Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures.
Deborah C. Mash, Craig A. Kovera, John Pablo, Rachel F. Tyndale, F D Ervin, I C Williams, E G Singleton, M Mayor
Annals of the New York Academy of Sciences September 1, 2000 DOI: 10.1111/j.1749-6632.2000.tb05213.x (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational study Peer reviewed |
|---|---|
| Population | Drug-dependent persons undergoing inpatient detoxification |
| Intervention | Ibogaine |
| Dose | single oral dose |
| Duration | 30-day follow-up after program discharge |
| Topics | Ibogaine |
| Keywords | Substance abuse treatment Addiction treatment Drug rehabilitation Detoxification Recovery support Addiction medicine Drug craving reduction Opioid dependence treatment Cocaine addiction therapy Relapse prevention Natural compounds Herbal remedies Phytochemicals Plant-based medicine Bioactive compounds Mental health Depressive symptoms Mood disorders Psychological well-being |
| Citations | 146 |
| Key findings | Ibogaine significantly decreased craving for cocaine and heroin and reduced depressive symptoms during inpatient detoxification, with effects lasting 30 days after discharge. |
Abstract
Ibogaine is an indole alkaloid found in the roots of Tabernanthe Iboga (Apocynaceae family), a rain forest shrub that is native to western Africa. Ibogaine is used by indigenous peoples in low doses to combat fatigue, hunger and thirst, and in higher doses as a sacrament in religious rituals. Members of American and European addict self-help groups have claimed that ibogaine promotes long-term drug abstinence from addictive substances, including psychostimulants and opiates. Anecdotal reports attest that a single dose of ibogaine eliminates opiate withdrawal symptoms and reduces drug craving for extended periods of time. The purported efficacy of ibogaine for the treatment of drug dependence may be due in part to an active metabolite. The majority of ibogaine biotransformation proceeds via CYP2D6, including the O-demethylation of ibogaine to 12-hydroxyibogamine (noribogaine). Blood concentration-time effect profiles of ibogaine and noribogaine obtained for individual subjects after single oral dose administrations demonstrate complex pharmacokinetic profiles. Ibogaine has shown preliminary efficacy for opiate detoxification and for short-term stabilization of drug-dependent persons as they prepare to enter substance abuse treatment. We report here that ibogaine significantly decreased craving for cocaine and heroin during inpatient detoxification. Self-reports of depressive symptoms were also significantly lower after ibogaine treatment and at 30 days after program discharge. Because ibogaine is cleared rapidly from the blood, the beneficial aftereffects of the drug on craving and depressed mood may be related to the effects of noribogaine on the central nervous system.