Hallucinogen Persisting Perception Disorder After Ibogaine Treatment for Opioid Dependence

Ibogaine is a naturally occurring alkaloid in the root bark of the African shrub Tabernanthe iboga. Studies show positive effects of a single dose of ibogaine on withdrawal symptoms, drug self-administration, and craving in animal models of substance use disorders and human case studies. Ibogaine is increasingly used as a remedy for substance use disorders in the lay-scene. However, ibogaine (either ingested as the root bark or in more purified form) has well-known dose-dependent adverse effects. These effects include among others ataxia and potentially lethal cardiac dysrhythmias. Here we report a case of hallucinogen persisting perception disorder (HPPD) that occurred after ibogaine treatment in a patient with opioid use disorder who participated in a phase II safety trial on ibogaine. Potential treatment options and existing literature on HPPD are discussed.