A case series of ibogaine toxicity reported to the United Kingdom National Poisons Information Service (NPIS) over a 10-year period.
Ella P Edwards, Laurence A Gray, Muhammad E M O Elamin, Aravindan Veiraiah, Ruben H K Thanacoody, James M Coulson
Clinical Toxicology March 1, 2025 DOI: 10.1080/15563650.2024.2447500 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective analysis Case report Peer reviewed |
|---|---|
| Sample size | 7 |
| Population | Patients who used ibogaine and were reported to the UK National Poisons Information Service |
| Intervention | Ibogaine |
| Dose | 5g to 34g |
| Topics | Ibogaine |
| Keywords | Cardiotoxicity Neurotoxicity Ibogaine toxicity: ibogaine Ibogaine risks Ibogaine dangers Ibogaine adverse effects Ibogaine complications Unregulated ibogaine use Plant-derived substances: iboga Natural compounds *iboga* plant Self-medication dangers: ibogaine Self-treatment risks Unregulated drug use Addiction treatment complications |
| Citations | 2 |
| Key points | Ibogaine use is associated with severe cardiotoxicity, including ventricular tachyarrhythmias and cardiac arrest, as well as neurological symptoms. |
Abstract
Ibogaine is a psychoactive alkaloid derived from the root bark of the West African shrub Tabernanthe iboga. It is not licensed in the United Kingdom but is used by individuals to alleviate drug or alcohol use. A retrospective analysis of telephone enquiries involving ibogaine between 1 January 2012 and 31 December 2022 to the United Kingdom National Poisons Information Service was performed. Eleven enquiries relating to seven patients were made to the United Kingdom National Poisons Information Service in this period. Five of these patients were male (71%) with the majority in the age category 31-40 years (57%). All patients presented symptomatically. The circumstances for all seven cases were recorded as "recreational abuse." The exact indication was not specified in three cases but in two cases it was being used to alleviate diacetylmorphine (heroin) use and in another two cases it was being used for relief from insomnia. Three sources of ibogaine were reported - in one case it was bought online, in one case by a dealer and in two cases it was bought from a shaman. When reported, the dose ingested ranged from 5g to 34g. Two patients took it in tablet form and four patients ingested the root bark. The time since exposure, when reported, ranged from 16 h to 1 month. Seven patients experienced neurological symptoms and six displayed features of cardiotoxicity. The most frequently reported features included cardiac arrest, hypoxia, torsade de pointes, QT interval prolongation, coma, convulsions, stupor, bradycardia, vomiting and anxiety. Our cases are consistent with other case reports that demon-strate ibogaine can cause severe cardiotoxicity, including ventricular tachyarrhythmias, prolonged QT interval, and tor-sade de pointes; which can lead to loss of cardiac output and arrest. Individuals using ibogaine in variable doses to self-treat for drug use are at risk of developing severe cardiotoxicity and neurological symptoms. Further studies to quantify dose-response relationship and to further improve knowledge of its pharmacokinetics are required.
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 |
| Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures. Drug-dependent persons undergoing inpatient detoxification | 2000 | Observational study | |
| 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 |
Citations in the library
Cited by 2
Cites 15
- Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures. Annals of the New York Academy of Sciences September 1, 2000
- The Anti-Addiction Drug Ibogaine and the Heart: A Delicate Relation Molecules January 29, 2015
- Ibogaine Detoxification Transitions Opioid and Cocaine Abusers Between Dependence and Abstinence: Clinical Observations and Treatment Outcomes. Frontiers in Pharmacology 2018
- Mechanisms of Antiaddictive Actions of Ibogainea. Annals of the New York Academy of Sciences May 1, 1998
- How toxic is ibogaine? Clinical Toxicology 2016
and 10 more in the library