A systematic literature review of clinical trials and therapeutic applications of ibogaine.

Abstract

Iboga and its primary alkaloids, ibogaine and noribogaine, have been of interest to researchers and practitioners, mainly due to their putative efficacy in treating substance use disorders (SUDs). For many SUDs, still no effective pharmacotherapies exist. Distinct psychoactive and somatic effects of the iboga alkaloids set them apart from classic hallucinogens like LSD, mescaline, and psilocybin. The study team performed this systematic review focusing on clinical data and therapeutic interventions involving ibogaine and noribogaine. The team conducted a search for all publications up to December 7, 2020, using PubMed and Embase following PRISMA guidelines. In total, we identified 743 records. In this review, we consider 24 studies, which included 705 individuals receiving ibogaine or noribogaine. This review includes two randomized, double-blind, controlled clinical trials, one double-blind controlled clinical trial, 17 open-label studies or case series (including observational or retrospective studies), three case reports, and one retrospective survey. The published data suggest that ibogaine is an effective therapeutic intervention within the context of SUDs, reducing withdrawal symptoms and craving. Data also point toward a beneficial impact on depressive and trauma-related psychological symptoms. However, studies have reported severe medical complications and deaths, which seem to be associated with neuro- and cardiotoxic effects of ibogaine. Two of these fatalities were described in the 24 studies included in this review. Treatment of SUDs and persisting comorbidities requires innovative treatment approaches. Rapid-onset therapies such as the application of ibogaine may offer novel treatment opportunities for specific individuals. Rigorous study designs within medical settings are necessary to warrant safe application, monitoring, and, possibly, medical intervention.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

• State of the evidence: Ibogaine for addiction ↕Mixed

  Published data suggest ibogaine reduces withdrawal symptoms and craving and may benefit depressive and trauma-related symptoms, but severe medical complications and deaths associated with neuro- and cardiotoxicity are reported.

  Synthesized September 21, 2026

Comparable studies

Other systematic reviews and meta-analyses on ibogaine for addiction, most cited first.