Review of newer treatments for suicidal thoughts finds ayahuasca among promising options

The question

Which drug and brain-stimulation treatments that are not officially approved for suicidal thoughts or suicide attempts show promise, based on the past decade of human research?

What they did

The authors ran a structured PubMed search and wrote a narrative review, meaning they described and interpreted the studies rather than combining their results statistically. They looked for studies in adults with suicidal ideation (thoughts of suicide) or a suicide attempt. Thirty-four studies were included: 22 on medications (13 efficacy trials, nine real-world effectiveness studies) and 12 on neuromodulation, which uses magnetic or electrical stimulation of the brain (nine efficacy, three effectiveness).

What they found

Across the controlled trials, suicidal thoughts often improved within days to weeks. Some trials found reductions in suicidal thinking that went beyond the change in depression scores, hinting the two may be partly separate, but the authors describe this evidence as inconsistent and dependent on how it was measured. Ayahuasca in major depression and treatment-resistant depression was listed among the interventions with encouraging results, alongside NMDA-related drugs (NRX-101, high-dose d-cycloserine, amantadine in one specific group), buprenorphine, and add-on pimavanserin. Smaller effects were seen for vortioxetine augmentation and zolpidem aimed at insomnia. Large observational datasets linked lower suicidality to folic acid, benztropine, testosterone initiation in transgender adults, and certain anticoagulants, while non-medical cannabis use was linked to worse trajectories of suicidal thinking; brain stimulation approaches such as accelerated or targeted repetitive transcranial magnetic stimulation, theta-burst stimulation and magnetic seizure therapy were also implicated in reducing suicidal thoughts.

The fine print

This is a narrative review, not a meta-analysis, so results were not statistically combined and the selection of studies involves judgment. The abstract gives no total number of participants, no effect sizes and no safety data. Ayahuasca is only one item in a long list; the review does not say how many ayahuasca studies were included or how large they were. Follow-up length and durability are named by the authors as open questions, and this summary is based on the abstract alone.

What it means

Ayahuasca appears in this review as one of several unapproved treatments with encouraging early signals for suicidal thinking, but the overall evidence base is described as inconsistent, and the authors call for trials that measure suicide-related outcomes directly and test how long any benefit lasts.

Evidence grade: Low. A narrative review that pools together controlled trials and observational studies of very different designs, without a pooled statistical analysis, so it can describe trends but not establish effects.

This summary is based on the study’s published abstract.