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.
In the evidence
This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.
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State of the evidence: Ibogaine Supports
A single oral ibogaine dose significantly decreased craving for cocaine and heroin during inpatient detoxification and reduced depressive symptoms that remained lower 30 days after discharge.
Synthesized
Comparable studies
Other observational and cohort studies on ibogaine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes. Adults with DSM-IV opioid dependence | 2018 | Observational study | n = 30 |
| Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study. Individuals receiving legal ibogaine treatment for opioid dependence in New Zealand | 2018 | Observational study | n = 14 |
| Treating drug dependence with the aid of ibogaine: a retrospective study. Former alcohol, cannabis, cocaine and crack users (72% poly-drug users) | 2014 | Retrospective analysis | n = 75 |
| Magnesium-ibogaine therapy in veterans with traumatic brain injuries. Male Special Operations Forces veterans with predominantly mild traumatic brain injury | 2024 | Prospective observational study | n = 30 |
| Changes in Withdrawal and Craving Scores in Participants Undergoing Opioid Detoxification Utilizing Ibogaine. Participants with opioid use disorder undergoing ibogaine detoxification | 2018 | Observational cohort | n = 50 |
Citations in the library
Cited by 96
- The ibogaine medical subculture. Journal of Ethnopharmacology January 4, 2008
- Glial Cell Line-Derived Neurotrophic Factor Mediates the Desirable Actions of the Anti-Addiction Drug Ibogaine against Alcohol Consumption Journal of Neuroscience January 19, 2005
- Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study. The American Journal of Drug and Alcohol Abuse 2018
- The Anti-Addiction Drug Ibogaine and the Heart: A Delicate Relation Molecules January 29, 2015
- Unique and potent effects of acute ibogaine on zebrafish: the developing utility of novel aquatic models for hallucinogenic drug research. Behavioural Brain Research 2013
and 91 more in the library
Cites 5
- A preliminary investigation of ibogaine: case reports and recommendations for further study. Journal of Substance Abuse Treatment 1994
- Medication Development of Ibogaine as a Pharmacotherapy for Drug Dependencea. Annals of the New York Academy of Sciences May 1, 1998
- Identification of a primary metabolite of ibogaine that targets serotonin transporters and elevates serotonin. Life Sciences 1995
- Pharmacological screen for activities of 12-hydroxyibogamine: a primary metabolite of the indole alkaloid ibogaine. Psychopharmacology September 1, 1996
- Noribogaine stimulates naloxone-sensitive [35S]GTPgammaS binding. Neuroreport January 5, 1998