people posing as shamans and abusing their power, for instance, sexually abusing participants, have also been reported.
To avoid the danger of malpractice, it’s essential you ensure you attend a well-vetted ceremony or retreat with experienced guides.
Experiencing a psychedelic crisis and risk of Psychosis and Hallucinogenic Perception Persisting Disorder: General risks for all psychedelics apply, read more under general psychedelic risks and harm-reduction advice.
Serotonin Syndrome: Consuming stimulants or serotonergic acting drugs alongside ayahuasca/ pharmahuascha increases the risk of serotonin syndrome. Read more under general psychedelic risks and harm-reduction advice.
Risky behaviours and impulsive decision-making: As mental coordination whilst under the influence of drugs is impaired, this can lead to somebody doing something dangerous or deadly. Having impaired judgement and false-senses of certainty may also mean people under the influence make decisions that wouldn’t otherwise if they were sober. Such decisions can lead to adverse consequences.
Difficulty “landing”: After experiencing profound changes in one’s sense of reality, it can sometimes be difficult to return to everyday life. Challenging experiences and being unable to understand or express the experience can leave people feeling isolated, confused, and distressed. Working with an integration coach or attending an integration circle can help people to make sense of their experience and ground back into everyday life.

How can the risks be minimised?

Make sure you’re familiar with and avoid using serotonin-increasing psychedelics with other drugs that could increase this risk.
It’s advisable to consume ayahuasca/ pharmahuasca preparations that have been prepared by an experienced person rather than attempting to make a mixture on your own. This is because using incorrect ingredients and/ or measurements could have serious, and even deadly, consequences.
If you’re considering attending an ayahuasca retreat or ceremony, it’s important to do lots of research beforehand to choose the right one. This research should involve looking into legitimacy and reviews. You can learn more about choosing the right retreat and ceremony by reading the “Finding the Right Facillitation” section of our website.
Taking psychedelics in a safe environment with a trusted trip sitter or guide can help reduce the risk of negative outcomes caused by impulsive decision-making and behaviours linked to impaired judgement.
Because ayahuasca can induce extreme shifts in someone’s sense of reality and perspectives, it’s a good idea for users to allow themselves time to relax and process their experience before going straight back to everyday life tasks, such as work or visiting the supermarket
Integrating a psychedelic experience has the potential to resolve trauma relating to difficult psychedelic experiences. Integration can also people process and learn-from psychedelic experiences. To learn more about integration and integration tools and tips, you can visit the “Psychedelic Integration” section of our website.

What are the potential benefits?

Scientific experiments have demonstrated both ayahuasca and pure DMT could be useful in the treatment of:

Web Pages

Guidance on choosing a safe and suited ayahuascha retreat https://ordinarytraveler.com/best-ayahuasca-retreat
Webpage explanation for the differences between DMT and Ayahuasca: https://spiritvineretreats.com/ayahuasca-blog/ayahuasca-vs-dmt/
Useful guide to help with integration of psychedelic experiences: https://psychedelictimes.com/integrating-a-psychedelic-experience-through-personal-and-spiritual-practices/
Psychonaut wiki: https://psychonautwiki.org/wiki/Pharmahuasca
ICEERS Support Centre: The International Center for Ethnobotanical Education, Research, and Service (ICEERS) is a non-profit organization dedicated to transforming society’s relationship with psychoactive plants. ICEERS Support Center has extensive experience supporting people going through difficult processes with psychoactive plants. https://www.iceers.org/support-center-2/

References and additional material

Credit to Dr Andrew Gibson for contributing his medical expertise and background in harm-reduction to the process of making this content.