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Ibogaine treatment is gaining attention as a potential breakthrough for addiction recovery. Derived from the African shrub Tabernanthe iboga, this psychoactive substance is known for its powerful effects on withdrawal symptoms and cravings. However, its legality and safety remain subjects of debate.
In this guide, we’ll explore how ibogaine treatment works, its benefits and risks, and what to expect during the process.
- Ibogaine interacts with multiple neurotransmitter systems in the brain, showing promise for treating substance use disorder and possibly other mental health conditions.
- Ibogaine is not FDA-approved and carries risks, including heart issues and psychological distress. It's illegal in the U.S. but available abroad.
- Limited rigorous scientific research on ibogaine is due to a lack of marketability, complexity of action, concerns about toxicity, and poor-quality research settings.
What is ibogaine?
Ibogaine is a substance found in the root bark of Tabernanthe iboga, a plant found predominantly in West Africa.[1] At low dosages, it boosts energy; at higher dosages, it can have a strong hallucinogenic effect.[2]
Ibogaine appears to have anti-addictive properties, though it is not yet clear how it is able to have that effect or how safe it might be.[1] Some people who have substance use disorder (SUD) and some clinicians are advocating for further research into the potential use of ibogaine in treating their disease and supporting recovery.
Ibogaine's effect on the brain
Ibogaine’s effects on the brain are complex and not yet fully understood. Where most drugs achieve their results primarily through the way they affect a single neurotransmitter system, ibogaine interacts with many different systems. The observed effects of taking ibogaine may come from complex interactions between those systems.[1]
Ibogaine may release serotonin, a neurotransmitter involved in depression, into the brain.[3] Antidepressants known as selective serotonin reuptake inhibitors (SSRIs) treat depression by reducing the amount of serotonin that is reabsorbed into cells. Noribogaine, which is produced as ibogaine is broken down by the body, also increases serotonin but through a different mechanism.[3] Thus, ibogaine actually increases the amount of serotonin in the brain through two complementary pathways.
The effects of ibogaine aren’t confined to the serotonin pathways. It also prevents nicotine from stimulating dopamine release, reducing the pleasurable effects of smoking. It binds with Kappa opioid receptors, potentially offering some pain relief by affecting dopamine release into the nucleus accumbens (NA) region of the brain. It further adds to dopamine release into the NA through its role as an NMDA antagonist.[3]
The body removes ibogaine from the blood relatively quickly, leading some researchers to suggest that its effects may be caused by changes to the central nervous system.[1] It appears to reverse some drug-related changes in the brain responsible for tolerance.[4]
What does ibogaine feel like?
As with any psychoactive substances, reactions to ibogaine vary between individuals. [1][5] Taking ibogaine can be illuminating, distressing, or both. The total duration of an ibogaine experience is usually between 24 and 96 hours, and most people will go through the following stages.
Stage 1
The first stage of an ibogaine experience is sometimes known as the “acute” stage. It has been reported to last between 2-14 hours.
This stage is often physically uncomfortable, with many users experiencing nausea and vomiting. Users may become dehydrated or have a distended bladder as a result of difficulty moving and being unable to void urine.
Emotionally, some users will experience a dreamlike state, possibly with the sensation of dying. People with SUD can perceive this as a form of detoxification.
Stage 2
The second stage of ibogaine can last between 4 and 30 hours. The physical discomfort of stage 1 is usually totally absent, with users regaining control of their bodies. Although most people will be awake and alert during this period, many appear to prefer to avoid external stimuli.
Stage 2 is characterized by intense, dream-like visions. Some are open-eye visual disturbances, such as colors being brighter than usual and distortions in depth perception. Closed-eye visions are more common, often taking the form of landscapes, people or spiritual entities, and events. Some of these can be positive images, but other users will experience scenes of extreme trauma or violence.
Many users report having exceptional recall of memories during this stage, including recovering lost memories. They also feel deep understanding, insight, and catharsis. Auditory hallucinations and synaesthesia are not uncommon.
Stage 3
As users enter stage 3, imagery becomes less intense. For the next 12-72 hours, they will typically rest and process their experience as they return to normal.
Stage 4
Some researchers refer to the longer-term effects of ibogaine as stage 4 of the experience. During this period, ibogaine users with SUD may have reduced cravings for drugs or alcohol, and their withdrawal symptoms can be significantly suppressed.
How is ibogaine used in mental health treatment?
Ibogaine has not received comprehensive research as a medication to help with mental health disorders, but there is limited evidence that it may be effective for some conditions.
Ibogaine is a known psychedelic and hallucinogen.[6] Many people using it report feeling that they have resolved past issues and healed underlying emotional damage and trauma.[5] This may suggest a possible role for ibogaine in treating mental health disorders.
Which conditions may ibogaine treatment help with?
The most common application for ibogaine is to treat substance use disorder (SUD).[1] Patients with SUD who take ibogaine in a clinic setting have reported feeling reduced cravings and withdrawal effects.[5] It has also been shown to reduce drug intake in rats.[7] However, it’s important to remember that animal studies are considered less reliable, as study results on animals do not always yield the same results in humans. Therefore, these results should be interpreted with caution, and additional research is needed to understand how ibogaine may affect humans.
Other potential uses for ibogaine in mental health include treating post-traumatic stress disorder (PTSD), anxiety, insomnia, depression, and traumatic brain injury.[6][8][9][10]
A brief history of ibogaine and its therapeutic benefits
Ibogaine has been used by the Bwiti people of Gabon, Africa, for centuries for healing, spirituality, and initiation. It is associated with the concept of death and rebirth. It was first discussed in the Western world in 1885.[11]
Research into the use of ibogaine to support substance abuse began in 1955 when it was offered to a small group of detoxified morphine addicts in Kentucky, but it became more prominent during the 1960s when Howard Lotsof investigated its anti-addictive properties.[1][12]
In the late 1960s, the World Health Assembly categorized ibogaine as “likely to cause dependency or endanger human health,” and the FDA followed suit, classifying it as a Schedule 1 drug.[1]
Research has continued into ibogaine outside of typical clinical settings, including with patients taking ibogaine in hotel rooms while being observed by researchers.[13]
Ibogaine use is currently available in different countries across the world. Regulations vary, and some clinics offer qualified medical supervision while others do not. Ibogaine remains a Schedule 1 controlled substance within the US.
Barriers to valid research
There has been relatively little rigorous scientific research into using ibogaine therapeutically. There are several reasons for this.
Lack of marketability
Researching new medicines is expensive, and the vast majority of the money for research and development comes from the pharmaceutical industry. As a plant extract, ibogaine cannot be patented, meaning that companies can’t recoup the money they would spend researching and testing it. This makes it difficult to find money to research the effects of ibogaine. The pharmaceutical industry generally opposes such research.[1]
Complexity of action
Unlike most pharmaceutical drugs, ibogaine appears to work in many different ways at once.[4] This makes it much more difficult (and expensive) to study than drugs that have their primary effect through a single action.
Suspected toxicity
High doses of ibogaine in rats have been shown to damage Purkinje cells in the cerebellum and cause tremors.[1] This, combined with several deaths of people shortly after taking ibogaine, has led to concerns about its safety. Noting these adverse effects in animals illustrates why human studies are typically pursued after animal safety has been verified. Because its safety profile is unknown, it is difficult to explain the risks of ibogaine to patients, although some studies have shown that the risk of death is higher without treatment.[14]
Poor quality research
Many centers currently providing ibogaine worldwide do not have sufficient qualified medical staff to conduct high-quality scientific research. As a result, much of the research into the effectiveness of ibogaine treatment has been based on retrospective self-report studies, which are often deemed unreliable, especially in health-related fields.[1]
Ibogaine and substance use disorder treatment
The most common medical use of ibogaine is to treat SUD, particularly opioid use. Stopping opioids is associated with a wide range of withdrawal symptoms, ranging from restlessness and sneezing to depression and seizures.[15] Ibogaine may reduce these effects for a period of days, weeks, or even longer.[5]
When being used to treat SUD, ibogaine is typically given as a single dose. Some patients will require subsequent doses, but it is not necessary to take ibogaine regularly or on an ongoing basis.[14]
Ibogaine treatment centers locations
Ibogaine is illegal for use in the US, but it can be used in other parts of the world. It has been available by prescription to treat SUD in New Zealand since 2009.[14] Ibogaine treatment centres can also be found across Mexico and South America.[16][17]
Are ibogaine treatment centers reliable?
Because different countries have different regulations around ibogaine use, there is significant variability in quality and safety of clinics. Those in New Zealand are closely regulated, while others in South America may have only limited connections to medical personnel and expertise.[14][17]
Ibogaine and brain injury symptom management
Ibogaine has also shown itself to have positive effects, both on the levels of associated disability and the related symptoms experienced after traumatic brain injuries (TBI).[9] This has most commonly been studied in veterans who fought with special forces and had TBIs from blast damage. Patients reported improvements in mood symptoms, such as PTSD or depression, and improvements in cognitive function, such as memory.[9]
There is a possibility that ibogaine may be able to encourage the repair of brain tissue following brain injury, though research into this area is in the early stages.[6]
The negative side of ibogaine treatment
Ibogaine treatment may be effective for some individuals, but it does carry risks, especially for those with pre-existing medical conditions.
Ibogaine can affect the heart, potentially causing bradycardia (lowered heart rate) or dysrhythmias (erratic heart rhythms).[9] Well-equipped clinics will provide an ECG before ibogaine use to ensure that it will be safe, plus a qualified physician will be present throughout to mitigate these risks.
Ibogaine may also cause pulmonary embolism (blood clots in the lungs), which can be life-threatening. This may be partially due to the length of time patients spend stationary, especially during the first stage of an ibogaine experience.[5]
Relatively little is known about how ibogaine might affect serious mental health disorders, including bipolar disorder, schizophrenia, or borderline personality disorder. These disorders often overlap with SUD, meaning that patients and clinicians will need to work together to decide whether the risk of harm from SUD outweighs any potential worsening of other mental health conditions.
Finally, an ibogaine experience can be highly distressing, with some patients experiencing visions or hallucinations of extreme violence and suffering.[5] Those with a history of trauma or PTSD should be alert to these risks and consider ways to manage them.
Ibogaine is currently illegal in the US and is not regulated by the Food and Drug Administration (FDA). This platform and its staff do not recommend or encourage the use of illegal substances; rather, this information is provided to be a factual resource for those who are seeking knowledge and understanding of mental health topics.
Conclusion
Ibogaine offers the potential for an effective new treatment for SUD and possibly for other mental health conditions. Much remains unknown, however, and the risks associated with ibogaine use should not be underestimated.
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