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.
Joseph P Barsuglia, Martin Polanco, Robert Palmer, Benjamin Malcolm, Benjamin Kelmendi, Tanya Calvey
Progress in Brain Research 2018 DOI: 10.1016/bs.pbr.2018.08.002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 31-year-old male military veteran with moderate alcohol use disorder |
| Interventions | Ibogaine hydrochloride 5-MeO-DMT |
| Dose | Ibogaine hydrochloride 1550 mg (17.9 mg/kg); vaporized 5-MeO-DMT from bufotoxin source 50 mg (estimated 5-7 mg 5-MeO-DMT) |
| Duration | 5 days post-treatment (with follow-up at 1 month and 2 months) |
| Topics | 5-MeO-DMT Addiction Ibogaine DMT |
| Keywords | Combination psychedelic therapy Psychedelic therapy psychedelic Psychedelic-assisted treatment Hallucinogen therapy Entheogenic medicine Psychedelic medicine Addiction treatment addiction Substance abuse treatment Recovery Sobriety Dependency therapy Drug rehabilitation Neuroimaging spect Brain imaging Neurobiology Brain scans Brain research |
| Citations | 37 |
| Key findings | Sequential administration of ibogaine and 5-MeO-DMT increased brain perfusion in regions associated with alcohol use disorders and coincided with short-term cessation of alcohol use and reduced cravings. |
Abstract
Ibogaine is a plant-derived alkaloid and dissociative psychedelic that demonstrates anti-addictive properties with several substances of abuse, including alcohol. 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring psychedelic known to occasion potent mystical-type experiences and also demonstrates anti-addictive properties. The potential therapeutic effects of both compounds in treating alcohol use disorder require further investigation and there are no published human neuroimaging findings of either treatment to date. We present the case of a 31-year-old male military veteran with moderate alcohol use disorder who sought treatment at an inpatient clinic in Mexico that utilized a sequential protocol with ibogaine hydrochloride (1550mg, 17.9mg/kg) on day 1, followed by vaporized 5-MeO-DMT (bufotoxin source 50mg, estimated 5-MeO-DMT content, 5-7mg) on day 3. The patient received SPECT neuroimaging that included a resting-state protocol before, and 3 days after completion of the program. During the patient's ibogaine treatment, he experienced dream-like visions that included content pertaining to his alcohol use and resolution of past developmental traumas. He described his treatment with 5-MeO-DMT as a peak transformational and spiritual breakthrough. On post-treatment SPECT neuroimaging, increases in brain perfusion were noted in bilateral caudate nuclei, left putamen, right insula, as well as temporal, occipital, and cerebellar regions compared to the patient's baseline scan. The patient reported improvement in mood, cessation of alcohol use, and reduced cravings at 5 days post-treatment, effects which were sustained at 1 month, with a partial return to mild alcohol use at 2 months. In this case, serial administration of ibogaine and 5-MeO-DMT resulted in increased perfusion in multiple brain regions broadly associated with alcohol use disorders and known pharmacology of both compounds, which coincided with a short-term therapeutic outcome. We present theoretical considerations regarding the potential of both psychedelic medicines in treating alcohol use disorders in the context of these isolated findings, and areas for future investigation.
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 |
| 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 |
| Ibogaine Consumption With Seizure-Like Episodes, QTc-Prolongation, and Captured Cardiac Dysrhythmias. 34-year-old white woman with heroin and cocaine use disorder | 2019 | 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 |