Pre-treatment clinical risk assessment

The manuals converge on the need for careful pre-treatment screening before ibogaine administration, with particular attention to medical risk factors that could make treatment unsafe. Across the extracts, there is repeated emphasis on cardiovascular review, laboratory or general medical evaluation, and checking for conditions that might increase adverse events, including organ dysfunction, pregnancy-related risk, and active psychiatric or neurological problems. They also align on the seriousness of ibogaine’s safety profile. The sources describe the need to recognise prior fatalities, fatal cardiac arrhythmias, and the possibility of drug interactions or concurrent substance use increasing toxicity. Cardiac risk is a clear shared focus, especially ECG review, prolonged QTc, and broader cardiovascular history. The manuals differ mainly in emphasis and level of specificity. The 2005 Iboga Therapy House protocol is the most detailed about formal clearance procedures, naming ECG, CBC, SMA-20 or liver panel, physician assessment, and case-by-case review of comorbidities. The 2003 manual places more emphasis on general intake, medication review, and avoiding concurrent drug use, while the 2021 study frames screening in terms of experimental or high-risk detoxification and highlights torsades de pointes, QTc prolongation, bradycardia, and ataxia more explicitly.