Psychedelic drug ayahuasca could treat PTSD, early studies hint. But exactly how it works isn’t clear.
EDITOR’S NOTE — This story includes discussion of suicide. If you or someone you know needs help, America’s National Suicide and Crisis Lifeline is available by calling or texting 988. There is also an online chat at 988lifeline.org.
In 2014, Navy fighter pilot Kegan “Smurf” Gill was flying an F/A-18 Super Hornet when a catastrophic malfunction sent the plane into a 695 mph (1,118 km/h) dive. He ejected seconds before impact and survived massive trauma: broken limbs, a broken neck and a severe brain injury.
Eventually, he was diagnosed with late-onset post-traumatic stress disorder (PTSD), which “impacted his flying career like a warhead.” As his racing career faded, he lost his sense of purpose and felt an intense sense of shame that he was letting down everyone who had ever believed in him. He even thought about suicide.
Gill continued to receive medication, and then “life really got out of hand.” He spent 40 days and nights locked up in a Department of Veterans Affairs psychiatric facility. “When I came out, I was a broken shell of a man in a drug-induced stupor,” Gill said.
But that’s not where his story ended. He connected with the Heroic Hearts Project (HHP)a nonprofit organization that connects veterans to supervised psychedelic therapy overseas, and in Peru, Gill underwent treatment with the psychedelic. ayahuasca — an experience that he says set him on the path to recovery.
THE HHP has hosted more than 1,100 veterans and spouses of veterans through its retirement programs.which aim to reduce or eliminate PTSD symptoms and improve participants’ quality of life. Most of the retreats involved ayahuasca, a psychoactive drink traditionally used by indigenous communities in the Amazon. Because ayahuasca is classified as a Schedule I controlled substance in the United States, these retreats take place in countries where the ceremony is legal.
But while anecdotal evidence abounds on the psychedelic drug’s purported benefits, research into its effectiveness lags behind that of other psychedelics, such as MDMA and psilocybin. Only a few little studies studied ayahuasca for PTSD, and these were not randomized, placebo-controlled clinical trials – the gold standard for demonstrating that a drug is effective. It is therefore difficult to determine whether ayahuasca reduces PTSD symptoms or whether other factors, such as therapy or the retreat environment, may help resolve PTSD symptoms.
To complicate matters further, the botanical brew of ayahuasca contains two main components: psychoactive DMT (N,N-Dimethyltryptamine) and beta-carbolines. The concentration of these ingredients varies between batches, making it difficult to create a standardized, reproducible dose required for rigorous clinical trials. In contrast, MDMA and psilocybin are unique molecules, which can be synthesized and packaged in a pure, consistent and standardized pill or capsule form, much easier to use in a research setting. Additionally, pharmaceutical companies face difficulties when trying to obtain patents on ayahuasca, reducing the financial incentive for the massive private investments needed for large-scale clinical trials.
“It will probably never be a treatment in the traditional sense of the term in the United States, because it is a herbal concoction,” believes the clinical psychologist. Gregory Fonzoco-director of the Charmaine and Gordon McGill Center for Psychedelic Research and Therapy at the University of Texas at Dell Medical School in Austin, told Live Science.
Measuring the impact
However, some researchers are trying to measure the impact of the medication on PTSD symptoms. The HHP research arm designed and conducted an observational study that followed 58 veterans; 45 participated in an ayahuasca retreat and 13 participated in a psilocybin retreat, between 2021 and 2024.
The scientists tracked changes in participants’ mental health before and after their psychedelic experiences. They found that participants in both arms had an average 29% reduction in depression symptoms and 26% reduction in PTSD symptomsas well as improvements in anxiety, sleep, emotional well-being and quality of life.
“We only took veterans who met the criteria for PTSD, and more than 80% of them no longer met those criteria,” says a neuroscientist. Grace Blest-Hopleydirector of research at HHP, told Live Science.
To further his research, Fonzo is currently collaborating with the HHP and conducting a study to examine the brain responses of veterans with PTSD and how they are changed after ayahuasca treatment.
Texas researchers are collecting a variety of brain imaging and clinical data, blood measurements and electroencephalographic (EEG) recordings from veterans before and after they participate in an ayahuasca retreat. EEG data provides a means to identify objective biomarkers of PTSD. Scientists aim to recruit 40 participants for the study, which will likely take another year, Fonzo said.
A complex composition
In the HHP observational study, while the ayahuasca and psilocybin groups showed a reduction in symptoms after treatment, ayahuasca appeared slightly more effective. However, the researchers cautioned that the study was not designed to directly compare treatments.
Fonzo believes the two compounds work in a two-phase process. In the first phase, psychedelics disrupt the psychological patterns people are stuck in and effectively “shake” the snow globe. The second phase is marked by an improvement in neuroplasticity, that is to say the ability to forge new connections between neurons. This second phase can last a few weeks. “This creates an opportunity for people to glean and consolidate their knowledge and reshape their brains in a way that is more conducive to mental health,” Fonzo said.
To achieve this effect, psilocybin and DMT, the main active component of ayahuasca, activate the serotonin 2A receptor in the brain. But ayahuasca also contains beta-carbolines, which increase levels of key mood chemicals serotonin and norepinephrine in the body and brain. THE The DMT found in ayahuasca also has its own targets, such as the “sigma-1 receptor”.“, leading to a broader and more complex effect on brain chemistry than that seen with psilocybin, Fonzo said.
Still, research on ayahuasca is in its early stages, Fonzo said, and it’s difficult to determine how other aspects of the retreat experience influence the drug’s effectiveness.
For example, HHP retreats place a strong emphasis on treatment and integration of the psychedelic experience, which may include therapy, community support, and lifestyle changes. “If you just take the drug, then continue as usual and don’t make any changes, our brains will revert to how they were before,” Blest-Hopley theorized.
Gill agreed. He feels that ayahuasca broke the darkness he lived in and fundamentally transformed him. But he began to heal after that, when he focused on sleep, nutrition, exercise, reconnecting with nature and community, and meditation, he said. Now an ultra-endurance athlete, motivational speaker and coach who has written a book about his experiencesGill says he wants to inspire anyone facing seemingly insurmountable challenges.
“I was able to grow back from the inside,” Gill said. “Now I become the father, husband, son and friend I was always meant to be.”
