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Death related to consumption of Rauvolfia sp. powder mislabeled as Tabernanthe iboga.

Thomas Gicquel, Chloé Hugbart, Françoise Le Devehat, Sylvie Lepage, Alain Baert, Renaud Bouvet, Isabelle Morel

Forensic Science International September 1, 2016 DOI: 10.1016/j.forsciint.2016.06.014 (opens in new tab)

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AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population 30-year-old woman who died after ingesting a mislabeled herbal product bought online
Topics Ibogaine
Keywords Ajmaline Rauvolfia Reserpine Yohimbine Fatal poisoning case Died Cause of death Mislabeled products Mislabeled natural products Product misidentification Verifying online remedies Herbal remedies Toxic alkaloids
Citations 20
Key findings A powder sold online as Tabernanthe iboga contained no ibogaine but instead toxic Rauvolfia alkaloids (ajmaline, yohimbine, reserpine), and their ingestion led to the woman's death.

Abstract

Powdered roots of iboga (Tabernanthe iboga) contain ibogaine, an alkaloid that has been used to treat addictions. We report the case of a 30-year-old woman who died after ingesting a powder labeled as Tabernanthe iboga she had bought online. Analysis of the powder revealed the absence of ibogaine but the presence of toxic alkaloids (ajmaline, yohimbine and reserpine) found in Rauvolfia sp. plant species. An original and specific LC-MS/MS method developed to quantify ajmaline, yohimbine and reserpine showed respective concentrations of 109.1ng/mL, 98.2ng/mL and 30.8ng/mL in blood, and 1528.2ng/mL, 914.2ng/mL and 561.2ng/mL in bile. Moreover, systematic toxicological analyses of biological samples showed the presence of oxazepam at therapeutic concentration and cannabinoids. Death could be attributed to ingestion of a substantial quantity of crushed roots of Rauvolfia in association with concomitant drug withdrawal.

Comparable studies

Other case reports and case series on ibogaine, most cited first.

Study Year Design Participants
Treatment of acute opioid withdrawal with ibogaine. Patients undergoing opioid detoxification with ibogaine in non-medical settings 1999 Case series n = 33
A preliminary investigation of ibogaine: case reports and recommendations for further study. Individuals addicted to opiates 1994 Case series n = 7
Long-QT Syndrome Induced by the Antiaddiction Drug Ibogaine A 31-year-old woman 2009 Case study n = 1
Distribution of ibogaine and noribogaine in a man following a poisoning involving root bark of the Tabernanthe iboga shrub. 48-year-old Caucasian male with a history of drug abuse who died after ingesting... 2006 Case study n = 1
A case report SPECT study and theoretical rationale for the sequential administration of ibogaine and 5-MeO-DMT in the treatment of alcohol use disorder. 31-year-old male military veteran with moderate alcohol use disorder 2018 Case study n = 1

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