Chapter 8 Ibogaine in the treatment of heroin withdrawal

Mash, Deborah C.; Kovera, Craig A.; Pablo, John; Tyndale, Rachel F.; Ervin, Frank R.; Kamlet, J D; Hearn, William Lee

doi:10.1016/s0099-9598(01)56012-5

Cited by 81 publications

(131 citation statements)

References 17 publications

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“…Ibogaine HCl has been typically administered as a single oral dose in the range of 10-25 mg/kg of body weight. Patients physically dependent on opioids have described significant attenuation of withdrawal symptoms within several hours of ingesting ibogaine, with subsequently sustained resolution of the opioid withdrawal syndrome (Alper et al, 1999;Mash et al, 2001). The advantages attributed to ibogaine are higher tolerability relative to other standard treatments for acute opioid withdrawal, and an interval of diminished drug craving that may last days to months following a treatment.…”

Section: Clinical Usementioning

confidence: 99%

“…Ibogaine is the most studied of the iboga alkaloids (Bartlett et al, 1958), a group of naturally occurring and synthetic indole alkaloids, some of which reportedly reduce opioid withdrawal symptoms and drug self-administration in humans (Luciano, 1998;Alper et al, 1999;Mash et al, 2001) or preclinical models (Glick et al, 2001). Presently in the setting of homes, hotel rooms and private clinics in North America and Europe, individuals in increasing numbers are taking ibogaine in what has been termed "a vast uncontrolled experiment" (Vastag, 2005).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The ibogaine medical subculture

Alper¹,

Lotsof²,

Kaplan³

2008

Journal of Ethnopharmacology

142

150

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Section: Clinical Usementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The ibogaine medical subculture

Alper¹,

Lotsof²,

Kaplan³

2008

Journal of Ethnopharmacology

142

150

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“…The halflife of noribogaine is much longer than ibogaine, resulting in relevant plasma-concentrations of noribogaine long after clearance of ibogaine [9,10]. They also described a post-mortem analysis of a patient following ingestion of ibogaine, which revealed high tissue concentrations of ibogaine and noribogaine in liver, spleen, lung and brain, implicating high lipophilicity of both ibogaine and its metabolite [11].…”

Section: Introductionmentioning

confidence: 99%

Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine

Henstra

Wong

Chahbouni

et al. 2017

Clinical Toxicology

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Background: Ibogaine is an agent that has been evaluated as an unapproved anti-addictive agent for the management of drug dependence. Sudden cardiac death has been described to occur secondary to its use. We describe the clinical effects and toxicokinetics of ibogaine and noribogaine in a single patient. For this purpose, we developed a LC-MS/MS-method to measure ibogaine and noribogaine plasma-concentrations. We used two compartments with first order absorption. Case details: The maximum concentration of ibogaine was 1.45 mg/L. Our patient developed markedly prolonged QTc interval of 647ms maximum, several multiple cardiac arrhythmias (i.e., atrial tachycardia and ventricular tachycardia and Torsades des Pointes). QTc-prolongation remained present until 12 days after ingestion, several days after ibogaine plasma-levels were low, implicating clinically relevant noribogaine concentrations long after ibogaine had been cleared from the plasma. The ratio k 12 /k 21 for noribogaine was 21.5 and 4.28 for ibogaine, implicating a lower distribution of noribogaine from the peripheral compartment into the central compartment compared to ibogaine. Conclusions: We demonstrated a linear relationship between the concentration of the metabolite and long duration of action, rather than with parent ibogaine. Therefore, after (prolonged) ibogaine ingestion, clinicians should beware of long-term effects due to its metabolite.

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“…Psychoactive properties of ibogaine have been known for decades [2,3]. More recently, based on experimental data from animals and anecdotal reports from addict self-help groups, it has been found that this drug has an efficacy in interrupting addiction to 'narcotics' (morphine and heroin), cocaine, amphetamine, alcohol and nicotine [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Indeed, ibogaine interacts with multiple neurotransmitter systems known to modulate drug addiction [15].…”

Section: Introductionmentioning

confidence: 99%