Ibogaine: Known To Save Lives, But Is It Dangerous To Some?

Ibogaine, it’s developed somewhat of a dangerous reputation, but is it really as dangerous as people claim, and what does ibogaine exactly do?

Ibogaine 

Ibogaine is a hallucinogenic substance found in plants such as the iboga plant that is traditionally used in African spiritual ceremonies, with a particular association with West Central African culture.

While ibogaine can reduce feelings of hunger, thirst, and exhaustion, it is more well known for its ability to induce intense hallucinogenic visions. Ibogaine’s hallucinogenic effects have been described as occurring over separate stages and lasting up to 72 hours. People report experiencing dream-like states, visual hallucinations, and feelings of reflection and revelation.

Ibogaine As A Substance Abuse Treatment 

As well as its hallucinogenic effects, ibogaine has also demonstrated anti-addictive properties, with the reduction or disappearance of addiction symptoms reported for patients addicted to substances including methamphetamine, cocaine, opioids, alcohol, and nicotine. 

One 12-month study analyzed the opioid dependencies of participants after treatment with ibogaine. The 14 participants were given a single ibogaine treatment and then measured for addiction severity over 12 months. Depression levels were also measured to gauge the possible secondary effects of ibogaine.

The results of this study showed that the ibogaine treatment resulted in a significant reduction in opioid withdrawal symptoms, with patients reporting either a cessation of opioid use or a reduction in opioid use.

Risks Of Ibogaine 

One of the main causes for concern with ibogaine use is its possible toxicity. A 2016 literature review found that 27 fatalities were reported following ibogaine ingestion. Cardiovascular conditions were found to be responsible for the deaths of these individuals when post mortem information was available. Another study found that 19 individuals outside of West Africa who took ibogaine from 1990 to 2008 died within 1.5 to 76 hours of delivery. 12 of these deaths were also linked to cardiovascular and/or substance abuse problems and so cardiovascular issues are thought to be a risk factor for ibogaine use. 

Ibogaine has also shown some neurotoxic properties with rat studies showing potential neurodegeneration possibly caused by excitotoxic effects in Purkinje cells in the cerebellum. 

Ibogaine Action 

Ibogaine acts with multiple neurotransmitter systems and has shown an affinity to interact with N-methyl-D-aspartate (NMDA), opioid receptors, serotonin, dopamine, and acetylcholine systems, which could all play a role in ibogaine’s hallucinogenic effects. 

Ibogaine’s possible negative effects on the heart might occur through hERG potassium channels in the heart. These channels might increase the cardiotoxicity of ibogaine through the role they play in the repolarization of cardiac action potentials as ibogaine is thought to possibly act of hERG channels to delay this repolarization, increase the gap between electrical heart waves and possibly cause arrhythmias and even cardiac arrest. 

Ibogaine is also largely metabolized by the CYP2D6 enzyme and this interaction could pose some risk for patients taking ibogaine alongside certain medications. CYP2D6 is also responsible for the metabolism of other medications and so it is possible that ibogaine use could result in reduced metabolism of these medications. 

Ibogaine: Safe For Use?

While ibogaine has shown significant potential as a treatment for some substance abuse conditions, there are some serious risks, especially for those suffering from pre-existing heart conditions and/or for patients taking certain medications. There is hope that future research involving synthetic ibogaine derivatives will demonstrate the same therapeutic effects without the toxic risks.

image by Kgjerstad