For most healthy adults who are carefully screened, cleared of interacting medications, and supervised by experienced people, serious problems with ayahuasca are uncommon. It is not risk-free, though. In the largest survey of ayahuasca drinkers to date, with more than 10,000 respondents, about 70% reported physical side effects, mostly nausea and vomiting, and 2.3% said they needed medical attention. The biggest risks come from combining ayahuasca with certain medications, from some heart and psychiatric conditions, and from drinking it without screening or supervision.
On this page: What are the common side effects? · What are the serious risks? · Can I do ayahuasca if I take antidepressants? · Who should not drink ayahuasca? · Can you die from ayahuasca? · How do retreats reduce the risk?
What are the common side effects of ayahuasca?
Most side effects are physical and short-lived. The Global Ayahuasca Survey, published in PLOS Global Public Health in 2022, found these were the most common:
- Nausea or vomiting: 62.0% of respondents
- Headache: 17.8%
- Abdominal pain: 12.8%
In ceremony, vomiting is called the purge, and it is understood as a release rather than something to be embarrassed about. Laboratory research has also measured temporary rises in heart rate and blood pressure after drinking ayahuasca (Riba et al., 2003), which is one reason we screen carefully for heart conditions.
Emotional intensity is common too. In the same survey, 55% reported challenging psychological effects, such as hearing or seeing things others don’t, or feeling disconnected or alone. We call these difficult passages. They can be intense, which is why experienced facilitators stay with every guest for the whole ceremony.
What are the serious risks of ayahuasca?
Serious harm is rare, but it is real, and it tends to follow a few patterns:
- Medication interactions. The vine in ayahuasca contains harmine and harmaline, which act as monoamine oxidase inhibitors (MAOIs). Combined with antidepressants and other drugs that raise serotonin, they can cause serotonin toxicity, which can be life-threatening (Malcolm & Thomas, 2021).
- Heart and blood-pressure strain in people with existing cardiovascular disease.
- Psychiatric crises in people with a personal history, or a strong family history, of psychosis or bipolar I disorder.
- Unsupervised use. The Global Ayahuasca Survey linked adverse effects to drinking outside a supervised setting, and also to physical health conditions, anxiety disorders and a past substance use disorder.
Can I do ayahuasca if I take antidepressants?
Not while you are taking them. SSRIs such as sertraline, escitalopram and fluoxetine, along with SNRIs, tricyclics and several other medication classes, are among the most dangerous combinations with ayahuasca because of the serotonin toxicity risk described above.
That does not mean you should stop your medication to attend a retreat. Never taper or stop a prescription on your own. If you and your prescribing physician decide together that pausing makes sense, clearing it takes time: anywhere from a few days to eight weeks or more, depending on the drug. Fluoxetine (Prozac) usually needs about five to six weeks. Our team builds your timeline with you and your doctor during screening. The full list of medications, supplements and foods to avoid is on our medical guidelines page.
Who should not drink ayahuasca?
Our intake screens for conditions where the risks are too high, including:
- pregnancy or breastfeeding
- significant heart disease, uncontrolled high blood pressure, or a history of stroke
- epilepsy or poorly controlled seizures
- bipolar I disorder, schizophrenia, or a strong family history of psychosis
- active suicidal thoughts or severe psychiatric instability
Pachamama Sanctuary welcomes guests aged 18 to 65, and people near the upper limit can ask about a case-by-case intake. Screening ends in one of three outcomes: go, not yet, or conditional. It is never a silent rejection. Review our Medical Guidelines before applying.
Can you die from ayahuasca?
Deaths linked to ayahuasca ceremonies have been reported, but they are rare. The known risk factors are medication interactions, serious pre-existing conditions and unsupervised use, so the most important safety steps happen before you ever sit in ceremony: an honest medical history, a medication plan made with your doctor, and a setting with experienced people present the entire time.
How do retreats reduce the risk?
Safety practices vary widely. A 2026 study in JAMA Network Open interviewed 49 publicly advertised psychedelic retreat organizations. All of them collected medical histories and 87.8% required or recommended stopping certain medications, but fewer than half (42.9%) worked with a licensed health care professional. The authors concluded that best-practice guidelines are needed.
Before booking any retreat, ask:
- What does your medical and psychological screening involve, and who reviews it?
- How do you handle medications, and will you coordinate with my doctor?
- Who is present during ceremony, and what is your emergency plan?
- How many guests are in a ceremony, and how many facilitators?
- What integration support do you offer afterward?
At Pachamama Sanctuary, which holds ayahuasca retreats in Maine and Orlando, every guest completes a medical and psychological intake and receives a personal washout timeline, along with our dieta and physical preparation guidelines. Ceremonies are held in intentionally small groups by experienced facilitators who stay present throughout. Afterward, past guests can join our free weekly Integration Circle on Zoom. To learn more about the medicine itself, read What Is Ayahuasca and How Does It Work? or see how long ayahuasca lasts. Our published code of ethics describes the standards we hold ourselves to.
