Background:
A naturally occurring plant alkaloid from Tabernathe iboga in West and Central Africa, traditionally used in ritualistic ceremonies due to hallucinogenic effects
Some evidence, initially from NYC in the 1960’s shows that it may prevent opioid cravings and mitigate withdrawal symptoms.
Also being studied for beneficial effects of depression and trauma-related psychological symptoms
No RCT’s, current data is from open label case series from USA and Netherlands, which have shown 6 months or longer periods of abstinence from drugs for 36% of 51 total treatments. Another study showed 25 out of 33 individuals having full resolution of opioid withdrawal sustained throughout 72 hour post treatment observation period.
Schedule I in USA since 1970.
Recently in media as state of Texas authorized clinical drug trials to research potential for treatment of OUD, depression, PTSD: https://gov.texas.gov/news/post/governor-abbott-signs-ibogaine-treatment-research-law-at-texas-capitol
Military Veterans, NFL, and UFC athletes also trying to treat traumatic brain injuries/CTE: https://www.latimes.com/california/story/2025-09-12/nfl-ufc-athletes-try-psychedlic-ibogaine-to-treat-brain-injury
Administered orally, individuals travel to Europe, Mexico for treatment
Pharmacology:
Highly Lipophilic and slowly released in body
Acts on multiple receptors: NMDA, opioid, serotonin, muscarinic, nicotinic.
Different from other classical hallucinogens (LSD, psilocybin, mescaline), which are primarily serotonin-mediated
Mechanism of action is thought to be related to modification of neuroadaptations from prior drug exposure.
Overdose Management:
Toxicity includes prolonged QTc, arrhythmias, seizures, and death due to inhibiting of a unique channel related to repolarization of the cardiac action potential.
Since there have not been any controlled trials, toxicity data is from case studies; A 2008 review found 19 worldwide deaths attributable to ibogaine from 1990-2008; 15 associated with detoxification.
Usual care for the above mentioned conditions, no specific antidotes studied
Withdrawal Management:
No withdrawal symptoms following chronic administration, from animal studies
References:
1. Alper KR, Lotsof HS, Kaplan CD. The ibogaine medical subculture. Journal of Ethnopharmacology. 2008;115(1):9-24. doi:10.1016/j.jep.2007.08.034
2. Köck P, Froelich K, Walter M, Lang U, Dürsteler KM. A systematic literature review of clinical trials and therapeutic applications of ibogaine. J Subst Abuse Treat. 2022;138:108717. doi:10.1016/j.jsat.2021.108717
3. Meisner JA, Wilcox SR, Richards JB. Ibogaine-associated cardiac arrest and death: case report and review of the literature. Therapeutic Advances in Psychopharmacology. 2016;6(2):95-98. doi:10.1177/2045125315626073
4. Mosca A, Chiappini S, Miuli A, et al. Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: A Systematic Review of the Current Literature. Curr Neuropharmacol. 2023;21(11):2178-2194. doi:10.2174/1570159X21666221017085612
5. Noller GE, Frampton CM, Yazar-Klosinski B. Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study. Am J Drug Alcohol Abuse. 2018;44(1):37-46. doi:10.1080/00952990.2017.1310218