Asthma and Ayahuasca - a dangerous combination?

[Hoopmaster]

Hi everyone,

I’m new here, and this is my first post.

I'm soon to be travelling to South America to experience Ayahuasca for the very first time. I'll be staying at a resort in Itacare, Brazil, for 10 days; over which time I'll get the opportunity to partake in a total of 5 Ayahuasca, and two salvia divinorum ceremonies. It seems like a dream come true for my partner and me. We are both very excited as to what the experience will have in store for us!

There is, however, one little niggling doubt I have chipping away at my mind that’s causing me to feel a bit anxious. The trouble is, I’m an asthmatic, and I’m quite concerned after reading several guides dealing with the possible risks and contraindications associated with ingesting a plant based MAO inhibitor, that the medication I’m currently receiving may elicit a negative response during the ceremony.

I’ve had this question in mind for a couple of weeks now, and I feel I’ve nearly exhausted all my options trying to find a definitive – or as close as – response, that can put my mind as ease. It’s a bit of a mind field to say the least!

It seems surprising to me, being as so many people these days suffer with Asthma, that there is not more information available on the subject. The information that is on offer I’ve found is generally very non-specific, simply stating that asthma inhalers should not be taken – end of. The implications of this to me are that, unless you can go without medication for a reasonable period of time, you shouldn’t do Ayahuasca - which is a bit of a depressing thought for any asthmatic interested in the experience.

Is it really so black and white? I hope not!

To the best of my knowledge, Asthma, like with many chronic illnesses is quite diverse, having several different types - and so too are the medications. There are preventers, which are often steroid based; and relievers, commonly Beta 2 agonists - which affect the body in very different ways.

What is it specifically in inhaler(s) that causes the potential risk?

Another forum member had this to say on the subject:

Quote:Unfortunately, β2-adrenergic agonists used in asthma inhalers (salmeterol, salbutamol, etc.) are contraindicated with monoamine oxidase inhibitors. It is still unclear how much MAO inhibition is achieved by ayahuasca tea out of the GI tract and the liver (probably depends on the total amounts of the β-carbolines harmine and harmaline ingested, with a possible threshold effect) but it is quite risky to guess about it with those sympathomimetic adrenergic agents (the risk is a hypertensive episode or crisis)

The above advice is very informative, stating that there is a potential risk of hypersensitive attack should one use a Beta 2 agonist (Reliever inhaler) when taking Ayahuasca. This makes sense seeing as Beta2 agonists work by copying certain effects of natural chemicals in the body - namely, adrenaline and noradrenalin. The β-carboline alkaloids in the brew – from what I can make out - inhibit the metabolism of these substances in the body, potentially allowing them to build up to dangerous levels.

I do have a β2-adrenergic agonist inhaler (Ventolin), but very seldom have to use it. I can go days without a puff, providing I’m in good health and use my preventer (Becotide) regularly. On doing a bit of research into Becotide (beclometasone dipropionate), I found that it is a type of medicine known as a corticosteroid; which is a type of steroid.

Here’s some info quoted from a website about corticosteroids:

Quote:“Corticosteroids are hormones that are produced naturally by the adrenal glands. They have many important functions, including control of inflammatory responses. Beclometasone is a synthetic corticosteroid and is used to decrease inflammation in the lungs. When beclometasone is inhaled into the lungs it is absorbed into the cells of the lungs and airways. Here it works by preventing the release of certain chemicals from the cells. These chemicals are important in the immune system and are normally involved in producing immune and allergic responses that result in inflammation. By decreasing the release of these chemicals in the lungs and airways, inflammation is reduced.”

Another websites says:

Quote:“Normally the adrenal glands release cortisol into the blood stream every morning. The brain monitors this amount and regulates the adrenal function. It cannot tell the difference between its own natural cortisone and that of steroid medicines”

Now in my opinion, I can’t really see the potential hazard in taking my preventer (Becotide) during the period of experiencing Ayahuasca; there doesn’t seem to be any obvious issues with the MAOI. But I’m certainly no doctor, and my opinion is uninformed at best, based only on the research I’ve carried out over the past couple of weeks - hence my still feeling a little anxious about the whole subject.

Now what I need to ask is: does anyone have any direct experience of taking Ayahuasca with asthma? If yes, what was it like for you? And also, is there anyone who has a good understanding of what I’m saying, and could perhaps shed a little light on the subject?

I just want to put my mind to rest and stop worrying!

I know it’s been quite a long winded post. Thanks for sticking with it!

Any thoughts would be appreciated...

Dylan

[snapper]

SWIM knows nothing about medicine, but if SWIM did, SWIM would think a steroid should be safe with a MAOI (barring individual hypersensitivity) unless it has a specific contraindication in the insert ( check it first). A steroid inhaler would be a good choice - albuterol (ventolin) and the others mentioned would be problematic given that they are sympathomimetic. The steroids in inhalers have the additional advantage of not attaining the bloodstream. For this reason, beclometasone is used in inhalers - it stays in the lungs and therefore is metabolized locally and does not have any systemic effect; it does not have any monoamines in it's structure, so MAO is not involved in it's breakdown.
Keep in mind that a DMT experience or a salvia experience could trigger an asthma attack so have a steroid inhaler ready or pretreat. No matter how reassuring people are, you are still taking a risk - albeit a small one.
Note that SWIM was asthmatic as a child and though it resolved, SWIM experiences severe bronchoconstriction on some psychedelics (esp. 2ci) which requires an inhaler (SWIM uses albuterol). SWIM never needs an inhaler in any other circumstance.
Note that SWIM does not know what SWIM is talking about and the above should be regarded as bad fiction..

[Hoopmaster]

Hi Snapper,

Thanks for such a quick response!

It's nice to actually meet someone two 'really' knows a little about asthma from personal experience. As I said in my post, this question has been chipping away at my mind for a couple of weeks now, and I was starting to become quite concerned about it; which was only exacerbated by the general lack of understanding of the subject.

With reference to your comments regarding the steroid based preventer (Becoitde) being a good choice, as it is metabolized locally in the lung and doesn't have much of a systemic effect - I think you may be right; this is the conclusion I came to through my research too. In fact, it's the whole reason I asked the doctor to change my medication to Becotide. As far as I know, there aren't any specific contraindications either - or least, not that I've manged to excavate through my inquiries. I think I'll contact the vendor on Monday anyway and ask, just to make sure.

All in all, you've pretty much mirrored my thoughts on the subject, which is reassuring.

I appreciate the advice. Thank you