Fatal Case of a 27‐Year‐Old Male After Taking Iboga in Withdrawal Treatment: <scp>GC</scp>‐<scp>MS</scp>/<scp>MS</scp> Determination of Ibogaine and Ibogamine in Iboga Roots and Postmortem Biological Material

Mazoyer, Cédric; Carlier, Jérémy; Boucher, Alexandra; Péoc’h, Michel; Lemeur, Catherine; Gaillard, Yvan

doi:10.1111/1556-4029.12250

Cited by 23 publications

(21 citation statements)

References 22 publications

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“…Therefore, we estimated that the total alkaloid content of the bark amounts to 7.8%. This number is higher than the 5–6% indole alkaloids in the root bark reported by Delourme-Houdé (1946), Marion (1952) and Dewick (2002) but lower than the alkaloid content of powdered iboga root (7.2% ibogaine, 0.6% ibogamine) reported by Mazoyer et al (2013). Only seven alkaloids have been reported for T. iboga previously (Table 1), all of which we identified by our plant metabolomics approach.…”

Section: Resultscontrasting

confidence: 63%

Phytochemical characterization of Tabernanthe iboga root bark and its effects on dysfunctional metabolism and cognitive performance in high-fat-fed C57BL/6J mice

Bading-Taika¹,

Akinyeke²,

Magaña³

et al. 2018

Journal of Food Bioactives

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Preparations of the root bark of Tabernanthe iboga have long been used in Central and West African traditional medicine to combat fatigue, as a neuro-stimulant in rituals, and for treatment of diabetes. The principal alkaloid of T. iboga, ibogaine, has attracted attention in many countries around the world for providing relief for opioid craving in drug addicts. Using a plant metabolomics approach, we detected five phenolic compounds, including 3-O-caffeoylquinic acid, and 30 alkaloids, seven of which were previously reported from T. iboga root bark. Following a report that iboga extracts contain insulinotropic agents, we aimed to determine the potential alleviating effects of the water extract of iboga root bark on high-fat diet (HFD)-induced hyperglycemia as well as its effects on cognitive function in male C57BL/6J mice. Feeding a HFD to mice for 10 weeks produced manifestations of metabolic syndrome such as increased body weight and increased plasma levels of glucose, triacylglycerols, total cholesterol, LDL-cholesterol, insulin, leptin, and pro-inflammatory mediators (IL-6, MCP-1, ICAM-1), as compared to mice fed a low-fat diet (LFD). Supplementation of HFD with iboga extract at ibogaine doses of 0.83 (low) and 2.07 (high) mg/kg/day did not improve these HFD-induced metabolic effects except for a reduction of plasma MCP-1 in the low dose group, indicative of an anti-inflammatory effect. When the HFD mice were tested in the water maze, the high-dose iboga extract caused hippocampus-dependent impairments in spatial learning and memory, as compared to mice receiving only a HFD.

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Section: Resultscontrasting

confidence: 63%

Phytochemical characterization of Tabernanthe iboga root bark and its effects on dysfunctional metabolism and cognitive performance in high-fat-fed C57BL/6J mice

Bading-Taika¹,

Akinyeke²,

Magaña³

et al. 2018

Journal of Food Bioactives

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“…For instance, retrospective chart reviews, surveys, and case reports all provide associative evidence that ibogaine reduces the severity of opioid withdrawal in humans (Sheppard, 1994;Alper et al, 1999;Davis et al, 2017;Brown and Alper, 2018;Malcolm et al, 2018), although no empirical studies have been published to formally support these reports. However, the widespread clinical adoption of ibogaine for OUD seems unlikely (Hoelen et al, 2009;Paling et al, 2012;Asua, 2013;Jalal et al, 2013) because it has a very narrow therapeutic window and is dangerous for persons with preexisting cardiovascular problems (Alper et al, 2012) or who plan to combine it with opioids (Mazoyer et al, 2013). Ibogaine also produced significant head and body tremors in many of the studies reviewed herein.…”

Section: Medications With Multiple Mechanisms Of Actionmentioning

confidence: 94%

Non-Opioid Neurotransmitter Systems that Contribute to the Opioid Withdrawal Syndrome: A Review of Preclinical and Human Evidence

Dunn

Huhn

Bergeria

et al. 2019

J Pharmacol Exp Ther

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Opioid misuse and abuse is a major international public health issue. Opioid use disorder (OUD) is largely maintained by a desire to suppress aversive opioid withdrawal symptoms. Opioid withdrawal in patients seeking abstinence from illicit or prescribed opioids is often managed by provision of a m-opioid agonist/partial agonist in combination with concomitant medications. Concomitant medications are administered based on their ability to treat specific symptoms rather than a mechanistic understanding of the opioid withdrawal syndrome; however, their use has not been statistically associated with improved treatment outcomes. Understanding the central and/or peripheral mechanisms that underlie individual withdrawal symptom expression in humans will help promote medication development for opioid withdrawal management. To support focused examination of mechanistically supported concomitant medications, this review summarizes evidence from preclinical (N 5 68) and human (N 5 30) studies that administered drugs acting on the dopamine, serotonin, cannabinoid, orexin/hypocretin, and glutamate systems and reported outcomes related to opioid withdrawal. These studies provide evidence that each of these systems contribute to opioid withdrawal severity. The Food and Drug Administration has approved medications acting on these respective systems for other indications and research in this area could support the repurposing of these medications to enhance opioid withdrawal treatment. These data support a focused examination of mechanistically informed concomitant medications to help reduce opioid withdrawal severity and enhance the continuum of care available for persons with OUD.

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“…Post mortem examination revealed sclerosis of the coronary arteries and liver cirrhosis and steatosis as possible concomitant morbidity. [25] described the case of a 27 year old caucasian male with a 15 year history of multiple substance abuse but no underlying cardiac pathology. He received a methadone-based substitution treatment and was additionally medicated with diazepam.…”

Section: Effects On the Cardiovascular Systemmentioning

confidence: 99%

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

2015

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The plant indole alkaloid ibogaine has shown promising anti-addictive properties in animal studies. Ibogaine is also anti-addictive in humans as the drug alleviates drug craving and impedes relapse of drug use. Although not licensed as therapeutic drug and despite safety concerns, ibogaine is currently used as an anti-addiction medication in alternative medicine in dozens of clinics worldwide. In recent years, alarming reports of life-threatening complications and sudden death cases, temporally associated with the administration of ibogaine, have been accumulating. These adverse reactions were hypothesised to be associated with ibogaine’s propensity to induce cardiac arrhythmias. The aim of this review is to recapitulate the current knowledge about ibogaine’s effects on the heart and the cardiovascular system, and to assess the cardiac risks associated with the use of this drug in anti- addiction therapy. The actions of 18-methoxycoronaridine (18-MC), a less toxic ibogaine congener with anti-addictive properties, are also considered.

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Fatal Case of a 27‐Year‐Old Male After Taking Iboga in Withdrawal Treatment: GC‐MS/MS Determination of Ibogaine and Ibogamine in Iboga Roots and Postmortem Biological Material

Cited by 23 publications

References 22 publications

Phytochemical characterization of Tabernanthe iboga root bark and its effects on dysfunctional metabolism and cognitive performance in high-fat-fed C57BL/6J mice

Phytochemical characterization of Tabernanthe iboga root bark and its effects on dysfunctional metabolism and cognitive performance in high-fat-fed C57BL/6J mice

Non-Opioid Neurotransmitter Systems that Contribute to the Opioid Withdrawal Syndrome: A Review of Preclinical and Human Evidence

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

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