Summary: New research shows that ayahuasca’s long-term effects on mental health depend strongly on a person’s prior mental health history and the setting in which the brew is taken. While many users report reductions in anxiety and depression symptoms, adverse mental states—such as feelings of disconnection, hopelessness, or being energetically attacked—appear more often among people with previous mood or anxiety disorders and among those who use ayahuasca in non-traditional or unsupportive environments.
Notably, some experiences typically labeled as adverse, like visual distortions or intense perceptual changes, were associated with improved mental health outcomes for certain users. Drawing on responses from more than 10,000 participants, the study highlights the protective role of communal, spiritually meaningful, or otherwise supportive settings and suggests that some challenging experiences may have therapeutic value when appropriately framed and integrated.
Key Facts:
- Context matters: Mental health benefits are more likely when ayahuasca is used in supportive, traditional, or community-based settings.
- History shapes response: People with prior anxiety or depressive disorders more often reported adverse mental states after use, though these states did not always predict poor long-term outcomes.
- Adverse vs. therapeutic: Certain experiences commonly labeled as adverse—particularly perceptual changes and visual distortions—were linked to better reported mental health for some participants, indicating they may play a therapeutic role.
Source: PLOS
Published April 30, 2025 in PLOS Mental Health by Óscar Andión (Research Sherpas, Spain), José Carlos Bouso (ICEERS and the University of Rovira i Virgili, Spain), Daniel Perkins (University of Melbourne and Swinburne University), and colleagues.
Ayahuasca is a traditional Amazonian decoction used in Indigenous healing practices and ceremonial contexts. Interest in its potential for treating mood disorders has grown in clinical and research settings, but systematic study of its adverse effects and their long-term significance has lagged behind. This study reanalyzes data from the Global Ayahuasca Survey (GAS) to clarify how post-ayahuasca adverse mental states relate to later mental health and which factors mediate that relationship.
The Global Ayahuasca Survey collected responses from 10,836 people between March 1, 2017 and December 31, 2019; the current analysis included 5,400 participants with complete data. Among those analyzed, 14.2% reported a prior anxiety disorder and 19.7% a prior depressive disorder. The team combined classical statistical approaches with machine learning techniques to examine associations between participant characteristics, reported adverse mental states after ayahuasca, and current mental health as measured by the SF-12 instrument.
The authors acknowledge important limitations: the survey was voluntary and many respondents completed it months or years after their ayahuasca experiences, which introduces potential self-selection and recall biases. Despite these caveats, several clear patterns emerged from the data.
First, a history of anxiety or depression and use in non-traditional settings were both associated with higher rates of reported adverse mental states after ayahuasca. Second, not all adverse states predicted worse long-term mental health. In particular, visual distortions and other perceptual changes correlated with better mental health outcomes in the present sample, whereas emotional reactions described as “feeling down,” “feeling disconnected,” or “feeling energetically attacked” tended to predict poorer long-term mental health.
These findings suggest that the conventional classification of some post-psychedelic experiences as strictly negative should be re-evaluated. The effect of a challenging experience appears to depend heavily on the context in which it occurs—such as the presence of experienced facilitators, a supportive group, or spiritual meaning—and on individual factors like age and psychiatric history.
The researchers emphasize that people with a history of depression or anxiety may require extra care and psychological support when considering ayahuasca. Supervision by experienced practitioners and opportunities for preparation and integration within a communal framework may help reduce harm and amplify therapeutic benefit.
Dr. José Carlos Bouso highlighted the importance of setting: “What stood out most to us was the significant difference in mental health outcomes between users who had supportive environments during their use and those who didn’t. This emphasizes the importance of a responsible and well-prepared setting for those seeking healing through ayahuasca.”
The authors conclude that future research should focus on ayahuasca use in real-world ceremonial and communal contexts, and that harm-reduction strategies and clinical guidelines should account for the nuanced ways that post-ayahuasca states can mediate long-term outcomes. Attention to preparation, facilitation, and integration—especially for people with prior mood disorders—will be critical to maximizing benefits and minimizing harms.
Additional quotes
On the research process: “Insights from the Global Ayahuasca Survey revealed how setting, preparation, and integration practices shape the overall experience and its longer-term impact,” said Dr. José Carlos Bouso.
On ayahuasca use: “When experienced in safe, supportive environments, ayahuasca may offer therapeutic benefits—particularly for those with a history of mood disorders—underscoring the importance of facilitators and ceremony structure.”
On spirituality: “Our results suggest that the spiritual significance of ceremonies can be protective, helping to reduce adverse emotional states such as anxiety, depression, and disconnection and contributing to overall improvement.”
About this psychopharmacology and mental health research news
Author: Charlotte Bhaskar
Source: PLOS
Contact: Charlotte Bhaskar – PLOS
Image: The image is credited to Neuroscience News
Original Research: Open access. “A new insight into ayahuasca’s adverse effects: Reanalysis and perspectives on its mediating role in mental health from the Global Ayahuasca Survey (GAS)” by José Carlos Bouso et al., PLOS Mental Health. DOI: 10.1371/journal.pmen.0000097
Abstract
A new insight into ayahuasca’s adverse effects: Reanalysis and perspectives on its mediating role in mental health from the Global Ayahuasca Survey (GAS)
Ayahuasca is a traditional Amazonian decoction central to the healing practices of many Indigenous communities and has spread internationally over recent decades. Researchers analyzed GAS responses from 10,836 participants who rated a set of predetermined adverse effects; 5,400 respondents with complete data were included in the final analysis. Data collection occurred from March 1, 2017 to December 31, 2019, with analysis access on November 30, 2021.
Machine learning and classical statistical methods examined how participant characteristics, post-ayahuasca adverse mental states, and mental health outcomes measured by the 12-Item Short Form Survey (SF-12) relate. Among respondents, 14.2% reported a prior anxiety disorder and 19.7% a prior depressive disorder, yet median SF-12 scores were comparable to the general population.
A history of anxiety or depression was linked to more reported adverse mental states following ayahuasca. Conversely, greater frequency of visual distortions and higher lifetime ayahuasca use were associated with better current mental health. Women reported more adverse states but did not show worse mental health outcomes overall. The authors recommend reconsidering how adverse states are classified in psychedelic research, as some experiences traditionally labeled negative may contribute to long-term psychological benefits when occurring in the right context. Better understanding these dynamics is essential for improving harm reduction and for guiding clinical or community practices, especially for individuals with prior depression who may need additional support.