Rare but relevant: Ibogaine and cardiovascular complications-prolonged QT interval and ventricular arrhythmias.
Tibor Markus Brunt
Addiction January 20, 2026 DOI: 10.1111/add.70319 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Randomized Placebo-controlled Open-label Peer reviewed |
|---|---|
| Intervention | Ibogaine |
| Topics | Ibogaine |
| Keywords | Qt interval Addiction treatment Cardiovascular Ventricular arrhythmias |
| Citations | 2 |
| Key findings | Ibogaine reduces craving and withdrawal in opioid and cocaine dependence but carries a risk of QTc prolongation and ventricular arrhythmias, even at therapeutic doses in individuals without pre-existing cardiac conditions. |
Abstract
Revived interest in psychedelic-assisted therapies has also renewed focus on ibogaine, a psychoactive alkaloid, for its notable anti-addictive potential. Evidence from observational, open-label, and limited randomized placebo-controlled trials indicates that ibogaine and its metabolite noribogaine reduce craving and withdrawal symptoms in opioid and cocaine-dependent individuals, primarily through multiple pharmacological mechanisms; however, ibogaine presents a rare yet clinically significant cardiotoxic risk: QTc prolongation and potentially fatal ventricular arrhythmias such as Torsades des Pointes. Case reports demonstrate that these events occur with therapeutic doses of ibogaine and in individuals without pre-existing cardiac conditions. A large interindividual variability in CYP2D6 metabolism of ibogaine was shown and might contribute to higher cardiovascular risk in certain individuals. Recent efforts to improve safety of ibogaine include different dosing strategies, cardiovascular monitoring and the development of ibogaine analogues, which retain anti-addictive efficacy while lacking cardiotoxicity in preclinical models. Future ibogaine-assisted treatment should be conducted exclusively under controlled medical supervision, with CYP2D6 genotyping and rigorous monitoring of cardiovascular functioning. Future clinical trials should prioritize evaluation of safer analogues and personalized dosing strategies to optimize the benefit-risk profile of this emerging therapy.
Comparable studies
Other narrative reviews on ibogaine, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelics as medicines for substance abuse rehabilitation: evaluating treatments with LSD, Peyote, Ibogaine and Ayahuasca. | 2014 | Review | |
| 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 | |
| Registered clinical studies investigating psychedelic drugs for psychiatric disorders. Registered clinical trials on clinicaltrials.gov evaluating psychedelics for... | 2021 | Review | n = 70 |
Citations in the library
Cited by 2
Cites 42
- Psychedelics Promote Structural and Functional Neural Plasticity Cell Reports June 1, 2018
- The ibogaine medical subculture. Journal of Ethnopharmacology January 4, 2008
- Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes. The American Journal of Drug and Alcohol Abuse 2018
- The Anti-Addiction Drug Ibogaine and the Heart: A Delicate Relation Molecules January 29, 2015
- Ibogaine, an anti-addictive drug: pharmacology and time to go further in development. A narrative review. Human & Experimental Toxicology March 1, 2008
and 37 more in the library