There is a growing interest in the use of psychedelics such as ayahuasca for the treatment of psychiatric disorders. Used ritually and medicinally by indigenous Amazonian peoples for centuries, ayahuasca is a decoction prepared from caapi (Banisteriopsis caapi, Malpighiaceae) stem and chacruna (Psychotria viridis, Rubiaceae) leaf or chagropanga (Diplopterys cabrerana, Malpighiaceae) leaf. In clinical studies, ayahuasca has shown therapeutic benefits in treatment-resistant depression and substance abuse, and these effects may be related to increased mindfulness capacity. Mindfulness is the psychological process of bringing one’s attention to experiences occurring in the present moment. It can be developed through the practice of meditation and other training techniques to promote non-judgmental awareness and enhance curiosity and openness. Mindfulness-Based Stress Reduction (MBSR) is an eight-week program that is used in clinical psychology and psychiatry to treat a range of mental health issues including anxiety, depression, psychosis, and addiction. In 2016, these authors reported that acute administration of ayahuasca produced benefits in three facets of mindfulness (decentering, non-judging, and non-reacting), and a follow-up study in 2017 found that the improvement in non-judging following an acute dose of ayahuasca was maintained two months later. While these findings suggest that ayahuasca may offer benefits in mindfulness analogous to those obtained with MBSR training, the specific mindfulness domains affected by either approach have not been assessed. This open-label, prospective study evaluated the effects of four weekly ayahuasca sessions and eight weeks of MBSR training on mindfulness capacity.
Hypothesizing that both interventions would offer significant benefits, the authors compared effects of MBSR and ayahuasca on pre- and post-intervention scores on the Five Facet Mindfulness Questionnaire (FFMQ), Experiences Questionnaire (EQ), and MINDSENS Composite Index (based on elements of the FFMQ and EQ proven most sensitive to meditative practices). The ayahuasca group was comprised of 10 participants from the Barcelona, Spain area who were recruited from a pool of individuals who had indicated an interest in participating in more than one ayahuasca session. None of the participants in the ayahuasca group reported any previous mindfulness training or any specific interest in improving mindfulness. Over a four-week span, the ayahuasca group participated in four sessions conducted in a non-religious, relaxing setting. The MBSR group was comprised of 10 ayahuasca-naïve and MBSR-naive participants with an interest in mindfulness who were recruited from a pool of individuals enrolled in an MBSR course. Participants in the MBSR group were instructed in mindfulness techniques (body scan, Hatha yoga, sitting meditation) in 2.5 hour-long sessions conducted once a week for eight weeks. They were encouraged to practice each day by listening to a 45-minute recording of formal meditation techniques and integrating mindfulness principles into daily activities. Both groups completed the FFMQ and EQ at baseline and after the last session. The start and end dates of the study and the study locations were not reported.
There were no significant between-group differences in mean FFMQ or EQ scores at baseline, and the groups were comparable in age and gender. In the MBSR group, significant increases (P<0.001) were seen in scores for all five FFMQ facets (observing, describing, acting with awareness, non-reacting, and non-judging). In the ayahuasca group, a significant increase (P=0.02) was seen only for non-judging. On the EQ, the MBSR group had significant improvements in decentering (P<0.001) but the scores for the ayahuasca group did not significantly change compared to baseline. MINDSENS Composite Index changed significantly in the MBSR group (P<0.001) but not in the ayahuasca group.
In summary, MBSR training but not ayahuasca significantly improved overall mindfulness scores. Four ayahuasca sessions were as effective as eight weeks of MBSR training at improving acceptance (non-judging facet of mindfulness), suggesting that ayahuasca may potentially be a more cost-effective tool for increasing acceptance. Acknowledged limitations of the study include the small sample size, the lack of chemical characterization of the ayahuasca, and the MBSR group having the explicit goal of improved mindfulness while those in the ayahuasca group had a variety of less defined goals. The authors point out that larger controlled studies are needed to confirm these findings, determine the optimal ayahuasca dose and dosage schedule, and explore the combined effect of mindfulness training and ayahuasca.
Soler J, Elices M, Dominguez-Clavé E, et al. Four weekly ayahuasca sessions lead to increases in “acceptance” capacities: a comparison study with a standard 8-week mindfulness training program. Front Pharmacol. March 2018;9:224. doi: 10.3389/fphar.2018.00224.