Fatalities Temporally Associated with the Ingestion of Ibogaine

Abstract

Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications. All available autopsy, toxicological, and investigative reports were systematically reviewed for the consecutive series of all known fatalities outside of West Central Africa temporally related to the use of ibogaine from 1990 through 2008. Nineteen individuals (15 men, four women between 24 and 54 years old) are known to have died within 1.5-76 h of taking ibogaine. The clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity. Advanced preexisting medical comorbidities, which were mainly cardiovascular, and/or one or more commonly abused substances explained or contributed to the death in 12 of the 14 cases for which adequate postmortem data were available. Other apparent risk factors include seizures associated with withdrawal from alcohol and benzodiazepines and the uninformed use of ethnopharmacological forms of ibogaine.

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

“…The growing use of ibogaine for this purpose is at least controversial since it has been associated with sudden death due to cardiac arrest [1]. Although human studies on ibogaine are relatively scarce, recent literature has detailed the pharmacokinetic and pharmacodynamic profile of ibogaine.…”

Mechanism of hERG Channel Block by the Psychoactive Indole Alkaloid Ibogaine

“…Ibogaine is a psychoactive indole alkaloid that is frequently used as an antiaddictive agent (Alper, 2001;Maciulaitis et al 2008), even though it has never been licensed as a therapeutic drug (Vastag, 2005;Alper et al, 2012). Therefore, ibogaine has never been subjected to thorough preclinical testing.…”

“…Therefore, ibogaine has never been subjected to thorough preclinical testing. Several cases of sudden death after ibogaine intake have been reported and were most likely caused by cardiac arrhythmias (Maas and Strubelt, 2006;Hoelen et al, 2009;Alper et al, 2012). Additional evidence for ibogaine's cardiotoxicity is provided by case reports on acquired long-QT intervals and resulting cardiac tachyarrhythmias subsequent to ingestion of this alkaloid (Hoelen et al, 2009;Paling et al, 2012;Pleskovic et al, 2012).…”

Remission of Severe Opioid Use Disorder with Ibogaine: A Case Report

“…Twenty-two deaths temporally related to ibogaine use have been reported between 1991 and 2014, most of which were associated with pre-existing medical comorbidities (particularly cardiovascular disease), concurrent use of other substances, and electrolyte imbalances (i.e. hypokalemia) (Alper, Stajic & Gill 2012; Koenig & Hilber 2015). Clinical reports and studies in animal models suggest that cardiac arrhythmias, induced by ibogaine’s propensity to prolong the QT interval, might have been responsible for many of these deaths (Koenig & Hilber 2015).…”