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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 28;30(6):406-7; author reply.
The case report "A Fatal Intoxication Following theIngestion of5-Methoxy-N,N-Dimethyltryptamine in an Ayahuasca Preparation" by Sklerov et al. (1) is misleading asto the nature and toxicity ofayahuasca. 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 isa case of"administration ofanayahuasca-like preparation containing 5MeO- DMT" (p 838, italics added) and further, that"this is the only reported case ofdeath following ingestion of hallucinogenic tryptamines contained inanayahuasca preparation" (p 841, italics added). The article's title also purports that this isa case of"5-Methoxy-N,N-Dimethyltryptamine inanAyahuasca Preparation" (italics added).

It is highly improbable that the levels of5-MeO-DMT found in the decedent's heart blood came from (or was "in") a plant-based preparation similar to theayahuasca medicine/sacrament used for centuries by indigenous healers oftheAmazon regions ofSouth America. Because there isnoknown plant or animal source that would provide such a large amount 5-MeO-DMT, we believe thedecedent must have ingested synthetic material. "Ayahuasca" refers to decoctions made from Banisteriopsis caapi and usually other admixture plants. One ofthese, Diplopterys cabrerana, does contain trace amounts of5-MeO-DMT. The most common ayahuasca admixture, however, is Psychotria oiridis, which like B. caapi, does notcontain 5-MeO-DMT. It isnotclear from the evidence presented which admixtures might have been in the herbal preparation, butthedisproportionately high level of5-MeO-DMT reported inthedecedent's heart blood (1.88 mglL) suggests that synthetic 5-MeO-DMT was taken subsequent toa more traditional herbal preparation. This point is not insignificant, as 5-MeO-DMT isfar more potent than its analogue DMT, and a confusion between the two could have been the cause ofan 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 thedecedent 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, asa superficial or uninformed reading of the article insinuates.
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