Ibogaine and Noribogaine
Deborah C. Mash, Michael Karukin
The Oxford Handbook of Opioids and Opioid Use Disorder December 18, 2023 DOI: 10.1093/oxfordhb/9780197618431.013.16 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Open-label Peer reviewed |
|---|---|
| Intervention | Ibogaine |
| Dose | single oral doses |
| Topics | Ibogaine |
| Key findings | Open-label observational evidence suggests ibogaine may be useful for treating opioid withdrawal symptoms and facilitating a transition to drug-free abstinence, but controlled clinical trials are needed to evaluate its benefits, risks, and safety. |
Abstract
Abstract Ibogaine is an indole alkaloid derived from the root bark of Tabernanthe iboga. The anti-addictive actions of ibogaine were first reported in the 1960s by persons using heroin. They offered personal testimonials that single oral doses of ibogaine abruptly blocked opioid withdrawal, and they remained drug-free after ibogaine exposure. Today, online forums describe ibogaine use for opioid withdrawal management by for-profit clinics and unskilled lay people, despite a lack of regulatory testing of ibogaine in human clinical trials. Discontinuation of opioid agonist therapy results in severely painful opioid withdrawal symptoms (OWS) that are followed by a persistent negative affect. For many patients seeking to discontinue opioids, the post-acute emotional disruption is a major obstacle for completion of full withdrawal. This chapter summarizes ibogaine’s clinical experience and open-label observational evidence that the drug is useful for treating the OWS and facilitating a transition to drug-free abstinence. The drug’s polypharmacy mode of action is considered in light of neuroadaptations in mu-opioid processes observed during acute withdrawal, which are mechanistically related to the protracted negative mood state that follows during opioid abstinence. Finally, the dark side of the unregulated use of ibogaine and concerns for patient safety are considered. The value proposition for development of ibogaine as a psychedelic drug product for addiction treatment will ultimately depend on the drug’s single dose regimen, benefits, risks, and safety measures demonstrated in controlled clinical trials.
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
Cites 23
- A non-hallucinogenic psychedelic analogue with therapeutic potential. Nature 2021
- Treatment of acute opioid withdrawal with ibogaine. American Journal on Addictions 1999
- The ibogaine medical subculture. Journal of Ethnopharmacology January 4, 2008
- A preliminary investigation of ibogaine: case reports and recommendations for further study. Journal of Substance Abuse Treatment 1994
- Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes. The American Journal of Drug and Alcohol Abuse 2018
and 18 more in the library