Ayahuasca Retreat FAQ's: Safety, Risks, Preparation, Diet, Safety & Integration

This FAQ's addresses the questions people most commonly search before booking an ayahuasca retreat—especially around danger, deaths, medical screening, medication interactions, and how to evaluate whether a ceremony setting is truly safe.

Important note: This is general education, not medical advice. Ayahuasca involves pharmacology (including MAOI activity) and can interact dangerously with certain medications and health conditions. If you take prescriptions (especially psychiatric meds), do not stop them abruptly—coordinate with your prescribing clinician.

Quick safety overview

Ayahuasca can be physically intense and psychologically profound. In large survey research, acute physical effects (primarily vomiting) are common, and a small percentage report needing medical attention. PMC
The most serious risks tend to cluster around:

Medication interactions (especially serotonergic drugs) due to MAOI activity in the brew. PMC+1
Cardiovascular stress (blood pressure/heart rhythm risk in susceptible people). ICEERS>+1
Psychiatric destabilization in people with bipolar spectrum, psychosis vulnerability, or unmanaged severe mental illness. PMC+2Cleveland Clinic+2
Unsafe settings: poor screening, unclear brew composition, lack of supervision, polydrug use, or inadequate emergency readiness. PMC+2ICEERS>+2

1) The Basic FAQ's

What is ayahuasca?

Ayahuasca is a traditional Amazonian psychoactive brew typically made from Banisteriopsis caapi (which contains beta-carbolines with MAOI properties) plus a DMT-containing admixture plant. The MAOI activity is a key reason ayahuasca can be pharmacologically risky with certain medications.

How does ayahuasca work?

At a high level: DMT is ordinarily broken down quickly in the gut. In ayahuasca, MAOI compounds can inhibit that breakdown, allowing DMT to become active orally—while also meaning drug interactions matter.

How long does an ayahuasca ceremony last?

Duration varies by dose, individual physiology, and context. Many ayahuasca retreats describe onset within the first hour and a multi-hour peak and resolution—often around a single evening in ceremony format.

2) Safety and risk

Is ayahuasca dangerous?

It can be—depending on who is taking it, what else they’re taking (meds/substances), and how the ceremony is run. Research and clinical literature generally describe ayahuasca as having a non-trivial adverse effect profile (especially nausea/vomiting) with higher-risk edge cases involving interactions, psychiatric vulnerability, or unsafe conditions.

Are ayahuasca ceremonies safe?

A well-run ceremony can reduce risk substantially, but “safe” is not a blanket statement. Screening, medical exclusion criteria, supervision, environment, and emergency planning are what separate higher-accountability settings from risky ones. publishes minimum safety standards and good-practice guidance specifically to reduce avoidable harms.

Have people died on ayahuasca? Are there ayahuasca deaths?

Yes—deaths have been reported in the medical literature and in real-world retreat contexts, though they appear to be rare relative to the total number of ceremonies globally. The circumstances are often complex and may involve adulterated brews, additional toxic plants, inadequate screening for drug interactions, polydrug combinations, or indirect harms during altered states.

Because reporting is inconsistent across countries and settings, there is no single definitive global “count” you can rely on. What matters operationally is understanding why tragedies occur and how reputable programs prevent them (screening, exclusions, medical readiness, supervision, no polydrug use, clear protocols).

What are the most common side effects?

Common acute effects include nausea, vomiting, and diarrhea, and they are frequently reported in survey data. In a large global survey, acute physical adverse effects (primarily vomiting) were reported by ~70%, and ~2.3% reported needing subsequent medical attention. PMC+1

Can ayahuasca cause serotonin syndrome?

The risk is most discussed when ayahuasca is combined with serotonergic medications (e.g., SSRIs/SNRIs and some other psychiatric drugs). Because ayahuasca has MAOI activity, combining it with serotonergic agents can plausibly increase risk of serotonin toxicity—this is one reason many safety guidelines require medication washout under medical supervision.

Can ayahuasca trigger psychosis or mania?

It can, particularly in people with bipolar disorder, a history of mania/hypomania, or a vulnerability to psychotic symptoms. Case reports document manic episodes following ayahuasca use in individuals with bipolar history.
Clinical and harm-reduction materials commonly advise avoiding ayahuasca in those with a history of psychosis or mania.

Who should NOT do ayahuasca?

While each program may define specifics, commonly cited higher-risk exclusions include:

Current use of contraindicated medications (especially serotonergic agents; certain stimulants; some opioids; cough medicines like dextromethorphan; and other interacting drugs). Temple of the Way of Light+1
History of psychosis or mania/hypomania (bipolar spectrum).
Significant cardiovascular disease, uncontrolled high blood pressure, or conditions where BP spikes are dangerous.
Situations where vomiting/altered consciousness creates unacceptable risk without appropriate monitoring (sleep apnea risk, severe frailty, etc.). Practical safety standards often include positioning guidance to reduce aspiration/suffocation risk.

If you are uncertain, the correct next step is a medical screening conversation—not self-guessing.

Can you die from vomiting during a ceremony?

Aspiration is one of the practical concerns in any setting where vomiting is common. Good-practice guidance explicitly recommends sitting rather than lying flat, and if lying down is necessary, using a safer side position to reduce suffocation risk.
This is a core reason why supervision and facilitator-to-guest ratios matter.

Is ayahuasca addictive?

Ayahuasca is not generally described as classically dependence-forming in the way substances like alcohol or opioids are. However, people can develop psychological patterns around repeated intense experiences. A responsible retreat will emphasize preparation, integration, and pacing rather than “chasing ceremonies.” (For broader safety framing, see safety materials.)

3) Medications, supplements, and health conditions

What medications are dangerous with ayahuasca?

Because ayahuasca has MAOI activity, interactions can be serious. Many medical guidelines list contraindicated categories, especially:

SSRIs / SNRIs / TCAs / certain other antidepressants
Certain stimulants
Certain opioids and serotonergic agents
Dextromethorphan (common in cough medicines)
Other interacting psychiatric or neurologic drugs

Retreat medical guidance pages often provide detailed lists; the key principle is: do not combine MAOI activity with serotonergic or interacting agents without medical oversight.

Should I stop my SSRI/SNRI to do ayahuasca?

Do not stop abruptly. Stopping antidepressants can cause withdrawal symptoms and destabilization. Any taper/washout should be done with your prescriber and aligned with safety protocols that account for pharmacokinetics and your clinical stability. Interaction risk is a central concern discussed in risk-assessment literature.

What about bipolar disorder, schizophrenia, or a family history of psychosis?

Most responsible guidance treats a history of psychosis or mania/hypomania as a major red flag and often an exclusion—given documented cases of manic switch and broader psychiatric risk discussions.

What if I have anxiety, depression, PTSD, or trauma history?

Many people seek retreats for these reasons, but suitability depends on stability, supports, screening, and integration plan. Even when experiences are ultimately perceived as beneficial, survey data show a meaningful minority seek professional support for post-ceremony mental health effects.

4) Ceremony experience: what to expect

What happens in an ayahuasca ceremony?

Ceremonies vary by tradition and retreat, but generally involve an evening container, guided facilitation, and a period where effects emerge after ingestion.

Why do people purge?

Nausea/vomiting is among the most commonly reported acute effects in both clinical and naturalistic data.
Culturally, some traditions interpret purging as cleansing, but from a safety standpoint, it also means programs must manage hydration, positioning, supervision, and sanitation professionally.

What should I wear?

Prioritize comfort, breathable layers, and items that manage temperature changes. Avoid anything restrictive. Many retreat checklists recommend simple, comfortable clothing appropriate for lying or sitting for long periods. (Specific packing lists vary by retreat format.)

5) Preparation (diet, lifestyle, mindset)

What is “la dieta” and why does it matter?

Many retreats recommend dietary and lifestyle preparation to reduce GI burden and avoid certain substances—often emphasizing simple foods and avoiding alcohol and other triggers. Temple of the Way of Light+1
Separately, from a pharmacology perspective, MAOI-related caution is one reason programs are strict about substances and medications.

Do I really need to follow the diet?

Different traditions vary, but most reputable centers treat preparation as part of risk management and experience quality. If a retreat tells you “diet doesn’t matter at all” while also doing minimal screening, that combination is a red flag.

Should I avoid alcohol and other drugs before the ceremony?

Yes—most reputable guidance advises avoiding alcohol and other psychoactives around ceremonies, because mixed-substance use increases unpredictability and risk.

6) Integration and aftercare

What is integration?

Integration is the process of turning a powerful experience into stable, healthy change—through reflection, support, sleep, nutrition, and (often) structured coaching or therapy. In survey data, post-ayahuasca mental health effects are not uncommon, and some people seek professional support.

How long after the ceremony should I wait to make major life decisions?

A conservative best practice is to give yourself time—often weeks—before making irreversible decisions, especially if you experienced intense emotional material. A quality retreat will encourage paced integration rather than impulsive “life overhauls.”

7) Choosing a safe retreat

What are red flags when choosing an ayahuasca retreat?

Common red flags include:

No real medical screening or vague “just sign a waiver” onboarding
Encouraging you to self-stop prescriptions without coordination
Unclear brew sourcing or “secret ingredients” with no accountability
Overcrowded ceremonies, low staff-to-guest ratio, or poor supervision
Facilitators normalizing extreme distress without a plan for stabilization
Promoting polydrug “menus” or mixing multiple powerful psychoactives in one retreat

Safety standards and minimum practices are explicitly addressed in published guides meant to help participants assess accountability.

What safety practices should I look for?

At minimum, ask whether the retreat has:

Written screening criteria and medication contraindication protocols Temple of the Way of Light+1
Clear emergency readiness and procedures (including for panic, confusion, hypertensive symptoms, or hypoglycemia scenarios)
Positioning/supervision practices to reduce vomiting-related hazards
A real integration pathway (support during the weeks after)

8) Legal questions

Is ayahuasca legal?

Legality varies by country and can be complex. In the United States, ayahuasca is generally considered illegal under federal law because it contains DMT (a Schedule I substance), though specific religious groups have obtained exemptions in court.
If you are traveling internationally, do not assume legality based on what you see advertised online; consult reliable, current resources and—when needed—legal counsel.