Ibogaine for treating drug dependence. What is a safe dose?
Leo J. Schep, Robin J Slaughter, S Galea, D Newcombe
Drug and Alcohol Dependence September 1, 2016 DOI: 10.1016/j.drugalcdep.2016.07.005 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Case report Peer reviewed |
|---|---|
| Intervention | ibogaine |
| Dose | 0.87 mg/kg |
| Topics | Ibogaine Addiction |
| Keywords | Drug dependence Qt prolongation Ibogaine treatment ibogaine Current ibogaine doses Effective treatment Neuronal injury Dangerous cardiac issues Affecting purkinje cells Far too high Precise calculation |
| Citations | 30 |
| Key findings | A safer initial human dose of ibogaine is calculated at 0.87 mg/kg, substantially lower than currently administered doses, and morbidities and mortalities will continue unless practitioners reconsider doses. |
Abstract
The indole alkaloid ibogaine, present in the root bark of the West African rain forest shrub Tabernanthe iboga, has been adopted in the West as a treatment for drug dependence. Treatment of patients requires large doses of the alkaloid to cause hallucinations, an alleged integral part of the patient's treatment regime. However, case reports and case series continue to describe evidences of ataxia, gastrointestinal distress, ventricular arrhythmias and sudden and unexplained deaths of patients undergoing treatment for drug dependence. High doses of ibogaine act on several classes of neurological receptors and transporters to achieve pharmacological responses associated with drug aversion; limited toxicology research suggests that intraperitoneal doses used to successfully treat rodents, for example, have also been shown to cause neuronal injury (purkinje cells) in the rat cerebellum. Limited research suggests lethality in rodents by the oral route can be achieved at approximately 263mg/kg body weight. To consider an appropriate and safe initial dose for humans, necessary safety factors need to be applied to the animal data; these would include factors such as intra- and inter-species variability and for susceptible people in a population (such as drug users). A calculated initial dose to treat patients could be approximated at 0.87mg/kg body weight, substantially lower than those presently being administered to treat drug users. Morbidities and mortalities will continue to occur unless practitioners reconsider doses being administered to their susceptible patients.
Comparable studies
Other narrative reviews on ibogaine for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The Anti-Addiction Drug Ibogaine and the Heart: A Delicate Relation Humans, animals | 2015 | Review | |
| Ibogaine in the treatment of substance dependence. | 2013 | Review | |
| Ibogaine, an anti-addictive drug: pharmacology and time to go further in development. A narrative review. | 2008 | Review | |
| A review of chemical agents in the pharmacotherapy of addiction. | 2002 | Review | |
| Engineering Safer Psychedelics for Treating Addiction. | 2021 | Review |
Citations in the library
Cited by 22
- A systematic literature review of clinical trials and therapeutic applications of ibogaine. Journal of Substance Abuse Treatment July 1, 2022
- Ibogaine as a treatment for substance misuse: Potential benefits and practical dangers. Progress in Brain Research 2018
- Safety of ibogaine administration in detoxification of opioid-dependent individuals: a descriptive open-label observational study. Addiction 2022
- Identifying setting factors associated with improved ibogaine safety: a systematic review of clinical studies. European Archives of Psychiatry and Clinical Neuroscience October 1, 2023
- The Ibogaine Experience: A Qualitative Study on the Acute Subjective Effects of Ibogaine Anthropology of Consciousness March 1, 2020
and 17 more in the library
Cites 34
- Degeneration of Purkinje cells in parasagittal zones of the cerebellar vermis after treatment with ibogaine or harmaline. Neuroscience July 1, 1993
- Treatment of acute opioid withdrawal with ibogaine. American Journal on Addictions 1999
- Effects and aftereffects of ibogaine on morphine self-administration in rats. European Journal of Pharmacology April 3, 1991
- The ibogaine medical subculture. Journal of Ethnopharmacology January 4, 2008
- A preliminary investigation of ibogaine: case reports and recommendations for further study. Journal of Substance Abuse Treatment 1994
and 29 more in the library