Introduction
The use of ayahuasca is increasingly expanding in Western society. References to ayahuasca appear more and more frequently on the Internet and in other media. However, it is difficult to find objective information about the potential risks and benefits associated with its use, or about what to expect when choosing to participate in a session. Here you will find information aimed at helping you make responsible decisions, reduce risks, and maximize potential benefits.
Decision making
Deciding to take ayahuasca
The decision to participate in a session should always be made by the individual, not by a relative or friend. This decision should be based on a clear understanding of the potential risks and benefits in relation to one’s medical history, mental health, and overall emotional condition.
Ayahuasca is sometimes presented as a panacea for any illness, and it may appear to offer an easy solution to personal problems. However, it is only a tool that, when used properly, can catalyze a therapeutic or personal growth process. Every person is different, and a large part of our internal thought processes and emotions remains unknown territory.
This is where this tool can play a role: it can help an individual gain greater awareness of their emotions, thoughts, behavior, body, and relationships. This increased self-awareness may facilitate a process of adjustment across these different aspects, resulting in an overall improvement in quality of life.
Types of sessions
Ayahuasca sessions are usually held in group settings ranging from five to twenty-five people; occasionally, there may be as many as one hundred participants in a single session—or even more. Sessions typically take place at night, although daytime sessions also occur less frequently. An ayahuasca session usually lasts between three and seven hours. In some centers or groups, participants stay overnight after the session, though this is not always the case. Each session is led by a facilitator, who may be a healer, a shaman or “neo-shaman,” a therapist, a padrinho or mestre in the ayahuasca churches, or another person with extensive experience who has been trained to facilitate sessions. At the beginning of the session, time is often reserved for participants to share their intentions and their reasons for taking part. Once this sharing is complete, the ayahuasca is distributed and participants drink their cup.
The ayahuasca experience can unfold in different phases. At times, exploring one’s inner world may be accompanied by emotional pain or other forms of distress, while at other moments it can involve a profound release of tension or stress. For this reason, it is not uncommon to hear participants crying or otherwise expressing emotional release during ayahuasca sessions — particularly in those oriented toward healing — throughout the night.
In addition, due to the purgative effects of ayahuasca, vomiting is common. This usually takes place into a bucket inside the ceremony space or in a designated area outside. In general, the music provided by the facilitator guides the experience, although some traditions and facilitators work partially or entirely in silence.
Broadly speaking, there are three types of ayahuasca sessions: traditional or shamanic, religious, and therapeutic. These categories are not mutually exclusive. A religious or shamanic session may have therapeutic outcomes, and a session oriented toward therapy may include mystical or religious experiences.
The shamanic session
There is a wide range of traditional and shamanic ayahuasca sessions. These are typically led by shamans—also known as curanderos (healers) or vegetalistas—from South America, or by Western practitioners who have been trained in Indigenous traditions, sometimes referred to as “neo-shamans.” These sessions are generally oriented toward healing and have a strong spiritual focus.
They may include preparatory purging practices prior to drinking ayahuasca, such as the ingestion of tobacco, intended to “cleanse” the body of perceived toxins. Sessions are often held in darkness or around a fire, and the experience is guided by the shaman’s singing, as well as live music using instruments such as maracas, drums, or mouth harps. Musical styles vary by country and tradition; for example, in Peru, ceremonial songs known as ícaros are commonly performed.
The shaman or healer is usually supported by assistants who help participants with practical needs—such as going to the toilet — or during difficult moments, and who may also take part in the musical elements of the ceremony. The shaman may use techniques such as blowing tobacco smoke on participants or cleansing the space with incense, including substances like Palo Santo or Agua Florida, in addition to guiding the session through music and song.
These sessions typically require intense personal engagement. Their worldview is rooted in Indigenous cosmologies with a strong spiritual focus, which distinguishes them from sessions grounded primarily in Western therapeutic frameworks.
The therapeutic session
In settings that adopt a therapeutic approach — understood within the framework of Western psychotherapy — ayahuasca is viewed as a tool that may support therapeutic or personal growth processes. These sessions usually include a preparation phase before the experience and an integration phase afterward.
Therapeutic sessions can vary widely depending on the facilitator and their method of working. Variations may include individual rather than group sessions, the use of different types of music (including a combination of recorded and live music), or working with silence in specific ways.
Sessions that include structured therapeutic work before and after the ayahuasca experience are more commonly found in Western therapeutic contexts than in traditional shamanic settings, where the focus is often primarily on the ceremony itself, with limited integration — sometimes only a brief discussion the following morning. As with all categories, there are exceptions.
The religious session
In many parts of the world, syncretic religious churches originating in Brazil use ayahuasca as a sacrament. The most well-known are Santo Daime, União do Vegetal, and Barquinha. Members of these churches may consume ayahuasca as frequently as two to four times per month.
Although the context is religious, these ceremonies often have healing dimensions, and fostering community cohesion is also a central aim. The religious, healing, and social objectives are typically intertwined. These sessions are highly ritualized and follow precise rules regarding participation and behavior.
Hymns are commonly sung during ceremonies, though some sessions are conducted in silence. In certain groups, participants may ask the mestres questions related to philosophical or religious topics during the session. Some ceremonies involve participants remaining seated, while others include simple, repetitive dances. Practices regarding overnight stays and integration work vary widely among churches.
Because these groups function as relatively small communities, participants often receive ongoing follow-up and support, which may be more or less formally structured, depending on the tradition and organization.
How to select a place
If you have decided to take ayahuasca, it is important to choose an appropriate context that aligns with your intentions and what you hope to gain from the experience. In general, it is advisable to avoid sessions that do not offer any form of preparation or integration. It is also recommended to choose settings in which those responsible provide some type of follow-up for participants. This ensures that, should you experience difficulties in the days or weeks following the session, you have access to support during the integration process. Ideally, the chosen place should allow participants to stay overnight after the experience, or even remain for an entire weekend, as this can facilitate rest, reflection, and integration.
For most people, the ayahuasca experience is largely introspective, often involving long periods of inner focus with closed eyes, although the group setting also plays an important role. Some individuals may feel uncomfortable sharing such an experience with strangers. In these cases, meeting the group beforehand or sharing intentions collectively can help create a sense of safety and ease.
Another key aspect to consider when choosing a center or group is whether they apply exclusion criteria. Responsible organizers usually conduct a prior interview and may exclude individuals who, due to specific medical, psychological, or emotional conditions, could be at greater risk of harm than benefit. If a group does not ask about your medical history or mental health, fails to inform you clearly about potential risks, or presents ayahuasca as a cure-all, it is unlikely to offer a safe or responsible setting.
Caution is also advised if a facilitator displays “guru-like” behavior, presents themselves as the “best” or uniquely qualified practitioner, lacks sensitivity toward your personal situation, or dismisses your reasons for wanting to participate. The same applies to anyone whose behavior includes sexual connotations or boundary violations. Promises of guaranteed outcomes are another clear warning sign.
Positive indicators include the provision of balanced and objective information about ayahuasca, small group sizes (ideally no more than twenty participants), the presence of trained assistants during the session, and a preliminary screening process for participants. Even under these conditions, it is still wise to seek feedback from people who have previously attended sessions with the same group or center, whether through social networks or direct contact.
Once you have decided where and with whom you wish to take ayahuasca, it is recommended to have a personal interview with the facilitator days or weeks before the session. Many facilitators suggest changes in daily habits prior to the experience — such as dietary adjustments or sexual abstinence. Each facilitator has their own criteria, and if you choose to place your trust in them, it is generally advisable to follow their recommendations, even if you do not fully understand or agree with all of them.
Risks & exclusion criteria
Physical risks
From a medical perspective, ayahuasca has relatively few contraindications. However, individuals with serious cardiovascular conditions should not take ayahuasca, as it can cause a mild increase in blood pressure. Laboratory studies have not shown alterations in liver function or other biochemical parameters following ayahuasca administration. A temporary modulation of the immune system has been observed, but this does not appear to have clear or lasting effects on health.
It is essential to consult a physician if you are taking any medication on a regular basis or if you may need medication during the days surrounding an ayahuasca session. The use of antidepressants and other psychotropic medications may be contraindicated, as may drugs metabolized by certain cytochrome enzymes. In addition, any medication that interacts with monoamine oxidase (MAO)—including MAO inhibitors—can pose serious risks when combined with ayahuasca. Combining ayahuasca with substances that share the same metabolic pathways can be dangerous, making consultation with a medical specialist particularly important.
If you have a chronic illness, it may also be dangerous to discontinue prescribed medication in order to take ayahuasca. This decision should never be made without medical supervision. In any case, always bring your medication with you, even if you expect to be away from home for only a few hours. Ayahuasca sessions are often held in remote locations that may be difficult to access, and delays in returning home could make the absence of medication problematic.
Tyramine is a naturally occurring monoamine found in certain foods, especially fermented products such as aged cheeses, soy sauce, wine, beer, and some meats and nuts. Lists of foods high in tyramine are widely available online. Combining ayahuasca with large amounts of tyramine can, in rare cases, lead to a hypertensive crisis, with symptoms such as nausea, vomiting, sweating, increased heart rate, and dilated pupils, and very rarely, serious complications such as brain hemorrhage or death.
That said, the MAO inhibitors present in ayahuasca are eliminated from the body relatively quickly, making poisoning unlikely if tyramine-rich foods are consumed before or after the session. Although it is rare for someone to eat such foods during an ayahuasca experience, it is recommended to avoid doing so.
Although uncommon, some people may faint during an ayahuasca session. It is therefore important to be aware that standing up suddenly — especially on hard surfaces or near solid objects — can increase the risk of injury in the event of a fall.
Psychological risks
If you have a history of psychiatric disorders such as schizophrenia, psychosis, bipolar disorder, or certain personality disorders, taking ayahuasca involves a significant risk, particularly if the condition is active. While conventional treatments for these conditions are not always satisfactory, this does not mean that alternative approaches are necessarily safe or effective.
If you still feel strongly about participating in an ayahuasca session, it is crucial to discuss your psychiatric history openly and honestly with the facilitator. Some facilitators will refuse admission based on such histories, while others may not. What matters most is not whether you are accepted, but whether the decision is made responsibly and with your well-being as the priority, rather than for financial or personal gain.
There are cases in which individuals with a history of mental disorders have had positive outcomes after taking ayahuasca, but there are also documented cases in which symptoms have re-emerged or worsened. It is therefore essential to take this risk seriously, choose the context and facilitator carefully, and be fully transparent about your medical and psychological background. The facilitator’s sincerity and commitment to your well-being are key indicators of a safe setting. If you do not perceive this sincerity — regardless of your mental health history — it is wise not to take ayahuasca with that person.
The most serious adverse outcome associated with ayahuasca is the persistence of psychological effects beyond the expected duration of the experience. In some cases, effects may intensify toward the end of the session — for example, after relaxation or vomiting — but if symptoms persist well after the session has ended, those responsible should be informed immediately.
There are techniques that can help individuals return to baseline, but in rare cases these are ineffective and medical treatment or longer-term care may be required. Such cases are very uncommon but are documented in the scientific literature. They may be related to pre-existing psychiatric conditions, although there are also rare reports involving individuals with no known mental health history.
Symptoms in these cases may include paranoia, ideas of self-reference (such as believing others are talking about you), delusions (fixed, incoherent beliefs), or severe confusion. These symptoms are distinct from temporary fear, confusion, or emotional distress that can occur during an ayahuasca experience and which are often transient and part of the process.
Benefits
While much research is still needed to scientifically demonstrate the therapeutic potential of ayahuasca for personal growth and clinical use, there is a substantial number of personal accounts describing experiences that are perceived as clearly beneficial, both for individuals and for those around them. These accounts often refer to what are described as “revelatory” or “refreshing” experiences, reported to bring meaningful physical and psychological benefits.
Many people also describe increased feelings of spirituality or mystical states, in which they experience a sense of connection to a larger reality rather than feeling isolated as individuals. For some, these experiences foster resilience, motivation, and a renewed capacity to face everyday life, while also enriching their personal worldview. Even challenging or difficult experiences are frequently described as instructive or helpful in the long term. It is uncommon for someone to emerge from an ayahuasca experience without having gained insight into themselves, their relationships with others, or their understanding of reality.
Although it is sometimes claimed that a single ayahuasca session can be more effective than many years of psychotherapy, such statements should be approached with caution. Sustainable therapeutic benefits — particularly those involving changes in dysfunctional behavior patterns, the processing of trauma, or difficulties related to family dynamics — generally require a broader therapeutic process. This includes adequate preparation, careful integration, and ongoing follow-up before and after the experience.
When ayahuasca is incorporated into a structured therapeutic framework, it may enhance the effectiveness of personal or therapeutic processes. There are reports of perceived benefits in people dealing with depression, burnout, grief, addiction, relational difficulties linked to guilt or emotional pain, childhood trauma, and in some cases, the acceptance of death among people with terminal illnesses.
Preparation
Therapeutic work with ayahuasca begins with careful preparation, which can help reduce risks and maximize potential benefits. Preparation can take place on three levels: psychological, social, and physical. Each person will find their own way to prepare, but the following guidelines may be helpful.
Psychological preparation
When ayahuasca is taken with therapeutic intent or for personal growth — such as modifying certain behaviors, improving relationships, or releasing emotional blockages — it is important to begin by increasing awareness of one’s personal state. This may involve reflecting on past, present, and future perspectives, as well as one’s relationship with the surrounding environment.
You may wish to consider where you currently find yourself in life, which challenges or recurring behavior patterns you have difficulty addressing, how these affect your relationships, and how your behavior influences your environment, and vice versa. The more reflection that takes place before the ayahuasca session, the more effectively the experience may act as a catalyst for this process. Support from a therapist can be especially helpful, though the perspective of a trusted friend or relative may also serve as a valuable mirror. This type of reflection can help foster self-awareness and support a more meaningful experience.
It is important not to approach the session with rigid expectations. Asking for specific outcomes — such as “show me the solution to my compulsive behavior” — can condition the experience and potentially interfere with it. Once you have clarified where you are in your life and what may be blocking your well-being and growth, it is generally recommended to enter the experience without fixed expectations, allowing it to unfold as it does. Trusting that whatever arises may contribute to personal insight or healing can be a helpful attitude.
Because the ayahuasca experience can be intense and may involve ego dissolution, confrontation with fear or mortality, or a temporary loss of control, it is important to be prepared to “go with the flow.” Maintaining trust in yourself, the facilitator, and the process itself can help. The more prepared you feel beforehand, the easier it may be to surrender to the experience.
In moments of difficulty, focusing on the breath can be useful. Slow, deep breathing — expanding the lower lungs and releasing tension with each long exhalation — may help calm the body and mind. Practicing this type of breathing during the preparation period can build confidence and provide a familiar grounding tool for the session.
It is common to move through different phases during the experience. Some may be challenging, while others may be pleasant, meaningful, or deeply satisfying. Preparing for difficult moments while remaining open to moments of beauty, insight, and profound meaning can support a more balanced and integrated experience.
Social preparation
If your intention involves working on relationships with family, partners, or friends, it may be helpful to open a dialogue with those involved during the preparation period, explaining your intention to address existing issues. If you are engaged in therapy prior to the session, you may also consider whether it would be appropriate to involve others in the process.
If you feel comfortable, you can explain that you plan to participate in a therapeutic experience involving an ethnobotanical tool such as ayahuasca, share your intentions, and invite feedback. Establishing trust, openness, and support within your social environment can be beneficial both before and after the experience.
Physical preparation
In traditional contexts — particularly in Peru — there is extensive knowledge surrounding dietary and behavioral preparation, often referred to as dietas. These may involve days, weeks, or even months of eating simple foods such as unripe baked plantain and white rice, with no salt, sugar, or oil. Specific plant decoctions may be consumed daily, alongside sexual abstinence and periods of isolation in nature. These practices often begin with the ingestion of emetic plants, such as tobacco or yawarpanga (Aristolochia didyma), with the intention of cleansing and sensitizing the body and mind. Traditionally, these diets are part of healing processes and the training of healers.
In Western contexts, the extent to which one follows dietary restrictions, fasting, physical exercise, meditation, or withdrawal from daily routines is a personal choice. Some people maintain their usual diet, while others reduce salt and sugar intake for several days or weeks, or fast in the days leading up to the session.
In general, light and healthy meals, along with good physical condition, may facilitate the experience and potentially improve safety. Dietary preparation can also serve as a way to reconnect with the body, increase self-awareness, and prepare mentally for the session. It is often recommended to eat plenty of fruits and vegetables in the days beforehand, have a light, carbohydrate-rich meal, and ensure that the last meal is consumed approximately four to six hours before the session.
If you are taking medications that are contraindicated with ayahuasca — such as certain antidepressants — it may be necessary to discontinue them at least two weeks before the session. This is a delicate process that must only be undertaken under strict medical supervision, as abruptly stopping psychiatric medication can be dangerous. Remember that there will always be another opportunity to take ayahuasca once you are safely free of such medications.
Herbal supplements such as St. John’s Wort and Ginkgo biloba are also contraindicated. Alcohol, stimulants, opioids, and other drugs should be avoided in the days or weeks leading up to the session. Ensuring adequate hydration and rest prior to the ceremony is strongly recommended.
The session
After ingesting ayahuasca, effects usually begin within ten minutes to one hour, depending on the individual, and may last two to four hours, sometimes longer. There are many types of ayahuasca, depending on how it is prepared. Shamans and facilitators may add different plants to modulate the effects, such as tobacco, Brugmansia, Brunfelsia, or others, each contributing specific qualities to the overall experience. As a result, both the duration and intensity of an ayahuasca session can vary considerably from one occasion to another.
Some centers or groups work with very potent preparations, while others use milder brews, sometimes offering several cups over the course of the session. Many facilitators avoid giving high doses to first-time participants, allowing them to become familiar with the effects before increasing the amount.
Ayahuasca produces changes in perception and in the way reality is experienced. Visual textures may appear brighter, more colorful, or composed of moving or luminous patterns. These changes are often noticeable with both open and closed eyes, although the experience tends to be more intense with eyes closed. A buzzing or ringing in the ears may signal that the psychological effects are beginning. Opening the eyes can sometimes help soften the intensity when the experience becomes overwhelming.
As the experience unfolds, visions may arise, ranging from abstract patterns to clearly defined images. Emotions are often felt more deeply, and forgotten or distant memories may surface. Some people report experiences interpreted as paranormal, such as telepathy or precognition. Regardless of how these experiences are understood, they are subjectively common elements of the ayahuasca experience.
Fear or difficult emotions may also emerge and can be accompanied by physical sensations such as tension or pain. During challenging moments, it can be helpful to breathe slowly and deeply, follow the music, and trust the process facilitated by ayahuasca and the guide. It is common — especially for beginners — not to experience visions in early sessions, although this varies. In some cases, it appears that visionary experiences develop gradually, as if requiring a form of perceptual or cognitive learning.
Ayahuasca also alters habitual patterns of thinking. At times, individuals may believe they are not experiencing any effects simply because visions are absent. However, changes in thought processes are often evident to external observers. For this reason, participants are advised not to leave a session prematurely, even if they feel bored or believe nothing is happening. Psychological effects may intensify later, and leaving early can increase the risk of accidents or distress.
If you have decided to take ayahuasca, remain in the session until those responsible indicate that it is appropriate to leave. Ayahuasca is a powerful plant and should be treated with respect, even when its effects seem subtle or delayed. There is always time to return home safely.
Many people describe ayahuasca as a mirror of the inner self. Just as unresolved conflicts may surface, so too can positive qualities, strengths, and moments of profound beauty and insight.
Feelings of paranoia may sometimes arise during the experience. Ayahuasca does not unfold in a linear way; it moves through different phases, some pleasant and others difficult. As in any life journey, moments of joy, sadness, insight, boredom, or disappointment may all occur. Clinically, temporary symptoms such as suspicion, paranoia, or thoughts of self-reference (for example, “everyone is looking at me”) may appear. These effects are transient and part of the experience, differing from pathological states by their temporary nature.
Learning to work with whatever arises is often considered the most helpful attitude during an ayahuasca session. Importantly, participants should never hesitate to ask for support from the facilitator when needed.
Some individuals report experiences resembling perinatal states, as described by psychiatrist Stanislav Grof. These experiences relate symbolically or somatically to the birth process and may involve sensations of pressure, breathlessness, pain, death-rebirth themes, or existential transitions. According to Grof’s model of the Basic Perinatal Matrices, such experiences reflect deep psychological material associated with early life. While potentially challenging, these states are considered meaningful in many traditional rites of passage.
Although an ayahuasca session may last four to six hours, depending on dosage and repeated ingestion, periods of confusion, disorientation, or loss of control typically do not exceed 30 minutes. That said, the perception of time is often profoundly altered. Ordinary temporal reference points may dissolve, and the experience may be governed entirely by subjective time.
After finishing the session
Once the session has ended, it is advisable to remain at the ceremony site rather than leaving immediately or driving. Sensitivity to external stimuli may be heightened, and emotional states can feel unsettled or mixed. Eating something light and writing down — even briefly — the main elements of the experience before sleeping can support the integration process.
Integration & follow up
Without an integration process, the insights and lessons gained during an ayahuasca experience may fade more quickly than expected. To support integration, it is advisable to engage in a sharing circle the day after the session with the therapist or facilitator and, when appropriate, with the group. Creative practices — such as drawing or other forms of artistic expression — can also help integrate what was experienced, allowing it to translate into everyday life.
Spending time in nature, swimming, or engaging in gentle physical activity may help you reconnect with your body and surroundings and regain a sense of grounding. If ayahuasca was taken for therapeutic reasons, continuing the process with the support of a therapist or another qualified professional can be especially beneficial at this stage. Ongoing support can help ensure that the experience is integrated in a healthy way and that its potential benefits are carried into daily life.
In the days following a session, emotions related to the experience may continue to emerge. In some cases, people report brief episodes of altered states of consciousness after the ceremony. While this can be unsettling, it is generally best to remain in a familiar and safe environment — such as at home — and to have someone nearby who can offer support if needed. Listening to calming music and allowing yourself to rest may also help. If you have any concerns or doubts, it is always advisable to contact the facilitator who led the session or your therapist.
In general, people return from an ayahuasca session with new perspectives on life and a desire to adjust certain behaviors or bring renewed energy into their relationships. This sense of clarity or motivation is not permanent. It is often strongest during the first week after the session, which makes this period particularly important for beginning to implement what was learned. Without conscious effort, insights may gradually fade and remain unintegrated.
If you feel open to it, attending several sessions with a therapist who understands the dynamics of ayahuasca experiences can enhance the positive impact on daily life. However, it is important to avoid making major life decisions too quickly. Do not sell your business, end a long-term relationship, or abandon your everyday life to move to the jungle just a week after taking ayahuasca. Give yourself time, perspective, and integration before acting on significant changes.
