What does the current research actually say about ayahuasca?

The evidence base is small but growing. Observational and early clinical studies suggest meaningful effects on depression, PTSD, addiction, and end-of-life anxiety, alongside sustained increases in wellbeing and mindfulness. The strongest signals come from work by Palhano-Fontes, Osório, dos Santos, and the Beckley/ICEERS teams. Big caveats: sample sizes are small, most participants self-select, long-term data is thin, and the ceremonial context (which the research usually can't isolate) is a huge variable.