A systematic literature review of clinical trials and therapeutic applications of ibogaine

This systematic review (2021) explores clinical trials involving ibogaine and noribogaine. Across the number of trials included, a total of 705 individuals were treated with either ibogaine or noribogaine. It was found that such interventions may be useful for treating substance use disorders, alleviating withdrawal symptoms and cravings. Importantly, a number of severe side effects, including death, that have been recorded in the trials are discussed.

Abstract

Background: Iboga and its primary alkaloids, ibogaine and noribogaine, have been of interest to researchers and practitioners, mainly due to their putative efficacy in treating substance use disorders (SUDs). For many SUDs, still, no effective pharmacotherapies exist. Distinct psychoactive and somatic effects of the iboga alkaloids set them apart from classic hallucinogens like LSD, mescaline, and psilocybin.

Aims: The study team performed this systematic review focusing on clinical data and therapeutic interventions involving ibogaine and noribogaine.

Methods: The team conducted a search for all publications up to December 7, 2020, using PubMed and Embase following PRISMA guidelines.

Results: In total, we identified 743 records. In this review, we consider 24 studies, which included 705 individuals receiving ibogaine or noribogaine. This review includes two randomized, double-blind, controlled clinical trials, one double-blind controlled clinical trial, 17 open-label studies or case series (including observational or retrospective studies), three case reports, and one retrospective survey. The published data suggest that ibogaine is an effective therapeutic intervention within the context of SUDs, reducing withdrawal symptoms and cravings. Data also point toward a beneficial impact on depressive and trauma-related psychological symptoms. However, studies have reported severe medical complications and deaths, which seem to be associated with neuro- and cardiotoxic effects of ibogaine. Two of these fatalities were described in the 24 studies included in this review.

Conclusion: Treatment of SUDs and persisting comorbidities requires innovative treatment approaches. Rapid-onset therapies such as the application of ibogaine may offer novel treatment opportunities for specific individuals. Rigorous study designs within medical settings are necessary to warrant safe application, monitoring, and, possibly, medical intervention.

Authors: Patrick Köck, Katharina Frölich, Marc Waller, Undine Lang & Kenneth M. Dürsteler

Authors Highlights

  • This review provides an overview of the therapeutic uses of ibogaine and noribogaine
  • Data suggests effectiveness in the treatment of substance use disorders
  • Data suggests potential benefits for depressive and post-traumatic symptoms
  • Fatalities have been reported among the screened literature
  • Due to potentially lethal consequences, rigorous medical settings may increase safety
  • Global consensus regarding legal status of ibogaine and noribogaine is absent
  • Eligible individuals may benefit from rapid-onset therapies like ibogaine

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Find this paper

A systematic literature review of clinical trials and therapeutic applications of ibogaine

https://doi.org/10.1016/j.jsat.2021.108717

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Published in
Journal of Substance Abuse Treatment
December 30, 2021
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Study details

Compounds studied
Ibogaine

Topics studied
Addiction

Study characteristics
Literature Review

Participants
705 Humans

Institutes

Institutes associated with this publication

University of Basel
The University of Basel Department of Biomedicine hosts the Liechti Lab research group, headed by Matthias Liechti.

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