Ayahuasca Dangers: The Do’s And Don’ts When Preparing For Your First Journey
Last reviewed and updated: June 17, 2026.
Key Takeaways
| Dangerous drug interactions | SSRIs, SNRIs, MAOIs, tramadol, lithium, MDMA, cocaine — all risk serotonin syndrome (potentially fatal) due to ayahuasca’s MAO inhibition |
| Dietary restrictions | Tyramine-rich foods (aged cheese, cured meats, red wine, fermented foods) must be avoided before ceremonies — not just spiritual tradition, it prevents dangerous blood pressure spikes |
| Screen your provider | Require: medical screening, dietary protocol, trained sober facilitators, no sexual contact policy, integration support — walk away from providers who minimize these |
| Physical risks | Vomiting (“purging”) is common; cardiovascular strain; disorientation — always have a sober, trusted guide present |
| Psychological risks | Not appropriate for people with personal/family history of psychosis or bipolar with psychotic features — medical screening is a real safety tool |
Deciding to take ayahuasca for the first time can be a big decision. Even without having prior experience with psychedelics, an ayahuasca journey can still be unexpectedly intense. As a powerful psychedelic brew, it’s important to respect the substance. This means preparing correctly for the experience. Without the right preparation, ayahuasca can, sometimes, present some dangers.
In this article, we describe all the things a person should (and shouldn’t) do to prepare for a first ayahuasca session. This will help avoid common ayahuasca dangers, and explain how to prepare for ayahuasca.
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Ayahuasca Dangers: Active Steps To Help You Avoid Them
First, let’s begin with some of the active steps to take before drinking ayahuasca.
Do In-Depth Research Into Ayahuasca Retreat Centers
There are many retreat centers in the world offering ayahuasca retreats. But which one will be the most professional, safe, and caring? Luckily, there are many ways to check this.
If there’s a retreat center that looks appealing, visit their website. Do they list reviews and testimonials on their website? If not, this is potentially a red flag. It may indicate the retreat center isn’t reputable or that it’s relatively new, in which case it’s hard to tell its level of quality. On the other hand, if there are reviews available, be sure to read them to get an idea of how well the care is during a session(s) with ayahuasca.
The caveat here, of course, is that websites are likely to only publish positive reviews. For this reason, it’s worth looking up an impartial review website dedicated to psychedelic retreats. These include Retreat Guru and AyaAdvisors. Both community forums offer positive and negative reviews, as well as show which centers are the best rated overall. Lastly, each shows the clinics prioritizing safety and emotional support.
Understand The Effects Of Ayahuasca
Another way to avoid ayahuasca dangers is to properly understand the effects of ayahuasca. In terms of protecting your health and safety, these means knowing how ayahuasca interacts with the below.
- Medications
- Physical conditions
- Mental health conditions
- Dietary choices
In the next section on what not to do before taking ayahuasca, we’ll take a look at the medications, physical conditions, mental health issues, and dietary factors that increase the risk of ayahuasca dangers.
It’s also vital to understand that an ayahuasca experience can be physically, emotionally, and perceptually intense. Reading or listening to books, articles, trip reports, and podcasts that discuss what an ayahuasca experience is like may prepare a person for the unique experience. However, no information can really convey what a personal, subjective journey will be like.
Avoid going into the experience with zero understanding about how to navigate a psychedelic journey, especially when it becomes challenging. Intense or difficult physical, emotional, and perceptual changes require learning some basic pieces of wisdom (e.g. not resisting the experience). Without these techniques in place, it might be harder to overcome periods of distress.
Ayahuasca Dangers: What Not To Do Before Your First Session
Now, let’s focus on the things to avoid doing before embarking on an ayahuasca journey.
Don’t Join An Ayahuasca Retreat Without Knowing Anything About It
Ayahuasca dangers include the risks you expose yourself to when joining an ayahuasca retreat without knowing if the provider is trustworthy or not. Unfortunately, there are many cases of shady pseudo-shamans offering travelers ayahuasca. These people may engage in unethical behavior, including stealing and sexual assault.
If traveling in areas where ayahuasca ceremonies are accessible and promoted (e.g. in Latin America), don’t trust someone just because they call themselves a shaman. And don’t join a ceremony as an impulse decision. This may lead to taking ayahuasca brew with untrustworthy people who only care about money, not safety or well-being.
Don’t Take Ayahuasca With Certain Medications
As mentioned earlier, there are some medications that are contraindicated with ayahuasca, meaning that the combination can be dangerous. Any medications that contain monoamine oxidase inhibitors (MAOI) can interact negatively with ayahuasca because the latter also contains MAOIs. This combination can lead to harmful effects.
Also, avoid drinking ayahuasca if currently using selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants. This dangerous combination, again due to the presence of MAOI in ayahuasca, can result in serotonin syndrome. This involves high levels of serotonin accumulating in the body, which can sometimes be fatal.
Don’t Take Ayahuasca With Certain Physical Conditions
Some physical conditions are also contraindicated with ayahuasca. It’s best for a user to avoid taking ayahuasca if there’s a serious underlying heart condition or high blood pressure. This is because ayahuasca can increase both heart rate and blood pressure. When taken with the conditions mentioned, there is an increased risk of dangerous side-effects.
Don’t Take Ayahuasca With Certain Mental Health Conditions
Some mental health conditions don’t mix well with psychedelics. These include psychotic disorders, like schizophrenia. Researchers have identified several cases of ayahuasca-induced psychotic episodes, with some involving individuals with a personal and possible family history of psychosis (e.g. schizophrenia, psychotic mania, and psychotic depression).
Clinical trials on psychedelics exclude those with psychosis or a family history of it because of the rare instances in which a psychedelic compound triggers a lasting psychotic reaction. If this applies to an individual, there is a chance that an ayahuasca session might worsen that person’s mental health.
Don’t Take Ayahuasca With Certain Foods
There are some foods to avoid eating when preparing for an ayahuasca journey, due to the presence of MAOIs in ayahuasca. This is why retreat centers often recommend that following an “ayahuasca diet“, known as the dieta, which excludes tyramine-containing foods.
Tyramine stimulates the release of the hormone epinephrine in the bloodstream. However, MAOI blocks epinephrine’s absorption. This can lead to nausea, occipital headache, and even intracranial hemorrhage. Foods to avoid include the following.
- Cheese
- Broad beans
- Fermented tofu
- Soy sauce
- Dry sausage
- Beer
- Chocolate
- Sauerkraut
- Caffeine
- Dried fruit
- Pickled foods
- Smoked meat
- Protein dietary supplements
- Yeast extracts
- Sourdough bread
- Red wine
- Avocados
Be wary of any retreat center that doesn’t address all of the contraindications discussed here. This is a definite red flag, as it shows they do not prioritize the well-being of its participants.
Regardless of an individual’s context for taking ayahuasca, it’s important to keep the above points in mind to protect both physical and mental health. Having support on standby is often essential to avoiding ayahuasca dangers.
Ensure both safety and comfort during a first ayahuasca journey by becoming knowledgeable about the brew. This allows making informed decisions about where to have the experience, who to have as a guide(s), and how to physically and mentally prepare for it.
Finally, don’t neglect the importance of ayahuasca integration. This refers to making sense of an experience. Know beforehand that time and support may be necessary after the experience to process what happened. Ayahuasca dangers can also involve difficulty with integrating a journey, which can lead to worsened mental health or even a spiritual emergency. Making sure that resources and support are utilized before an experience will assist with integration, while helping mitigate any ayahuasca dangers.
Ayahuasca Safety in 2025: What The Retreat Boom Has Changed
Ayahuasca tourism has grown substantially since this article was first written. More people than ever are traveling to Peru, Costa Rica, Brazil, and the Netherlands to participate in ayahuasca ceremonies — and the quality, safety practices, and accountability of the operators vary enormously. This growth has brought both greater access to the medicine and a corresponding increase in reported adverse events, including psychological crises, sexual misconduct by facilitators, and a small number of deaths in unregulated settings. Understanding how to evaluate a ceremony provider has never been more important.
Critical Drug Interactions To Know Before Any Ceremony
Ayahuasca contains beta-carboline MAO inhibitors (harmine, harmaline, tetrahydroharmine) which give it its distinctive psychoactive effect — but these same compounds create serious interaction risks with a wide range of common medications and substances. The most dangerous category is serotonin syndrome: a potentially life-threatening condition caused by excess serotonin activity. Any drug that increases serotonin levels — SSRIs, SNRIs, MAOIs, tramadol, lithium, MDMA, cocaine — combined with ayahuasca’s MAO inhibition can cause serotonin syndrome, characterized by agitation, high fever, rapid heart rate, and in severe cases, seizures or death. This is not a theoretical risk; multiple fatalities in ceremony settings have involved participants who did not disclose SSRI use.
Beyond serotonin syndrome, tyramine-containing foods (aged cheeses, cured meats, fermented foods, red wine) interact with MAO inhibition to cause dangerous hypertensive episodes — sudden, severe spikes in blood pressure. This is why reputable ceremony providers require a dietary protocol (the “ayahuasca diet” or “dieta”) in the days preceding a ceremony: it is not merely a spiritual tradition but a medical precaution. Stimulants, including recreational cocaine and prescription amphetamines (Adderall, Ritalin), are also contraindicated.
How To Screen A Retreat Provider
With the proliferation of ceremony providers worldwide, knowing what to look for has become a practical necessity. Reputable providers will: conduct a detailed medical and medication screening before accepting participants; provide clear pre-ceremony protocols (dietary restrictions, medication washout periods); have trained facilitators or medical staff present who can handle a psychological crisis; maintain a safe physical environment where participants are not left alone; have explicit policies against sexual contact between facilitators and participants; and provide some form of post-ceremony integration support. Warning signs include providers who minimize medication interaction risks, rush the medical intake process, promise miraculous healing outcomes, or combine ayahuasca with other psychoactive substances without explicit medical oversight. The Church of the Eagle and the Condor, ICEERS (International Center for Ethnobotanical Education, Research and Service), and the Multidisciplinary Association for Psychedelic Studies offer resources for finding vetted providers.
Frequently Asked Questions
Is ayahuasca dangerous?
Ayahuasca carries real risks, particularly for people with certain health conditions or who are taking specific medications. The most serious risk is serotonin syndrome — a potentially fatal condition that can occur when ayahuasca’s MAO-inhibiting compounds interact with serotonergic medications (SSRIs, SNRIs, tramadol, MDMA). Cardiovascular risks are elevated for people with heart conditions due to the stimulant properties of the brew. Psychologically, ayahuasca is one of the more challenging psychedelic experiences — people with personal or family history of psychosis, bipolar disorder with psychotic features, or certain other psychiatric conditions may be at increased risk for difficult or destabilizing experiences. In healthy individuals with no contraindicated medications who participate in properly run ceremonies, serious adverse events are uncommon — but they are not zero, and deaths have occurred.
What medications interact dangerously with ayahuasca?
The most serious interactions are with drugs that affect serotonin: SSRIs (fluoxetine/Prozac, sertraline/Zoloft, escitalopram/Lexapro, others), SNRIs (venlafaxine/Effexor, duloxetine/Cymbalta), MAO inhibitors (phenelzine, tranylcypromine, selegiline, linezolid), tramadol, lithium, St. John’s Wort, and recreational serotonergics like MDMA and cocaine. The interaction risk is serotonin syndrome. Beyond serotonin, stimulants (Adderall, Ritalin, methamphetamine) interact dangerously with ayahuasca’s MAO inhibition. Antipsychotics, benzodiazepines, and certain cardiovascular medications also carry interaction risks. A complete medication review with a knowledgeable practitioner before any ceremony is not optional — it is a basic safety requirement.
How do you find a safe ayahuasca ceremony?
Look for providers who conduct thorough medical and medication screening before accepting participants, require a dietary protocol in the days before ceremony, have trained facilitators or medical staff present, maintain explicit policies against sexual contact with participants, and offer post-ceremony integration support. Reputable providers will not minimize drug interaction risks or guarantee specific healing outcomes. International resources including ICEERS (International Center for Ethnobotanical Education, Research and Service) and MAPS provide information for evaluating providers. In the United States, ayahuasca remains a controlled substance, so domestic ceremonies generally operate in religious or legally gray contexts — increasing the importance of thorough vetting.
Can you do ayahuasca alone?
Experienced practitioners strongly advise against solo ayahuasca use, particularly for first-timers. The experience is physically intense — vomiting (“purging”) is common, and some people experience profound disorientation — and having a sober, trusted guide present significantly reduces the risk of harm. The traditional ceremony structure exists for practical safety reasons, not just spiritual ones. At minimum, a sober sitter should be present for anyone consuming ayahuasca outside a ceremony setting. Additionally, without medical screening and medication review, solo use carries the full drug interaction risk without any safeguard. Even in remote or home settings where experienced participants do solo work, they are typically people with extensive prior ceremony experience who have already established they have no contraindicated conditions.
Wendi
August 16, 2022 at 3:13 pmIn addition to getting away from pills, I want to experience JOY again. Being a grown-up is extremely difficult. My parents didn’t warn my brother and I that you experience the decay of Joy as you get older. There’s too many adult responsibilities and it does make us feel like robots just going through the motions, waiting for death. Where’s the Joie de vivre?