Syndrome of Inappropriate Antidiuretic Hormone Secretion Following Ayahuasca Use in a Satanic Ritual: A Case Report

Ayahuasca is a psychedelic blend originating from South America that has been used for hundreds of years by local tribes in ritualistic ceremonies. For the last few decades, its usage has expanded to North America in various mindfulness retreats that can benefit from its hallucinogenic properties. In this case report, our patient had attended a satanic ritual where he had consumed copious amounts of Ayahuasca over three days. Upon his return, he continued having demonic hallucinations along with paranoid delusion with increasing bouts of nausea and vomiting. He was brought in by first responders due to suicidal ideations, and shortly after arrival, he became unresponsive with seizure-like activity. The patient was evaluated to be comatose with a Glasgow Coma Scale (GCS) score of 3, and upon securing the airway, was transferred to the critical care unit. Laboratory results showed a case of hypoosmolar hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH), and following the supportive care, he was able to recover within four days of admission. We theorize that due to the similarity in the pharmacodynamics of the active compound of Ayahuasca, and drugs such as monoamine oxidase inhibitors (MAOI) and 3,4-methylenedioxymethamphetamine (MDMA), it can result in SIADH in its users.