How toxic is ibogaine?

@article{Litjens2016HowTI,
  title={How toxic is ibogaine?},
  author={Ruud P W Litjens and Tibor Markus Brunt},
  journal={Clinical Toxicology},
  year={2016},
  volume={54},
  pages={297 - 302}
}
CONTEXT Ibogaine is a psychoactive indole alkaloid found in the African rainforest shrub Tabernanthe Iboga. [] Key Method The search criteria were "mechanism of action", "pharmacokinetics", "pharmacodynamics", "neurotransmitters", "toxicology", "toxicity", "cardiac", "neurotoxic", "human data", "animal data", "addiction", "anti-addictive", "withdrawal", "death" and "fatalities". The searches identified 382 unique references, of which 156 involved human data. Further research revealed 14 detailed…

The antiaddictive effects of ibogaine: A systematic literature review of human studies

Case series suggest that a single dose or a few treatments with ibogaine may significantly reduce drug withdrawal, craving, and self-administration in dependent individuals lasting from 24 h to weeks or months.

Safety of ibogaine administration in detoxification of opioid dependent individuals: a descriptive open-label observational study.

This open‐label observational study found that ibogaine treatment of patients with opioid use disorder can induce a clinically relevant but reversible QTc prolongation, bradycardia, and severe ataxia.

On the toxicity of ibogaine

The totality of animal and human data suggests neurodegeneration does not occur with ‘‘therapeutic’’ ibogaine dosing, and serious adverse events during therapeutic use may be mitigated by pretreatment screening to include a careful medical history, careful medication history, blood chemistries, and ECG prior to enrolment into a proper treatment protocol.

Morphing of Ibogaine: A Successful Attempt into the Search for Sigma-2 Receptor Ligands

A deconstruction study on the ibogaine tricyclic moiety and a successive scaffold-hopping of the indole counterpart are reported to facilitate the investigation of iboga alkaloid derivatives which may serve as templates for the design of selective σ2 receptor ligands.

Phytochemical characterization of Tabernanthe iboga root bark and its effects on dysfunctional metabolism and cognitive performance in high-fat-fed C57BL/6J mice.

The potential alleviating effects of the water extract of iboga root bark on high-fat diet (HFD)-induced hyperglycemia as well as its effects on cognitive function in male C57BL/6J mice were determined.

In reply – on the toxicity of ibogaine

It is agreed that neurotoxicity is most likely not to occur at doses reported in therapeutic treatments, but questions their suggestion that some of the doses used in therapy could be considered ‘‘safe’’, like in Mash et al.

Detoxification from methadone using low, repeated, and increasing doses of ibogaine: A case report

It is not clear if ibogaine at low doses could be used therapeutically in people on methadone maintenance treatments (MMT), but a case report of a female on MMT for 17 years who performed a self-treatment with several low and cumulative doses of ibogance over a 6-week period successfully eliminated her withdrawal symptoms.

Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine

After (prolonged) ibogaine ingestion, clinicians should beware of long-term effects due to its metabolite, and demonstrate a linear relationship between the concentration of the metabolite and long duration of action.

References

SHOWING 1-10 OF 54 REFERENCES

Ibogaine: Complex Pharmacokinetics, Concerns for Safety, and Preliminary Efficacy Measures

It is reported here that ibogaine significantly decreased craving for cocaine and heroin during inpatient detoxification and for short‐term stabilization of drug‐dependent persons as they prepare to enter substance abuse treatment.

Ibogaine, an anti-addictive drug: pharmacology and time to go further in development. A narrative review

The purpose of this article was to review data from the literature concerning physicochemical properties, bio-analytical methods, and pharmacology of ibogaine; this article will be focused on the use of this drug as anti-addictive agent.

Comparative neuropharmacology of ibogaine and its O-desmethyl metabolite, noribogaine.

Fatalities Temporally Associated with the Ingestion of Ibogaine

Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications and the clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity.

Mechanisms of Antiaddictive Actions of Ibogaine a

The authors' ongoing studies in rats suggest that kappa agonist and NMDA antagonist actions contribute to ibogaine's effects on opioid and stimulant self‐administration, while the serotonergic actions may be more important for ibogane‐induced decreases in alcohol intake.

Life-threatening complications of ibogaine: three case reports.

It is of great importance that clinicians are aware of these potentially serious side effects and realise that widespread online marketing practices will give many more people access to ibogaine.

Medication development of ibogaine as a pharmacotherapy for drug dependence.

A rising tolerance study using single administration of ibogaine for treatment of cocaine dependency is initiated to determine safety, pharmacokinetics and dose effects, and to identify relevant parameters of efficacy in cocaine-dependent patients.

Ibogaine: a review.

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Distribution of ibogaine and noribogaine in a man following a poisoning involving root bark of the Tabernanthe iboga shrub.

The tissue distribution of ibogaine and noribogaine, the main metabolite of ibogsaine, in a 48-year-old Caucasian male found dead at his home after a poisoning involving the ingestion of root bark from the shrub Tabernanthe iboga is reported.
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