Ayahuasca is a South American psychoactive plant brew used as traditional medicine in spiritual and in cultural rituals. This is a review of the current understanding about the pharmacological mechanisms that may be interacting in ayahuasca. Searches were performed using PubMed, PsycINFO, and Web of Science databases and 16 papers were selected. As hypothesized, the primary narrative in existing research revolved around prevention of deamination of N,N-dimethyltryptamine (N,N-DMT, also referred to as DMT) by monoamine oxidase inhibitors (MAOIs) in ayahuasca. Two of the constituents, DMT and harmine, have been studied more than the secondary harmala alkaloids. At present, it is unclear whether the pharmacological interactions in ayahuasca act synergistically or additively to produce psychoactive drug effects. The included studies suggest that our current understanding of the preparation’s synergistic mechanisms is limited and that more complex processes may be involved; there is not yet enough data to determine any potential synergistic interaction between the known compounds in ayahuasca. Our pharmacological understanding of its compounds must be increased to avoid the potential risks of ayahuasca use.

Efforts to investigate psychiatric disorders across cultures routinely ignore a pervasive cultural influence, namely the culture of psychiatry. This article focuses on how the culture of psychiatry affects our understanding of posttraumatic stress disorder (PTSD). PTSD is diagnosed by means of standardized symptom criteria and scales. Yet it is a heterogeneous phenomenon. The illusion of homogeneity is fostered by a categorical conception of traumatic memory that homogenizes posttraumatic memories and erects an obstacle to investigating the disorder's historical nature, clinical phenomenology, and neuro-physiology and neuro-anatomy. I illustrate this process, via an epidemic of PTSD that now affects a quarter of a million American war veterans.

Los esfuerzos para investigar trastornos psiquiátricos a través de las culturas, por lo general ignoran una frecuente influencia cultural, que es la propia cultura de psiquiatría. Este artículo se enfoca en cómo la cultura de psiquiatría afecta nuestro entendimiento del trastorno de estrés post-traumático (TEPP). El TEPP se diagnostica mediante criterios de síntomas y escalas. No obstante, es un fenómeno heterogéneo. La ilusión de homogeneidad es fomentada por una concepción categórica de memoria de trauma que homogeneiza las memorias post-trauma y crea un obstáculo para investigar la historia natural del trastorno, la fenomenología clínica, neurofisiología y neuroanatomía. Ilustro este proceso por medio de una epidemia de TEPP que afecta a un cuarto de millón de veteranos de guerra en Norteamérica.

Os esforços para investigar transtornos psiquiátricos em diferentes culturas rotineiramente ignoram a difusa influência cultural, principalmente a cultura da psiquiatria. Este artigo enfoca como a cultura da psiquiatria afeta a nossa compreensão do transtorno de estresse pós-traumático (PTSD). PTSD é diagnosticado por meio de critérios de sintomas padronizados e escalas. No entanto, é um fenômeno heterogêneo. A ilusão de homogeneidade é fomentada por uma concepção categórica da memória traumática que homogeniza as memórias pós-traumáticas e erige um obstáculo para investigar a natureza da desordem histórica, a fenomenologia clínica, e a neurofisiologia e neuroanatomia. Explico este processo por meio de uma epidemia de PTSD que atualmente afeta um quarto de um milhão de veteranos de guerra americanos.