Substance Use Disorders (SUD)Ibogaine

Ibogaine in the treatment of substance dependence

This review article (2013) reviews the progress and obstacles of ibogaine in the treatment of substance dependence (e.g. opioids, alcohol) from 'underground' to controlled clinical trials.

Authors

  • Brown, T. K.

Published

Current Drug Abuse Reviews
meta Study

Abstract

Ibogaine is a psychoactive alkaloid derived from Tabernanthe iboga, a plant used in initiatory rituals in West Central Africa. Largely because of ibogaine’s status as a Schedule I substance in the U.S., the development of ibogaine’s use in the treatment of drug addiction took place outside conventional clinical and medical settings. This article reviews the history of ibogaine’s use in the treatment of drug addiction, and discusses progress made towards, and obstacles blocking, the establishment of controlled clinical trials of ibogaine’s efficacy. Preclinical research has generally supported anecdotal claims that ibogaine attenuates withdrawal symptoms and reduces drug cravings. Concerns about ibogaine’s safety, as well as a dearth of solid data from human studies, have hampered progress in its development as an approved medication. This article outlines major findings from preclinical studies, discusses concerns about ibogaine’s safety, and details previous and ongoing research on ibogaine’s use as an anti-addictive treatment for humans.

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Research Summary of 'Ibogaine in the treatment of substance dependence'

Introduction

Brown and colleagues place ibogaine in historical and cultural context as a naturally occurring indole alkaloid derived from Tabernanthe iboga, long used in West Central African ritual and later explored in Western psychiatric and addiction contexts. Early anecdotal reports and a body of preclinical work raised the possibility that ibogaine can attenuate opiate withdrawal and reduce drug self-administration, but regulatory scheduling, safety concerns and a predominance of informal, non‑controlled treatments have limited conventional clinical development. The paper reviews ibogaine's ethnographic roots, the emergence of an informal “ibogaine medical subculture,” and the stalled attempts to conduct controlled trials in the United States and Europe. This review sets out to summarise the available preclinical pharmacology, human case reports and small clinical studies, and the safety record of ibogaine, with particular attention to evidence bearing on its efficacy as an ‘‘addiction interrupter’’ and the obstacles to its development as an approved medication. The authors also describe ongoing observational studies intended to address gaps in long‑term outcome data and identify directions for future research and risk‑management practices.

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Study Details

References (8)

Papers cited by this study that are also in Blossom

The ibogaine medical subculture

Alper, K. R., Lotsof, H. S., Kaplan, C. D. · Journal of Ethnopharmacology (2007)

Inhibitory effects of ibogaine on cocaine self-administration in rats

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

Treatment of acute opioid withdrawal with ibogaine

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

Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials

Krebs, T. S., Johansen, P. Ø. · Journal of Psychopharmacology (2012)

Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness

Maclean, K. A., Johnson, M. W., Griffiths, R. R. · Journal of Psychopharmacology (2011)

Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance

Griffiths, R. R., Richards, W. A., Mccann, U. et al. · Journal of Psychopharmacology (2006)

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Psychedelic therapy in the treatment of addiction: the past, present and future

Zafar, R., Siegel, M., Harding, R. et al. · Frontiers in Psychiatry (2023)

Ibogaine Blocks Cue- and Drug-Induced Reinstatement of Conditioned Place Preference to Ethanol in Male Mice

Henriques, G. M., Anjos-Santos, A., Rodrigues, I. R. et al. · Frontiers in Pharmacology (2021)

The adverse events of ibogaine in humans: an updated systematic review of the literature (2015-2020)

Ona, G., Rocha, J. M., Bouso, J. C. et al. · Psychopharmacology (2021)

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Cardiac arrest after ibogaine intoxication

Steinberg, C., Deyell, M. W. · Journal of Arrhythmia (2018)

10 cited
Changes in Withdrawal and Craving Scores in Participants Undergoing Opioid Detoxification Utilizing Ibogaine

Malcolm, B., Polanco, M., Barsuglia, J. P. · Journal of Psychoactive Drugs (2018)

49 cited
Subjective effectiveness of ibogaine treatment for problematic opioid consumption: Short-and long-term outcomes and current psychological functioning

Davis, A. K., Barsuglia, J. P., Windham-Herman, A. M. et al. · Journal of Psychedelic Studies (2017)

47 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)

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

Wilkins, C., Dos Santos, R. G., Solá, J. et al. · Journal of Psychedelic Studies (2017)

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The iboga alkaloids

Lavaud, C., Massiot, G. · Progress in the Chemistry of Organic Natural Products (2017)

Tripping up addiction: the use of psychedelic drugs in the treatment of problematic drug and alcohol use

Morgan, C. J. A., McAndrew, A., Stevens, T. et al. · Current Opinion in Behavioral Sciences (2017)

Treating drug dependence with the aid of ibogaine: a qualitative study

Schenberg, E. E., de Castro Comis, M. A., Alexandre, J. F. M. et al. · Journal of Psychedelic Studies (2016)

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

Dos Santos, R. G., Bouso, J. C., Hallak, J. E. · Journal of Psychedelic Studies (2016)

Clinical Applications of Hallucinogens: A Review

Garcia-Romeu, A., Kersgaard, B., Addy, P. H. · Experimental and Clinical Psychopharmacology (2016)

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A Public-Health-Based Vision for the Management and Regulation of Psychedelics

Haden, M., Emerson, B., Tupper, K. W. · Journal of Psychoactive Drugs (2016)

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Mania following use of ibogaine: A case series

Marta, C. J., Ryan, W. C., Kopelowicz, A. et al. · The American Journal on Addictions (2015)

The Anti-Addiction Drug Ibogaine and the Heart: A Delicate Relation

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

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)

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