Ibogaine Consumption With Seizure-Like Episodes, QTc-Prolongation, and Captured Cardiac Dysrhythmias.
James Grogan, Roy R Gerona, Jerry W Snow, Louise Kao
Journal of Emergency Medicine October 1, 2019 DOI: 10.1016/j.jemermed.2019.06.052 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Qualitative Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 34-year-old white woman with heroin and cocaine use disorder |
| Intervention | ibogaine |
| Dose | 2 g |
| Topics | Addiction Ibogaine |
| Keywords | Tabernanthe iboga Addiction medicine Indole alkaloid Torsades de pointes Ibogaine safety: ibogaine Severe risks Life-threatening qtc prolongation Seizure-like episodes Cardiac dangers Unregulated ibogaine use Self-administering ibogaine Consuming this substance Critical insight Clinical awareness Iboga alkaloids: ibogaine |
| Citations | 16 |
| Key findings | Ibogaine exposure caused QTc prolongation and torsade de pointes in a patient who ingested the substance obtained from an Internet supplier. |
Abstract
Ibogaine is a psychoactive indole alkaloid that has been investigated for use as a treatment for opioid addiction. While not commercially available in the United States, it is available via Internet suppliers. Ibogaine use has been associated with significant cardiac and neurologic effects, such as QT-segment prolongation, cardiac dysrhythmias, hallucinations, seizures, and central nervous system depression. We present a case of verified ibogaine exposure with associated QTc prolongation and torsade de pointes with qualitative analysis of the ingested substance, and examine the history, social context, availability, and perceptions of ibogaine's effects and safety. A 34-year-old white woman with medical history significant for heroin and cocaine use disorder presented with reported seizures 1 day after ingestion of 2 g ibogaine powder purchased from an Internet supplier. Shortly after ingestion, she experienced hallucinations and was reported by family to have four to five seizure-like episodes, at one point becoming apneic. In the emergency department, she was noted to have QTc prolongation and several episodes of torsade de pointes. Qualitative analysis confirmed the presence of ibogaine in the empty foil packages containing the ingested substance. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: As increasing numbers of opioid-dependent patients attempt to curtail their substance use disorders, we anticipate a rise in ibogaine exposures, necessitating awareness by front-line clinicians in recognizing and treating a drug exposure that can rapidly become life-threatening.
Comparable studies
Other case reports and case series on ibogaine for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Long-QT Syndrome Induced by the Antiaddiction Drug Ibogaine A 31-year-old woman | 2009 | Case study | n = 1 |
| A case report SPECT study and theoretical rationale for the sequential administration of ibogaine and 5-MeO-DMT in the treatment of alcohol use disorder. 31-year-old male military veteran with moderate alcohol use disorder | 2018 | Case study | n = 1 |
| Remission of Severe Opioid Use Disorder with Ibogaine: A Case Report. 37-year-old female with severe opioid use disorder | 2016 | Case study | n = 1 |
| Novel treatment of opioid use disorder using ibogaine and iboga in two adults Individuals with opioid use disorder accessing ibogaine through private unregulated... | 2020 | Case series | n = 2 |
| Risk management in a global market of alternative addiction care: a case study of the ibogaine medical subculture | 2025 | Case study |
Citations in the library
Cited by 9
- A systematic literature review of clinical trials and therapeutic applications of ibogaine. Journal of Substance Abuse Treatment July 1, 2022
- The adverse events of ibogaine in humans: an updated systematic review of the literature (2015-2020). Psychopharmacology June 1, 2022
- Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: ASystematic Review of the Current Literature Current Neuropharmacology October 20, 2022
- Evaluating the toxicity and therapeutic potential of ibogaine in the treatment of chronic opioid abuse Expert Opinion on Drug Metabolism & Toxicology June 18, 2021
- Pharmacologic Similarities and Differences Among Hallucinogens The Journal of Clinical Pharmacology August 1, 2021
and 4 more in the library
Cites 21
- Treatment of acute opioid withdrawal with ibogaine. American Journal on Addictions 1999
- 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
- Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study. The American Journal of Drug and Alcohol Abuse 2018
- Ibogaine: complex pharmacokinetics, concerns for safety, and preliminary efficacy measures. Annals of the New York Academy of Sciences September 1, 2000
and 16 more in the library