Ibogaine treatment for drug addiction, how it can help but has risks
March 9 2017 by
Ray Sahelian, M.D.

Ibogaine is a natural alkaloid that has been studied in the treatment of withdrawal symptoms and craving in those with a history of drug misuse.

Drug addiction and ibogaine
Extraction studies of Tabernanthe iboga and Voacanga africana.
Nat Prod Lett. 2002. Jenks CW.
The root bark of Tabernanthe iboga contains ibogaine as its predominant alkaloid and has been an important source of it. Ibogaine is used experimentally to interrupt drug addiction and allow therapeutic intervention, but is currently unaffordable to doctors in less economically developed countries. To meet this need, an extraction of alkaloids from T. iboga root bark was optimized and simplified to use only diluted vinegar and ammonia, and was successfully applied to related alkaloids from Voacanga africana bark also. The alkaloids were converted to their hydrochlorides and purified, and the minor alkaloids were recovered.

Where is ibogaine found?
Tabernanthe iboga contains ibogaine as its predominant alkaloid. Voacanga africana, a bark used for ulcer protection, also has some ibogaine.

Side effects, danger, risk, toxicity
It has been determined that the median lethal dose of ibogaine and noribogaine equals to 263 mg and 630 mg/kg of mouse body mass, respectively. The toxicity of ibogaine is 2.4 times higher than that of noribogaine. Medicina (Kaunas). 2008; Acute toxicity of ibogaine and noribogaine. Kubiliene A, Marksiene R, Kazlauskas S, Sadauskiene I, Razukas A, Ivanov L. Department of Analytical and Toxicological Chemistry, Kaunas University of Medicine, Kaunas, Lithuania.

Long-QT syndrome induced by the antiaddiction drug ibogaine.
N Engl J Medicine. 2009; Hoelen DW, Spiering W, Valk GD.

J Forensic Leg Med. 2013. Ibogaine related sudden death: a case report. Ibogaine is a naturally occurring alkaloid derived from the roots of the rain forest shrub Tabernanthe iboga. Deaths have occurred temporarily related to the use. However, although not licensed as therapeutic drug, and despite evidence that ibogaine may disturb the rhythm of the heart, this alkaloid is currently used as an anti-addiction drug in alternative medicine for detoxification purposes. We report the case of a man who died suddenly 12-24 h after ibogaine use for alcohol detoxification treatment. In the autopsy liver cirrhosis and heavy fatty infiltration was found. The concentration was 2 mg/l. The potential risks of ibogaine use, especially for persons with pathological medical background, are discussed.

J Med Case Rep. 2015. "Herbal seizures" - atypical symptoms after ibogaine intoxication: a case report. Misuse of various new psychotropic substances such as ibogaine is increasing rapidly. Knowledge of their negative side effects is sparse. We present a case of intoxication with the herbal substance ibogaine in a 22-year-old white man. After taking a cumulative dose of 38 g (taken in two doses), he developed visual memories, nausea and vomiting. He developed a generalized tonic-clonic seizure with additional grand mal seizures. He was treated with midazolam and levetiracetam. Extended drug screenings and computed tomography and magnetic resonance imaging findings were all negative. Knowledge of the side effects of ibogaine has mainly come from reports of cardiovascular complications; seizures are rarely mentioned and experimental findings are inconsistent. It seems that ibogaine acts like a proconvulsive drug at high doses.