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Forensic Toxicology

, Volume 36, Issue 1, pp 212–221 | Cite as

Ayahuasca and Kambo intoxication after alternative natural therapy for depression, confirmed by mass spectrometry

  • Damila Rodrigues de Morais
  • Rafael Lanaro
  • Ingrid Lopes Barbosa
  • Jandyson Machado Santos
  • Kelly Francisco Cunha
  • Vinicius Veri Hernandes
  • Elias Paulo Tessaro
  • Cezar Silvino Gomes
  • Marcos Nogueira Eberlin
  • Jose Luiz Costa
Case Report

Abstract

Purpose

We present a case report about an acute intoxication episode after an oral administration of Ayahuasca and dermal exposure of Kambo for treatment of depression. The clinical features observed were hallucination, agitation, tremors of extremities, oral paresthesia, skin lesions and seizures. Diazepam was administered by the emergency service and was effective in controlling hallucination, but failed to control agitation and seizures.

Methods

Patient biological fluids (urine and serum) and the samples of Ayahuasca and Kambo were submitted to toxicological analysis using liquid-liquid extraction followed by liquid chromatography–tandem mass spectrometry and high-resolution electrospray ionization-mass spectrometry.

Results

The main active compounds present in Ayahuasca, N,N-dimethyltryptamine, harmine, harmaline and tetrahydroharmine were found and quantified in the different samples, confirming the use by the patient. In Kambo secretion used in the ritual, we were able to find sixteen potently active peptides: adenoregulin, bombesin, bombesinnona peptide, bradykinin -phe(8)-psi-CH2NH-arg(9)-, caerulein, deltorphin, neurokinin B, phyllomedusin, phyllocaerulein, phyllokinin, phyllolitorin, preprotachykinin B (50–79), ranatachykinin A, sauvagine, T-kinin and urechistachykinin II.

Conclusions

The patient was discharged the day after exposure without any sequel. Clinical and toxicological analysis indicated that the symptoms presented by the patient occurred due to a joint action produced by the substances identified in both materials. To the best of our knowledge, this is the first case involving probable intoxication by simultaneous administration of Ayahuasca and Kambo.

Keywords

Ayahuasca Kambo Depression treatment N,N-Dimethyltryptamine Adenoregulin High-resolution ESI-MS 

Notes

Acknowledgements

The authors thank all the institutions, Coordination for Improvement of Personnel with Higher Education—CAPES (Process Number 23038.006844/2014-46), The National Council for Scientific and Technological Development—CNPq (Process Number 830525/1999-8) and São Paulo Research Foundation—FAPESP (Process Number 2015/10650-8 and 2016/23157-0) for the fellowships and the financial support.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest.

Ethical approval

The small amounts of blank human blood (to be prepared to serum) and urine samples were collected from healthy volunteers after obtaining the informed consent. This article does not contain any studies with animals performed by any of the authors.

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Copyright information

© Japanese Association of Forensic Toxicology and Springer Japan KK, part of Springer Nature 2017

Authors and Affiliations

  • Damila Rodrigues de Morais
    • 1
  • Rafael Lanaro
    • 2
    • 3
  • Ingrid Lopes Barbosa
    • 1
  • Jandyson Machado Santos
    • 1
  • Kelly Francisco Cunha
    • 4
  • Vinicius Veri Hernandes
    • 1
  • Elias Paulo Tessaro
    • 1
  • Cezar Silvino Gomes
    • 5
  • Marcos Nogueira Eberlin
    • 1
  • Jose Luiz Costa
    • 2
    • 6
  1. 1.ThoMSon Mass Spectrometry LaboratoryUniversity of Campinas (UNICAMP)CampinasBrazil
  2. 2.Poison Control CenterUniversity of Campinas (UNICAMP)CampinasBrazil
  3. 3.Department of Pharmacology, Faculty of Medical SciencesUniversity of Campinas (UNICAMP)CampinasBrazil
  4. 4.Faculty of Medical SciencesUniversity of Campinas (UNICAMP)CampinasBrazil
  5. 5.Brazilian Federal PoliceNatalBrazil
  6. 6.Faculty of Pharmaceutical SciencesUniversity of Campinas (UNICAMP)CampinasBrazil

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