title: Switch to mania after ayahuasca consumption in a man with bipolar disorder: a case report.
abstract: BACKGROUND
  There is an increasing use of ayahuasca for recreational purposes. Furthermore, there is a growing evidence for the antidepressant properties of its components. However, there are no reports on the effects of this substance in the psychiatric setting. Harmaline, one of the main components of ayahuasca, is a selective and reversible MAO-A inhibitor and a serotonin reuptake inhibitor.
  
  
  METHODS
  We present the case of a man with bipolar disorder who had a manic episode after an ayahuasca consumption ritual. This patient had had at least one hypomanic episode in the past and is currently depressed. We discuss the diagnostic repercussion of this manic episode.
  
  
  CONCLUSIONS
  There is lack of specificity in the diagnosis of substance-induced mental disorder. The knowledge of the pharmacodynamic properties of ayahuasca consumption allows a more physiopathological approach to the diagnosis of the patient.
authors.affiliation: Hospital de Emergencias Psiquiatricas Torcuato de Alvear, Av Warnes 2630, Capital Federal, Argentina ; Bipolar Disorder Program, Neurosciences Institute, Favaloro University, Buenos Aires, Argentina.
authors.forename: Alejandro G
authors.initials: AG
authors.lastname: Szmulewicz
authors.affiliation: Hospital de Emergencias Psiquiatricas Torcuato de Alvear, Av Warnes 2630, Capital Federal, Argentina.
authors.forename: Marina P
authors.initials: MP
authors.lastname: Valerio
authors.affiliation: Hospital de Emergencias Psiquiatricas Torcuato de Alvear, Av Warnes 2630, Capital Federal, Argentina.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Smith
keywords: Ayahuasca; Bipolar disorder; DSM 5; MAO inhibitors; Switch to mania