The purge is the vomiting that often comes with ayahuasca. It is among the most common physical effects: in a placebo-controlled trial of 29 people with treatment-resistant depression, 57% of those given ayahuasca vomited, against none on placebo (Palhano-Fontes et al., 2019). Some practitioners call the brew itself “la purga”, and vomiting is traditionally seen as expelling physical toxins and psychological trauma (Ruffell et al., 2023).
Researchers disagree about how central it is. Two anthropologists, drawing on interviews or surveys with 227 people between 2003 and 2015, conclude that purging has been integral to the therapeutic use of ayahuasca across and beyond Amazonia, and argue it should not be dismissed as a mere side effect (Fotiou and Gearin, 2019). Bernd Brabec de Mori reports the opposite from the community he studied: in around 100 sessions with traditional Shipibo healers, he saw no healer vomit (Brabec de Mori, 2021). Both can be true in different settings.
The meaning given to the purge is an interpretation, not evidence of a health benefit. Vomiting also makes blinding hard in trials, because participants can tell which group they are in. Severe or ongoing vomiting is a medical concern, not a sign that a process is working. This is not medical advice.
Sources
- Palhano-Fontes et al., 2019, Psychological Medicine: ayahuasca in treatment-resistant depression
- Fotiou and Gearin, 2019, Social Science & Medicine: purging and the body
- Brabec de Mori, 2021, Frontiers in Psychology: social attribution and ayahuasca healing
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