The anti-addiction drug ibogaine inhibits cardiac ion channels: a study to assess the drug’s proarrhythmic potential
Xaver Koenig, Michael Kovar, Lena Rubi, Ágnes K. Mike, Péter Lukács, Vaibhavkumar S Gawali, Hannes Todt, Walter Sandtner, Karlheinz Hilber
BMC Pharmacology and Toxicology September 1, 2012 DOI: 10.1186/2050-6511-13-s1-a38 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Experimental study Peer reviewed |
|---|---|
| Population | Heterologously expressed ion channels in TSA-201 cells and native channels in isolated mouse and guinea pig ventricular cardiomyocytes |
| Interventions | Ibogaine 18-methoxycoronaridine (18-MC) |
| Topics | Addiction Ibogaine |
| Keywords | Drug Pharmacology |
| Key findings | Ibogaine inhibits cardiac ion channels at therapeutic concentrations, making it potentially proarrhythmic, but its calcium channel blockade may counteract some proarrhythmic effects. |
Abstract
The plant alkaloid ibogaine has shown promising anti-addictive properties in animals and humans. Although not licensed as a therapeutic drug, and despite evidence that ibogaine may disturb the rhythm of the heart, this alkaloid is used as an anti-addiction drug in alternative medicine. We have recently reported that therapeutic concentrations of ibogaine inhibit human ERG (hERG) potassium channels, and thereby uncovered a mechanism by which the drug may induce life-threatening cardiac arrhythmias. Here, to assess the drug’s proarrhythmic potential in more detail, we studied the effects of ibogaine and its congener 18-methoxycoronaridine (18-MC) on various cardiac voltage-gated ion channels by using the whole cell patch clamp technique. Besides heterologously expressed ion channels in TSA-201 cells, native channels in isolated mouse and guinea pig ventricular cardiomyocytes were also studied. Finally, we performed computer simulations to estimate drug effects on the human cardiac action potential (AP). We confirmed that heterologously expressed hERG currents are reduced by ibogaine in low micromolar concentrations (IC 50 , 4 µM). Moreover, at higher concentration, the drug also reduced human Na V 1.5 sodium currents. Experiments on mouse cardiomyocytes confirmed that ibogaine also inhibits voltage-gated ion channels in their native environment. 18-MC also reduced cardiac ion currents, but less potently than ibogaine. Although blocking hERG channels, ibogaine did not prolong the AP in guinea-pig cardiomyocytes at low micromolar concentrations. Higher concentrations (>10 µM) even shortened the AP. Finally, implementation of ibogaine’s inhibitory effects on ion channels in a computer model of a human ventricular cardiomyocyte suggested that calcium channel blockade by the drug counteracts the AP-prolonging effect generated by hERG inhibition. Because ibogaine inhibits cardiac ion channels in therapeutic concentrations, the drug is potentially proarrhythmic. The risk of its administration, however, is possibly reduced by the fact that the drug also shows antiarrhythmic properties.
Comparable studies
Other preclinical and animal studies on ibogaine for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Glial Cell Line-Derived Neurotrophic Factor Mediates the Desirable Actions of the Anti-Addiction Drug Ibogaine against Alcohol Consumption Rats | 2005 | Experimental study | |
| Effects of ibogaine on acute signs of morphine withdrawal in rats: independence from tremor. Morphine-dependent rats | 1992 | Randomized controlled trial | |
| Autoregulation of glial cell line-derived neurotrophic factor expression: implications for the long-lasting actions of the anti-addiction drug, Ibogaine. Dopaminergic-like SHSY5Y cell line | 2006 | In vitro cell culture study | |
| A dose-response study of ibogaine-induced neuropathology in the rat cerebellum. Rats | 2000 | Dose-response study | n = 30 |
| Oral noribogaine shows high brain uptake and anti-withdrawal effects not associated with place preference in rodents. Mice and rats | 2016 | Experimental study with three experiments |