Ayahuasca and Fibromyalgia: Promising Mechanisms, Missing Evidence: A Mini-review

Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread musculoskeletal pain, fatigue, and cognitive symptoms. Despite current therapeutic strategies, many patients continue to experience the poor outcomes. Ayahuasca, a traditional Amazonian brew containing N, N-dimethyltryptamine (DMT), and β-carboline alkaloids, has shown antinociceptive and anti-inflammatory properties in preclinical research, raising interest in its potential for FM. To systematically assess the available evidence on ayahuasca in FM and identify the existing research gaps. A systematic search was conducted across PubMed, Embase, Scopus, SciELO, LILACS, CNKI, Russian databases, and gray literature sources (Oasisbr, Brazilian Digital Library of Theses and Dissertations [BDTD], and institutional repositories). Search terms combined “fibromyalgia” with “ayahuasca,” “DMT,” and “β-carboline.” No language or year restrictions was applied. The final search was conducted on October 2025. No clinical trials, case series, or observational studies directly assessing ayahuasca in FM were identified. Available data are limited to preclinical studies showing analgesic and anti-inflammatory effects, as well as anecdotal and qualitative reports of reduced pain and improved coping in the ritual contexts. There is currently no clinical evidence supporting ayahuasca as a treatment for FM. While mechanistic and preclinical findings justify scientific interest, any clinical translation should proceed cautiously through ethically designed early-phase trials with rigorous safety monitoring and culturally sensitive frameworks.