Ayahuasca retreats in Costa Rica

What to check before booking

• 8 of 13 centres describe a medical screening process on their own sites. Each profile quotes what the centre says.

The medical exclusions and interactions below are the ones published research and harm-reduction services flag for ayahuasca. Ask any centre how its screening handles each one.

• Serotonin syndrome with SSRIs and other serotonergic drugsSerious risk

  The MAO-inhibiting harmala alkaloids in ayahuasca combined with SSRI antidepressants may induce a serotonin syndrome with a potentially grave outcome. ICEERS states that combining MAOIs with SSRIs or other serotonergic medications is contraindicated. (Journal of Psychoactive Drugs, 1998; ICEERS, 2026)

• Why MAOI-containing brews carry more interaction riskSerious risk

  A review of serotonin toxicity notes that true serotonin toxicity typically occurs with overdose or when a drug that increases synaptic serotonin is combined with an MAOI; serotonergic drugs without MAOIs are low risk with psychedelics that also lack MAOIs. Warning signs needing immediate medical attention include myoclonus, extreme or fluctuating vital signs, agitation or coma, muscle rigidity, high fever and seizures. (Psychopharmacology (Berl), 2022)

• Other contraindicated medicines and supplementsSerious risk

  ICEERS lists antidepressants and other psychotropic medications, drugs metabolised by certain cytochrome enzymes, and any medication that interacts with MAO (including MAO inhibitors) as potentially contraindicated, and names St John's wort and Ginkgo biloba as contraindicated herbal supplements. It advises avoiding alcohol, stimulants, opioids and other drugs in the days or weeks before a session. (ICEERS, 2018)

• Stopping medication before a ceremonySerious risk

  ICEERS says contraindicated medications such as certain antidepressants may need to be stopped at least two weeks before a session, but only under strict medical supervision because abruptly stopping psychiatric medication can be dangerous. It also warns that stopping medication for a chronic illness to take ayahuasca can itself be dangerous. (ICEERS, 2018)

• Psychosis and personal or family psychiatric historySerious risk

  A systematic review found case reports of psychotic episodes after ayahuasca or DMT, several in people with a personal or possibly family history of psychosis or mania, and concluded that people with a personal or family history of any psychotic illness or non-psychotic mania should avoid hallucinogens. ICEERS describes ayahuasca as contraindicated for people with severe psychiatric disorders, particularly those prone to psychosis. (Therapeutic Advances in Psychopharmacology, 2017; ICEERS, 2026; ICEERS, 2018)

• Deaths linked to ayahuasca often involved other substancesSerious risk

  An ICEERS review of 58 deaths that media attributed to ayahuasca between 2010 and 2022 states that no autopsy attributed death to acute intoxication with the traditional brew; in 4 cases tobacco seems to have been the direct cause, one death was from scopolamine (a Brugmansia admixture was suspected in two others) and one US death seems to have followed an overdose of synthetic 5-MeO-DMT taken hours after ayahuasca. ICEERS is an ayahuasca advocacy and harm-reduction organisation, and it notes 16 cases where the cause could not be determined. (ICEERS, 2023)

• Tobacco purge teaSerious risk

  CBC News reported that Canadian Jennifer Logan, 32, died at a retreat near Puerto Maldonado, Peru, in January 2015 after drinking a mapacho 'tobacco purge tea' in a ceremony; she died of pulmonary edema and her family believed the tea played a role. (CBC News, 2015; ICEERS, 2023)

• Ayahuasca combined with 5-MeO-DMTSerious risk

  A published autopsy case describes a 25-year-old man found dead after taking herbal extracts containing beta-carbolines and tryptamines; heart blood contained 5-MeO-DMT (1.88 mg/L) plus DMT, harmine, harmaline and tetrahydroharmine, and the medical examiner ruled the cause hallucinogenic amine intoxication. (Journal of Analytical Toxicology, 2005)

• Combination with ayahuasca can be fatalSerious risk

  A published autopsy case attributed a death to hallucinogenic amine intoxication after 5-MeO-DMT was taken together with harmala alkaloids, and ICEERS reports a US death that seems to have followed an overdose of synthetic 5-MeO-DMT taken hours after ayahuasca. Retreats that offer toad medicine alongside ayahuasca therefore raise interaction concerns. (Journal of Analytical Toxicology, 2005; ICEERS, 2023)

• Sexual abuse by healers and facilitatorsSerious risk

  Chacruna's community guide warns that ceremonies or healing sessions alone with a healer have been a common context for sexual abuse, that practices such as sopladas and plant baths do not involve touching private parts or require nudity, and that sexual contact between healer and participant during or directly after ceremonies is not acceptable in ayahuasca traditions. (Chacruna Institute for Psychedelic Plant Medicines, 2018)

• Monitoring gaps in unregulated ibogaine careSerious risk

  The New Zealand Health and Disability Commissioner case shows a death where a clinic departed from its own protocol, did not obtain written consent and left an 'iboga assistant' solely responsible for monitoring a patient after ibogaine; the assistant was also found in breach for failing to monitor adequately. (New Zealand Health and Disability Commissioner, 2015)

Every cited ayahuasca safety fact