Depressive DisordersAnxiety DisordersOpioid Use Disorder (OUD)Tobacco/Nicotine Use Disorder (TUD)Substance Use Disorders (SUD)Medicinal Chemistry & Drug DevelopmentIbogaine

DARK Classics in Chemical Neuroscience: Ibogaine

This literature review (2018) of the history of ibogaine looks back at the early use, pharmacological studies, and subsequent clinical trials that investigate this compound for the treatment of mental health disorders.

Authors

  • Wasko, M. J.
  • Witt-Enderby, P. A.
  • Surratt, C. K.

Published

ACS Chemical Neuroscience
meta Study

Abstract

The West African iboga plant has been used for centuries by the Bwiti and Mbiri tribes to induce hallucinations during religious ceremonies. Ibogaine, the principal alkaloid responsible for iboga’s psychedelic properties, was isolated and sold as an antidepressant in France for decades before its adverse effects precipitated its removal from the market. An ibogaine resurgence in the 1960s was driven by U.S. heroin addicts who claimed that ibogaine cured their opiate addictions. Behavioral pharmacologic studies in animal models provided evidence that ibogaine could blunt self-administration of not only opiates but cocaine, amphetamines, and nicotine. Ibogaine displays moderate-to-weak affinities for a wide spectrum of receptor and transporter proteins; recent work suggests that its actions at nicotinic acetylcholine receptor subtypes may underlie its reputed antiopiate effects. At micromolar levels, ibogaine is neurotoxic and cardiotoxic and has been linked to several deaths by cardiac arrest. Structure-activity studies led to the isolation of the ibogaine analog 18-methoxycoronaridine (18-MC), an α3β4 nicotinic receptor modulator that retains ibogaine’s anticraving properties with few or no adverse effects. Clinical trials of 18-MC treatment of nicotine addiction are pending. Ibogaine analogs may also hold promise for treating anxiety and depression via the “psychedelic-assisted therapy” approach that employs hallucinogens including psilocybin and methylenedioxymethamphetamine (“ecstasy”).

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Research Summary of 'DARK Classics in Chemical Neuroscience: Ibogaine'

Introduction

Wasko and colleagues frame ibogaine as a historically and pharmacologically significant but controversial psychoactive alkaloid derived from the West African Tabernanthe iboga plant. The introduction traces iboga's traditional uses by Bwiti and Mbiri communities (low doses as stimulant; high doses for initiation rituals) and recounts the isolation of ibogaine (10-methoxyibogamine) in 1901 and its prescription in France for several decades. Interest in ibogaine as an anti‑addiction agent escalated after Howard Lotsof's anecdotal report in the 1960s that a single exposure relieved his heroin withdrawal and cravings, a narrative that stimulated preclinical and later medicinal chemistry work aimed at retaining antiaddictive effects while reducing toxicity. This review sets out to synthesise chemical, pharmacokinetic, pharmacological, toxicological, and historical data on ibogaine and its analogs, with particular attention to the development of 18‑methoxycoronaridine (18‑MC) as a putative safer antiaddiction candidate. The authors position the article as a ‘‘DARK Classic’’ profile: detailing both the therapeutic promise suggested by animal and anecdotal human data and the serious adverse effects that have limited clinical development and led to regulatory restriction.

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Study Details

References (16)

Papers cited by this study that are also in Blossom

Ibogaine treatment outcomes for opioid dependence from a twelve-month follow-up observational study

Frampton, C. M., Yazar-Klosinski, B., Nollar, G. E. · The American Journal of Drug and Alcohol Abuse (2017)

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Alper, K. R., Lotsof, H. S., Frenken, G. M. N. et al. · The American Journal on Addictions (2010)

Inhibitory effects of ibogaine on cocaine self-administration in rats

Cappendijk, S. L. T., Dzoljic, M. R. · European Journal of Pharmacology (1993)

Influence of CYP2D6 activity on the pharmacokinetics and pharmacodynamics of a single 20 mg dose of ibogaine in healthy volunteers

Glue, P., Lenagh-Glue, Z., Winter, H. et al. · Journal of Clinical Pharmacology (2015)

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Glue, P., Lockhart, M., Lam, F. et al. · Journal of Clinical Pharmacology (2014)

52 cited
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Maillet, E. L., Milon, N., Heghinian, M. D. et al. · Neuropharmacology (2015)

Effect of Iboga Alkaloids on µ-Opioid Receptor-Coupled G Protein Activation

Antonio, T., Childers, S. R., Rothman, R. B. et al. · PLOS ONE (2013)

Treating drug dependence with the aid of ibogaine: A retrospective study

Schenberg, E. E., de Castro Comis, M. A., Chaves, T. V. et al. · Journal of Psychopharmacology (2014)

Effects of low dose ibogaine on subjective mood state and psychological performance

Forsyth, B., Machado, L., Jowett, T. et al. · Journal of Ethnopharmacology (2016)

Show all 16 references
The Anti-Addiction Drug Ibogaine and the Heart: A Delicate Relation

Koenig, X., Hilber, K. · Journal of Humanistic Psychology (2015)

A phenomenological analysis of the subjective experience elicited by ibogaine in the context of a drug dependence treatment

Schenberg, E. E., de Castro Comis, M. A., Alexandre, J. F. M. et al. · Journal of Psychedelic Studies (2017)

35 cited
Treatment of opioid use disorder with ibogaine: detoxification and drug use outcomes

Brown, T. K., Alper, K. · The American Journal of Drug and Alcohol Abuse (2017)

NMDAR inhibition-independent antidepressant actions of ketamine metabolites

Zanos, P., Moaddel, P. J., Morris, P. J. et al. · Nature (2016)

Implications for psychedelic-assisted psychotherapy: functional magnetic resonance imaging study with psilocybin

Carhart-Harris, R. L., Leech, R., Williams, T. M. et al. · British Journal of Psychiatry (2018)

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Novel Class of Psychedelic Iboga Alkaloids Disrupts Opioid Use

Havel, V., Kruegel, A. C., Bechand, B. et al. · Biorxiv (2023)

The Promise of Psychedelic Science

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