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Callaway JC, Grob CS, McKenna DJ, Nichols DE, Shulgin A, Tupper KW. 
“A demand for clarity regarding a case report on the ingestion of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) in an Ayahuasca preparation”. 
J Anal Toxicol. 2006 Jul-Aug;30(6):406-7; author reply.
The case report "A Fatal Intoxication Following the Ingestion of 5-Methoxy-N,N-Dimethyltryptamine in an Ayahuasca Preparation" by Sklerov et al. (1) is misleading as to the nature and toxicity of ayahuasca. The authors of the article state that: "the decedent ingested a preparation from a South American tree bark 'ooasca' (sic) and approximately 4 h later ingested tryptamines" (p 839). However, elsewhere in the article they assert that this is a case of "administration of an ayahuasca-like preparation containing 5MeO-DMT" (p 838, italics added) and further, that "this is the only reported case of death following ingestion of hallucinogenic tryptamines contained in an ayahuasca preparation" (p 841, italics added). The article's title also purports that this is a case of "5-Methoxy-N,N-Dimethyltryptamine in an Ayahuasca Preparation" (italics added).

It is highly improbable that the levels of 5-MeO-DMT found in the decedent's heart blood came from (or was "in") a plant-based preparation similar to the ayahuasca medicine/sacrament used for centuries by indigenous healers of theAmazon regions of South America. Because there is no known plant or animal source that would provide such a large amount 5-MeO-DMT, we believe the decedent must have ingested synthetic material. "Ayahuasca" refers to decoctions made from Banisteriopsis caapi and usually other admixture plants. One of these, Diplopterys cabrerana, does contain trace amounts of5-MeO-DMT. The most common ayahuasca admixture, however, is Psychotria viridis, which like B. caapi, does not contain 5-MeO-DMT. It is not clear from the evidence presented which admixtures might have been in the herbal preparation, but the disproportionately high level of 5-MeO-DMT reported in the decedent's heart blood (1.88 mglL) suggests that synthetic 5-MeO-DMT was taken subsequent to a more traditional herbal preparation. This point is not insignificant, as 5-MeO-DMT is far more potent than its analogue DMT, and a confusion between the two could have been the cause of an unintentional overdose of the former, particularly in combination with potentiating beta-carbolines. Most salient, however, is that there is no evidence that the 5-MeO-DMT ingested by the decedent was "in" (i.e., a constituent of) anything resembling a traditional ayahuasca brew or that his death from "hallucinogenic amine intoxication" can in any way be attributed to ayahuasca per se, as a superficial or uninformed reading of the article insinuates.

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