Decision-Making Guide for Taking Ayahuasca

References to ayahuasca appear more and more frequently on the Internet and other media. However, it is difficult to find objective information about the potential risks and benefits associated with its use and what you can expect when choosing to participate in a ceremony. Below you can find information that is aimed to help you make responsible decisions, reduce risks and maximize potential benefits.

Wondering About Potential Drug or Medication Interactions?

ICEERS, a non-profit organization working with psychedelics has recently launched a Drug Interaction Service. We consider ICEERS to be a credible source of information about ayahuasca and other psychedelics.


For a good overview on ayahuasca safety, you can download the ICEERS ayahuasca safety profile here.

Decision Making Guide

Deciding to take ayahuasca

The decision to participate in a ceremony should always be one taken by the individual, not by their relative or friends, no matter how well-intentioned. This decision should be based on a clear understanding of the potential risks and benefits in relation to your medical history, mental health, and general emotional condition. Ayahuasca is a tool which, if used properly, can catalyze a spiritual growth process. Every person is different and a large part of our internal thought processes and emotions are unknown territory. This is where this tool can have its function: it can allow an individual to gain more awareness of their emotions, thoughts, behavior, body and relationships. This increased self-awareness can facilitate a process of adjustment to these different aspects, resulting in an overall improvement in life.

Group Setting

Companionship ceremonies are usually done in a group setting ranging from several people or more, depending on the facility or facilitator. The ceremonies usually take place at night although facilitators may schedule ceremonies in the day as well. An ayahuasca ceremony usually lasts between three and seven hours. Members should not leave the ceremony once started and leaving the facility after the ceremony is closed is not allowed – sleeping at the facility on mats or in rooms is the norm. The ceremony is always led by a facilitator who has been vetted by the Companionship. All of our facilitators must go through an application process and facilitators must meet Companionship criteria to conduct ceremonies.

At the beginning of the ceremony there is often some time reserved for the participants to share their intentions for the ceremony and why he/she has decided to participate. Once the sharing of intention is finished, the ayahuasca is distributed for the participants to drink.

The ayahuasca experience can have different phases. Sometimes, exploring one’s inner world can be accompanied by emotional pain or other form of suffering. It can also be accompanied by a release of stress. Therefore, it is not uncommon to hear participants crying, laughing or expressing this release in a ceremony in various ways. Also, due to the purgative effects of ayahuasca, vomiting may occur, which is done into a bucket. A washroom for participants is also available.


The music, singing or chants made by the facilitator is what leads the experience although there are also facilitators that may choose to work with silence. All Companionship ceremonies are geared toward the spiritual development of the participants and the facilitator is merely the conduit or helper for the spiritual awakening.

All Companionship facilitators are mindful of their role as a facilitator only. Ceremony participants should not get carried away by giving the facilitator credit for their profound experiences. Facilitators must be helpful and supportive but, as much as possible, ensure that each participant understands that they direct their own process and they are solely responsible for their own evolution, discoveries, connections and insights.

Shipibo Religion

Companionship ceremonies are based on centuries-old Shipibo religious healing traditions. Depending on the facilitator ceremonies are usually held in the dark or around a fire if outdoors. The experience is guided by the singing of the facilitator, live music with instruments like maracas, drums, mouth harp, etc. or in some cases, recorded music. The type of music will vary based on the abilities of the facilitator.

The facilitator may be accompanied by assistants or helpers who help participants with practical issues such as going to the toilet or in difficult moments. As well, they may also be involved in the musical performance. The facilitator may use techniques such as blowing tobacco smoke on the participants or odorizing the room and participants with incense such as Palo Santo or Agua Florida. Companionship ceremonies are based on traditional indigenous Amazonian culture which has a spiritual and spiritualist focus.

Companionship ceremonies incorporate a preparation phase before the ceremony and an integration phase after it. Ceremonies may vary according to the facilitator and his/her way of working. Some variants may be the possibility of the use of different types of music, alternating digital music with live music or working with silence in different ways.

Integration and After-Care Support

The Companionship provides integration and after-care support for our members as part of our services, depending on the resources available. For anyone who has had a difficult ceremony or is having trouble integrating a ceremony, we strive to provide as much individual care as possible. This is done directly through our facilitators and is also available through the Companionship and our after-care support program. If you happen to experience any issues in the period following the ceremony or difficulties with the integration of the experience, you can receive support for the time needed.

For most people, an ayahuasca experience is an introspective experience, most of which is spent looking inwards although the group element also plays an important role. It may be that you feel uncomfortable being surrounded by a group of strangers with whom you will share the ceremony. Knowing your fellow Companionship members before taking ayahuasca or sharing group intentions often helps to relax and is encouraged within the Companionship. After all, you will be sharing a very transcendental experience with them. Many deep friendships are forged in a Companionship ceremony.

All members must fill out the medical/mental health and informed consent forms prior to being accepted into the ceremony. As well any new member must have an interview with their facilitator prior to admission. The forms are available online in a fillable electronic form or on paper and are available from your facilitator.

The interview with your facilitator is a two-way conversation. You are encouraged to ask questions about how the facilitator runs his ceremonies and see if you feel comfortable with him or her. If you do not feel comfortable with the facilitator we urge you to consider not attending. Set, setting, facilitator and participants are important to your experience.

The Companionship has exclusion criteria and we do ask you for your medical history or possible psychiatric conditions. We also inform you of the potential risks of taking ayahuasca. This is all available online in your member profile for your convenience or it can be provided by your facilitator.

The Companionship offers you a responsible and safe setting within our capabilities. We steadfastly discourage our facilitators from ‘guru’ behaviors, or presenting him/herself as an authority or expert. We are all learning and evolving however so if you feel your facilitator is not sensitive to your personal situation it is highly recommended not to put your faith in his/her hands. You may want to hear the opinions of people who have previously participated with your proposed facilitator through the Companionship website or through your social networks or direct contact.

Risks & Exclusion Criteria

Physical risks

In medical terms, ayahuasca has few contraindications. If you have a serious cardiovascular disorder you should not take ayahuasca, as it slightly increases blood pressure. No alterations of liver function and other biochemical parameters have been observed after the administration of ayahuasca in the laboratory. Only a modulation of the immune system has been detected, but this is temporary and does not seem to have any clear effects on health.

You may want to consult with a physician if you are taking any medication chronically, or if you have to take medication during the days of the ayahuasca ceremony. The use of antidepressants and other psychotropic drugs may be contraindicated for the use of ayahuasca, as well as the use of drugs metabolized by certain cytochromes. Not only psychotropic drugs may be contraindicated; so might any drug capable of interacting with MAO (as MAOIs: Monoamine oxidase inhibitors). The combined use of ayahuasca with drugs that use the same metabolic pathways is potentially dangerous. It is very important to understand the risks. Please exclude yourself from the ceremony if you feel you may be at risk.

If you have a chronic illness, it can be dangerous to stop taking your medication for some time with the intent to take ayahuasca. It is very important to consult your doctor or specialist . In any case always carry the medication with you. If for any reason you cannot return home on time after a ceremony, not having your medication with you can become a problem.


Tyramine is a monoamine that is naturally present in some foods. Fermented products such as aged cheeses, soy sauce, wine or beer, and certain meats, nuts, etc., are rich in tyramines. On the internet you can find lists of products that are rich in tyramine. Avoid combining foods with high concentrations of tyramine with ayahuasca as it may cause symptoms such as nausea, vomiting, sweating, increased heart rate, dilated pupils and, very infrequently, brain hemorrhage.

In any case, the ayahuasca MAOIs disappear from the body very quickly, so it is unlikely that you will have poisoning if you take foods rich in tyramine before or after the ceremony.

Although not very common, there are cases of people who faint during the experience. It is important to be aware that if a participant gets up on a hard floor or with hard objects around, you can get hurt if you fall. Most new participants usually lay on their mats during the ceremony. Help is available if you need to go to the washroom and you feel unsteady.

Psychological risks

If you have a history of psychiatric disorders such as schizophrenia, psychosis, personality disorders, or bipolar disorder, among others, taking ayahuasca involves risk, especially if your disorder is active. It is true that the use of medications for such conditions is not always satisfactory, but that does not mean that ‘alternative’ treatments are. If you are still convinced that you want to have an ayahuasca experience, it is very important that you openly discuss this with the facilitator of the ceremony. Some facilitators will refuse to admit you to their ceremonies and others might not.

There are people with histories of mental disorders that have done well after taking ayahuasca, but there are also others in which symptoms have re-emerged. It is therefore very important to take that risk into account, choose well with whom you are going to take ayahuasca, and to be sincere and honest about your medical history. The sincerity of the facilitator regarding your well-being is also very important. If you don’t perceive this sincerity, and this also counts for people without a history of mental disorders, it is wise not to take ayahuasca with that facilitator.

Usually, the worst thing that can happen after ingesting ayahuasca is that the effects may be prolonged after they should have begun to disappear. It may happen that the effects increase at the end of the ceremony because you relax yourself, or after vomiting, but if they persist long after the ceremony ends you should notify the facilitator or the Companionship. There are techniques to help you get back to normal, but there are some cases where this does not work and medication or even treatment may be required. These cases are very rare, but they exist. This may come about because of a prior psychiatric condition, but there are some cases of seemingly psychologically healthy people who have gone through these experiences as well. These cases are very rare and symptoms may include paranoia, ideas of self-reference (“everyone talks about me”), delusions (ideas that are incoherent and absurd) or severe confusion. These symptoms are very different from episodes of fear or confusion that can occur under the effects of ayahuasca, which are transient and often part of the experience.


The Companionship offers the Sacred Vine for spiritual progress. This includes what is referred to as ‘revelatory’ or ‘refreshing’ experiences with high personal benefit in many ways. Many people experience feelings of spirituality or mystical states, where they feel one with a greater reality instead of a mere singularity. This may give participants renewed courage and strength to continue to face difficult situations or circumstances and enriches their personal worldview. Even difficult ayahuasca experiences are often instructive and helpful. Rarely does someone come out of an ayahuasca experience without having learned something important in relation to themselves, to others or about the nature of reality itself.


Therapeutic work with ayahuasca starts with good preparation in order to reduce risks and maximize potential benefits. There are three levels on which one can prepare for this type of experience: psychological, social and physical. Obviously, each person has to find his/her way to prepare. Here are some tips that may be helpful.

Psychological preparation

If one takes ayahuasca with spiritual intent or for personal growth, such as adjusting certain behavior, enhancing meaningful relationships or releasing emotional blockages, it is important to start working on gaining more awareness about your personal state. You can take your past, present and future perspectives into account, as well as your relation with your environment.

You can reflect on issues that have to do with where you find yourself in life, which problems or recurrent behavior patterns you do not manage to solve or adjust, how they affect your interpersonal dynamics or relationships and how your behavior influences your environment and vice versa. The more you reflect on these issues before your ceremony, the more the ayahuasca can function as a catalyst in this process. Ideally, a therapist can provide a neutral mirror to facilitate this process or even just the help of a close friend or relative can help. Reflecting on all these aspects can help you gain awareness about yourself, allowing the ayahuasca experience to be as productive as possible.


It is very important not to have specific expectations for the ceremony. Asking for specific things like ‘show me the solution to the problems of my life/job/situation’ may interfere with the experience. Once you become aware of where you are in your life and what blocks your spiritual growth and well-being, go into the experience without expectations, just letting yourself go with where the experience takes you. It is then all about having confidence that whatever happens during the ceremony is what really helps us with our spiritual growth and health.

An ayahuasca ceremony can be very intense and can deconstruct the ‘ego’ (the mental construction of the self), confront one with death or with his/her fears, or cause an overwhelming feeling of losing control. You should be ready to go with the flow, breathe and relax. The effects will wear off. The more prepared you are when you enter the ceremony, the easier it will be to let yourself be guided by the experience and not your expectations. Sometimes there may be a real struggle between fear and trust, in which case it is useful to focus on your own breathing. Concentrating on slow and deep breathing with the bottom of the lungs and releasing tensions in the body with each long exhalation can be a good technique to relax and let go. During the preparation before the experience it can be useful to sit down occasionally to breathe and gain confidence for the meeting you will have with this plant.

In any case it is common to go through different phases during the experience some of which might be very challenging. Other phases might be very nice, full of meaning and vital satisfaction. As much as you should prepare for the eventual difficult moments, you should enjoy the beautiful moments that you may experience with ayahuasca. Spiritual states with deep meaning can be revealing and sometimes accompanied by ineffable beauty and joy.

Social preparation

In case you want to adjust your relationship with family, partner or friends, or deal with issues involving other significant people in you life, you should open a dialogue with these people explaining your intentions.

If you feel confident you can explain to people in your life that you are going to participate in a Spiritual ceremony in which an ethnobotanical tool (ayahuasca) is used consider sharing your intentions and getting their feedback. Establishing a relationship of trust and support is beneficial for all parties. On this website you can find information for family or friends about how they can support a loved one who is going through a therapeutic process with ayahuasca.

Physical preparation

In some Amazonian cultures diets before a ceremony are vitally important. For days, weeks or even months the individual eats only certain types of foods. The intention is to cleanse and sensitize the body and psyche to the effects of the plants taken so that they can produce more benefit. Originally these diets are a way of healing and are part of the training of the healers.

How far you want to go with diets, fasting, isolation from everyday environment, sports or meditation before taking ayahuasca depends on you. You can find our recommended dietary guidelines on this website. There are people who maintain their normal diet, others ingest less salt and sugar for a few days or weeks, others fast the days before, etc.

In general, one can say that healthy and light meals and maintaining a good physical condition can facilitate the ayahuasca experience and perhaps make it safer. Such diets can also be a way to connect with the body and blockages you feel, help you gain self-awareness and prepare you for the ceremony. It is often advised to take plenty of vegetables and fruit the days before the ceremony, have a light breakfast and carbohydrate-rich meal, and make sure that the last meal is about 4-6 hours before the ceremony.

If you take medications that are contraindicated with ayahuasca, such as antidepressants, it is advisable to stop using it two weeks before the ceremony. This is a process that you may want to do under the supervision of a specialist as interrupting the use of a psychiatric medication may cause serious problems. Keep in mind that there will always be time to take ayahuasca once you’re free of your medication. Herbal preparations containing St. John’s Wort and Ginkgo biloba are contraindicated with ayahuasca. Avoid alcohol, stimulants, opiates and other drugs during the days or weeks before the ceremony. Keep your body hydrated and well rested before the ceremony.

Ceremony Effects

After ingesting the ayahuasca the effects can be felt, depending on the person, in about ten minutes to one hour, and can last up to two to four hours or more. Companionship ayahuasca is prepared by traditional practitioners in the Amazon and only contains two plants – Chacruna (Psychotria viridis) and the Sacred Vine (Banisteriopsis caapi). There are no other adjunct plants or additives to the tea. As well, each batch of ayahuasca is tested by experienced people by actually taking the medicine to determine its strength and characteristics.

Many facilitators do not give high doses to people taking the tea for the first time. The facilitator may offer a second dose to people in a ceremony, typically after at least an hour after the first ingestion.

The ayahuasca experience produces changes in the way we perceive reality. Some people have very mild experiences and some people have more intense experiences. There is no way to gauge this before your first ceremony. The texture of reality may become brighter more colorful and composed of patterns of luminous energetic vibration. The beginning of the experience is usually when one notices that the textures of reality is changing. Also the appearance of a buzzing in the ears can announce that the effects are approaching. Usually, the experience is more intense with the eyes closed. If the experience is too intense with eyes closed simply open your eyes which dampens the effects.

During the course of the experience, visions may appear with abstract motifs or clearly identifiable sharp images. Emotions are perceived more profoundly and one can access forgotten memories. You may experience phenomena such as telepathy or precognition. Early researchers labelled ayahuasca as “telepathine” as this was one of their noted effects.

Fears or difficult emotions can appear that may be accompanied by blockages in the body (pains, tension, etc.). This is all part of the spiritual awakening. The best thing to do in the more intense parts of the ceremony is to breathe slowly and deeply, go with the music and have confidence in the process induced by the ayahuasca and the facilitator.

Beginners may not have visionary effects in the first ceremonies but this is not always the case. It seems that in some cases, it seems the ayahuasca visions need some kind of visual and cognitive learning process before they can be fully experienced.

A spiritual awakening also modifies our habitual ways of thinking. When one is not experiencing visions you might believe you are not experiencing any psychological effect, while the truth is that an external observer would clearly notice such effects. So never leave a ceremony because you think you’re not experiencing any effects. If you’ve decided to participate in a ceremony do not leave the ceremony until after the ceremony is closed.

It is better to spend some time being bored than end up in an accident because you wanted to leave abruptly before the end of the ceremony. Or taking the risk that the psychological effects manifest intensely after you leave. Ayahuasca is a powerful plant – take it with respect even if you think you are not having any effects. For some people, it takes time for the effects to be noticed. Be cautious, there is time enough to go home.

Many consider ayahuasca as a mirror of the inner self and while internal conflicts may arise you may also experience intense joy or rapturous states. When this happens, the experience can be of indescribable beauty.

It can sometimes happen that you have feelings of paranoia during the course of a ceremony. The ayahuasca experience is not linear, rather it goes through different phases, some may be more pleasant and others may be more difficult. As in any journey that is undertaken in life, there are moments of laughter, moments of sadness, moments of euphoria, moments of sudden insights and revealed truths and even moments of boredom and disappointment.

Sometimes symptoms may appear similar to those seen in mental illness, primarily suspicion, paranoia and thoughts of self-reference – “everyone is looking at me” or “this or that happens because somehow I induce it”. These effects are normal during the course of the experience and are transient. The appearance of these effects is proof that these are experiences that happen to all of us at some moment in our lives under whatever circumstances and although they can be uncomfortable, learning to deal with them is just part of our spiritual growth. Learning to deal with whatever comes up is always the best attitude for an ayahuasca ceremony. And most importantly do not hesitate to ask for help from your facilitator or a helper when you consider that you need it. That is what he/she is there for.

It may also happen that one is being immersed in perinatal states, as described by psychiatrist Stanislav Grof. The term refers to perinatal experiences related to the birth process. During an ayahuasca experience one can relive the birth process itself. According to Grof, the birth marks the first traumatic event a human being has to face and he described this experience in four phases which correspond to different stages of labor. Perinatal experiences can be very challenging and involve physical sensations such as breathlessness, pressure by contractions, pain and psychological experiences of death and rebirth, existential void, psycho-spiritual rebirth and other sensations. These experiences are the basis for many of the rites of passage of ancient cultures.

While the ayahuasca experience lasts approximately four to six hours, depending on the number of ingestions, the moments of confusion and disorientation or feeling of lack of control over the experience usually do not last more than twenty or thirty minutes. As well, the usual perception of time under the influence of ayahuasca can be altered considerably. Time as we experience it in ordinary states may even cease to exist,so it is one’s own subjective time that governs the experience.

After finishing the ceremony

Upon finishing the ceremony, it is advisable to stay in the facility and not take the car or leave immediately to the outside world. You may be more sensitive than usual to external stimuli and you might feel emotionally mixed. Eating something light and journalling your experience before bedtime may be helpful for the integration process.

Integration & Follow up

The integration process is as important as the ceremony itself. To integrate the experience it is advisable to participate in the sharing the day after with the facilitator and the group. Drawing or artistic expression of what you have lived during the ceremony helps to integrate the experience, allowing it to benefit your daily life. Getting in touch with nature, swimming or physical activities can help you to connect again with reality and to ground yourself.

It is most beneficial to continue your process with the support of the Companionship or a qualified person. After-care help is available through the Companionship as well. It will help you integrate everything and maximize the benefits of the experience in daily life. Especially during the days following the ceremony emotions can still emerge that are related to the experience.

There are cases of people who have experienced episodes of altered states of consciousness during the days after the ceremony. It is best to stay in a familiar space (e.g. at home) with someone that can be by your side if possible. Playing a musical instrument or soothing music  can help. Grounding activities include walking in nature, physical activity, eating salty foods, cold or warm showers,  drawing, artistic activities and other relaxing or engaging pastimes.

If you are having any problems do not hesitate to contact your facilitator or the Companionship support program. In general, after an ayahuasca ceremony one goes home with new perspectives on life and you may feel the need to adjust certain behavior(s) or alter interpersonal dynamics.

This is especially true in the weeks after the ceremony and it is during this period that one has to take what was learned and start to implement it. However, before making a significant decision make sure you’ve given it enough thought – do not sell your home or business, separate yourself from your spouse or leave your everyday life after an ayahuasca ceremony.

Give yourself time to fully adjust and consider putting off major decisions until some time later. You’ve just been through a life-altering experience, relax and give it time to unfold.