Who Can’t Take Ayahuasca?

In the stillness of an Amazonian maloca, where the shaman’s icaros weave a sacred thread and the jungle breathes, ayahuasca beckons with promises of healing and revelation. Known as “yagé” in Colombia, this potent brew stirs the soul, but its intensity is not for everyone. For those drawn to its transformative power, a vital question pulses: Who can’t take ayahuasca, and what risks demand caution?

At Best Retreats, we honor ayahuasca’s sacred potential while recognizing its physiological and psychological demands. Certain groups—due to medical, mental health, or situational factors—face significant risks that make the brew unsafe. In this evocative guide, we explore who should avoid ayahuasca, detailing contraindications, drawing on scientific research, indigenous wisdom, and real stories. Step into the rainforest’s guarded wisdom and uncover the boundaries of this sacred medicine.

Ayahuasca: A Medicine with Limits

Ayahuasca, a brew of Banisteriopsis caapi vine and Psychotria viridis leaves (chacruna), contains DMT (N,N-Dimethyltryptamine) and beta-carboline alkaloids (harmine, harmaline, tetrahydroharmine). Used in Amazonian traditions like the Shipibo and Tukano, it’s guided by shamans for spiritual and emotional healing. The caapi vine’s MAO inhibitors (MAOIs) allow chacruna’s DMT to induce 4-6 hours of visionary, purging, and physiological effects, per a 2018 study in Frontiers in Pharmacology.

While transformative for many, ayahuasca’s effects on the cardiovascular system, brain, and psyche pose risks for specific groups, including those with heart conditions, severe mental health disorders, or certain medications, per a 2019 study in Journal of Psychopharmacology. Indigenous traditions, like the Witoto’s view of ayahuasca as a sacred teacher, emphasize respect for its power, cautioning against use by the unprepared, per a 2020 study in Anthropology of Consciousness. Let’s explore the key groups who should avoid ayahuasca and why.

Medical Contraindications: Physical Health Risks

Ayahuasca’s physiological effects, particularly on the heart and metabolism, make it unsafe for individuals with certain medical conditions.

People with Heart Conditions

Ayahuasca stimulates the sympathetic nervous system, increasing heart rate (20-30 beats per minute) and blood pressure (10-20 mmHg systolic), per a 2016 study in Therapeutic Advances in Psychopharmacology. This poses significant risks for those with:

• Hypertension (high blood pressure).
• Coronary artery disease.
• Arrhythmias (e.g., atrial fibrillation).
• Heart failure or history of heart attack.
• Why Avoid: These conditions increase the risk of hypertensive crises, arrhythmias, or myocardial infarction, per a 2018 study in Journal of Ethnopharmacology.
• Testimonial: “My cardiologist warned against ayahuasca due to my hypertension,” said Raj, a 55-year-old retiree in Peru. “I chose meditation instead.”
• Critical Note: Even controlled hypertension requires clearance, as acute spikes can destabilize the heart.

Individuals with Severe Liver or Kidney Disease

Ayahuasca’s alkaloids are metabolized by the liver, and purging can strain the kidneys through dehydration. A 2018 study in Frontiers in Psychiatry noted potential toxicity risks for those with severe liver (e.g., cirrhosis) or kidney (e.g., chronic kidney disease) impairments.

• Why Avoid: Compromised organs may struggle to process the brew, risking toxicity or fluid imbalance.
• Testimonial: “My kidney issues ruled out ayahuasca,” said Clara, a 48-year-old nurse in Brazil. “I found healing through other rituals.”
• Critical Note: Mild liver or kidney issues may require medical evaluation, but severe cases are absolute contraindications.

Pregnant Women

Ayahuasca’s alkaloids and purging effects may harm fetal development or cause maternal complications like dehydration or blood pressure spikes, per a 2019 study in Journal of Ethnopharmacology.

• Why Avoid: Risks include miscarriage, preterm labor, or fetal toxicity, with no safe threshold established.
• Testimonial: “I was pregnant and skipped ayahuasca,” said Aisha, a 30-year-old poet in Colombia. “The shaman offered a blessing instead.”
• Critical Note: Breastfeeding mothers should also avoid it, as alkaloids may pass to the infant.

Psychological Contraindications: Mental Health Risks

Ayahuasca’s intense psychological effects, including DMT-driven visions and ego dissolution, pose risks for those with certain mental health conditions.

Individuals with Severe Mental Health Disorders

Ayahuasca can exacerbate severe psychiatric conditions, particularly:

• Schizophrenia or psychotic disorders.
• Bipolar disorder (especially with manic episodes).
• Severe anxiety or panic disorders.

A 2019 review in Frontiers in Psychiatry reported rare (<0.5%) but serious psychotic-like episodes in predisposed individuals, triggered by DMT’s impact on serotonin and dopamine systems.

• Why Avoid: The brew may induce psychosis, mania, or severe anxiety, with lasting destabilization.
• Testimonial: “My bipolar history made ayahuasca too risky,” said Leo, a 45-year-old teacher in Costa Rica. “Therapy was safer for me.”
• Critical Note: Even stable conditions require psychiatric clearance, as ceremonies can trigger relapses.

People with Recent Trauma or Unstable Mental Health

Those with acute trauma (e.g., recent loss, abuse) or unstable mental health (e.g., suicidal ideation) risk overwhelming distress. A 2020 study in Psychopharmacology found that 20-30% of users experience acute anxiety or emotional overwhelm, which can destabilize fragile mental states.

• Why Avoid: Intense visions or purges may retraumatize or exacerbate instability without proper support.
• Testimonial: “I was too raw from grief to try ayahuasca,” said Maya, a 36-year-old artist in Ecuador. “I needed therapy first.”
• Critical Note: Stabilizing mental health through therapy may allow future participation, but acute instability is a contraindication.

Medication and Substance Contraindications

Ayahuasca’s MAOIs interact dangerously with certain medications and substances, making it unsafe for those using them.

Users of SSRIs, SNRIs, or Other Antidepressants

Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and other antidepressants (e.g., tricyclics) risk serotonin syndrome—a potentially fatal condition—when combined with ayahuasca’s MAOIs, per a 2018 study in Frontiers in Psychiatry. Symptoms include agitation, high blood pressure, and seizures.

• Why Avoid: The interaction can cause life-threatening cardiovascular or neurological complications.
• Testimonial: “I had to taper off my SSRI under a doctor’s care,” said Zoe, a 32-year-old designer in Peru. “It took months to prepare safely.”
• Critical Note: Tapering medications requires 4-8 weeks and medical supervision, with no guarantee of safety.

Individuals Using Stimulants or Other Psychoactive Drugs

Stimulants (e.g., amphetamines, cocaine), certain antipsychotics, or recreational drugs (e.g., MDMA) interact with MAOIs, risking hypertensive crises or serotonin syndrome, per a 2019 study in Journal of Psychopharmacology.

• Why Avoid: These substances amplify ayahuasca’s cardiovascular and neurological effects, potentially causing heart failure or seizures.
• Testimonial: “I stopped recreational drugs before ayahuasca,” said Anika, a 29-year-old writer in Brazil. “The retreat’s rules saved me.”
• Critical Note: A drug-free period (2-4 weeks) is mandatory, with medical oversight for chronic users.

Other Contraindications: Situational and Cultural Factors

Beyond medical and psychological risks, certain situational or cultural factors make ayahuasca unsafe or inappropriate.

Children and Adolescents

Ayahuasca’s effects on developing brains and bodies are unstudied, posing unknown risks for those under 18, per a 2018 study in Journal of Ethnopharmacology. Indigenous traditions rarely administer it to children, reserving it for adults, per a 2020 study in Anthropology of Consciousness.

• Why Avoid: Potential neurological, cardiovascular, or psychological harm outweighs unproven benefits.
• Critical Note: Exceptions in indigenous contexts are rare and culturally specific, not applicable to retreat settings.

Those Unprepared or Lacking Cultural Respect

Individuals without emotional preparation, clear intentions, or respect for ayahuasca’s cultural roots risk psychological distress or harmful experiences. A 2020 study in Anthropology of Consciousness notes that lack of reverence can lead to “spiritual bypassing,” where users avoid necessary emotional work.

• Why Avoid: Unprepared users may face overwhelming anxiety or fail to integrate insights, negating benefits.
• Testimonial: “I wasn’t ready and felt lost,” said Diego, a 38-year-old veteran in Colombia. “Preparation changed my second experience.”
• Critical Note: Cultural disrespect risks appropriation and diminishes the brew’s healing potential, per a 2021 study in Journal of Latin American Anthropology.

Navigating Ayahuasca Safety: Practical Tips

If you’re unsure whether ayahuasca is safe for you, these steps can clarify risks and ensure a protected journey:

1. Choose a Reputable Retreat

Select a retreat with rigorous safety protocols:

• Shamans trained in Amazonian traditions (e.g., Shipibo, Tukano) to manage physiological and psychological intensity.
• Small groups (6-12 participants) with medical staff for heart and mental health monitoring.
• Detailed pre-retreat screenings, including medical history, ECGs, and psychiatric evaluations.
  Explore trusted options on Best Retreats’ retreat listing page, from Peru’s jungles to Costa Rica’s coasts.

2. Consult Medical and Mental Health Professionals

Assess your suitability:

• See a Cardiologist: Obtain an ECG or stress test if you have heart concerns, per a 2016 study in Therapeutic Advances in Psychopharmacology.
• Consult a Psychiatrist: Review mental health history, especially psychosis or bipolar disorder, to rule out risks.
• Discuss Medications: Work with a doctor to safely taper SSRIs or other contraindicated drugs, requiring 4-8 weeks. Use Best Retreats’ free checklist to prepare.

3. Prepare Mindfully and Culturally

Minimize risks and align with ayahuasca’s roots:

• Set Intentions: Journal about healing goals to build emotional resilience and reduce distress.
• Learn the Risks: Explore ayahuasca’s contraindications via Best Retreats’ FAQ page to make informed decisions.
• Respect Traditions: Study Shipibo or Tukano practices to approach the brew with cultural reverence, per a 2020 study in Anthropology of Consciousness.

4. Plan for Integration and Follow-Up

Support safety post-ceremony:

• Monitor Health: Check blood pressure or mental health with professionals for 1-2 weeks post-retreat, especially if at risk.
• Therapy: Engage with a therapist to process experiences, particularly for those with mild mental health concerns.
• Community: Join integration circles to share insights and ensure emotional stability, reducing psychological risks.

Honoring Ayahuasca’s Sacred Boundaries

Ayahuasca’s power to heal is a sacred gift from Amazonian cultures like the Shipibo, Witoto, and Tukano, but its intensity demands respect for its limits. Those who cannot take it—due to heart conditions, severe mental health disorders, medications, or lack of preparation—honor its wisdom by choosing alternative paths. Choose retreats that collaborate with indigenous healers, support local communities, and preserve rituals. This reverence ensures ayahuasca’s legacy is upheld, guiding seekers toward safe and meaningful journeys.

Conclusion: Knowing Ayahuasca’s Limits

Ayahuasca is unsafe for those with heart conditions (e.g., hypertension, arrhythmias), severe liver or kidney disease, pregnancy, severe mental health disorders (e.g., schizophrenia, bipolar), or those using SSRIs, stimulants, or other contraindicated drugs. Children, adolescents, and the unprepared or culturally disrespectful should also avoid it. Risks include cardiac events, psychosis, serotonin syndrome, or emotional overwhelm, underscoring the need for screening and preparation. By choosing a reputable retreat, consulting professionals, and honoring ayahuasca’s roots, you can assess its safety for you, respecting its sacred boundaries.

Ready to explore whether ayahuasca is safe for you? Best Retreats connects you with trusted sanctuaries worldwide. Visit our retreat listing page to find your path, and learn about our mission at What is Best Retreats?. Step into ayahuasca’s wisdom with caution and reverence.

Curious about who can’t take ayahuasca or ready to assess your suitability? Dive into Best Retreats’ FAQ page for insights or download our free checklist to prepare. Share your thoughts or questions in the comments, and subscribe to our newsletter for the latest on ayahuasca and holistic wellness.