Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: A
Systematic Review of the Current Literature

Mosca, Alessio; Chiappini, Stefania; Miuli, Andrea; Mancusi, Gianluca; Santovito, Maria Chiara; Carlo, Francesco Di; Pettorruso, Mauro; Corkery, John; Canessa, Carlos; Martinotti, Giovanni; Giannantonio, Massimo Di

doi:10.2174/1570159x21666221017085612

Cited by 8 publications

(4 citation statements)

References 91 publications

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“…This review will summarize the available data on the use of serotonergic psychedelics for the treatment of chronic pain and OUD. This review complements prior reviews on psychedelics [16][17][18][19][20] by presenting a synthesis of the mechanisms for how this class of compounds could be useful to treat OUD and chronic pain independently, as well as when these conditions co-occur. In addition, we propose mechanistic and methodological insights for future research needs, including trial design considerations in this area.…”

Section: Introductionmentioning

confidence: 92%

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From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

Weleff,

Nunes,

Costa

et al. 2023

Preprint

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The rise of psychedelics in contemporary medicine has sparked interest in their potential therapeutic applications. While traditionally associated with countercultural movements and recreational use, recent research has shed light on the potential benefits of psychedelics in various mental health conditions. In this review, we explore the emerging role of psychedelics in the management of chronic pain and opioid use disorder (OUD), two critical areas in need of innovative treatment options. Pain control remains a significant clinical challenge, particularly for individuals with OUD and those who receive long-term opioid therapy (LTOT) who develop marked tolerance to opioid-induced analgesia. Despite the magnitude of this problem, there is a scarcity of controlled studies investigating pain management alternatives for these populations. Drawing from preclinical and human evidence, we highlight the potential of psychedelics to act on shared neurobiological substrates of chronic pain and opioid use disorder, potentially reversing pain- and opioid-induced neuroadaptations, such as central sensitization. We elaborate on the multifaceted dimensions of the pain experience (sensory, affective, and cognitive) and their intersections that overlap with opioid-related phenomena (opioid craving and withdrawal), hypothesizing how these processes can be modulated by psychedelics. After summarizing the available clinical research, we propose mechanistic insights and methodological considerations for the design of future translational studies and clinical trials, building on a shared clinical and neurobiological understanding of chronic pain and OUD. Our intention is to provide timely perspectives that accelerate the development and exploration of novel therapeutics for chronic pain and OUD amidst the escalating opioid crisis.

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Section: Introductionmentioning

confidence: 92%

“…There is a large preclinical foundation exploring ibogaine and noribogaine in addiction paradigms and for opioid withdrawal. 103…”

Section: Ibogaine and Noribogainementioning

confidence: 99%

From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

Weleff,

Nunes,

Costa

et al. 2023

Preprint

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“…Examples of such sacramental use include religious consumption of ayahuasca ( 12 , 23 ) and the religious sacrament performed by the Native American Church (NAC) in which peyote is consumed as part of an all-night communal prayer and song ceremony for the purpose of healing physical or spiritual imbalances that an individual or the community may be experiencing ( 15 , 24 – 26 ). Similarly, ibogaine is often used in ceremonial contexts and in clinical research for addiction treatment ( 27 , 28 ). Use in these contexts has been associated with remission of psychopathologies such as depression, anxiety, and SUD ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

The association between naturalistic use of psychedelics and co-occurring substance use disorders

2023

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ObjectiveClassic psychedelics (LSD, psilocybin, and peyote/mescaline) have been used to support addiction treatment in a variety of contexts ranging from ceremonial use to clinical trials. The aim of this study was to test the hypothesis that past naturalistic use of classic psychedelics would be associated with decreased prevalence of substance use disorder, when controlling for known confounders.MethodsThis cross-sectional study used 2017 NSDUH survey data to evaluate the association between past use of the classic psychedelics LSD, psilocybin and peyote/mescaline and past year substance dependence or abuse. We calculated adjusted odds ratios by multivariate logistic regression, controlling for a range of sociodemographic variables, use of non-psychedelic illicit drugs and mental health related variables.ResultsA total of 56,276 participants were included in this study. Past use of LSD and psilocybin were associated with increased odds of substance dependence or abuse compared to those who had never used psychedelics before, and this was more likely for those who had used LSD more recently. However, prior use of peyote or mescaline was associated with lower odds of past year substance dependence or abuse compared to people who had never used psychedelics before (aOR = 0.68, p < 0.001). Past use of classic psychedelics was not associated with nicotine dependence.ConclusionPast use of peyote/mescaline was associated with decreased odds of substance use disorder compared to people who had never used psychedelics before, while past use of LSD or psilocybin was not. It remains unclear whether this difference is due to pharmacological differences between these compounds or simply due to the context in which peyote/mescaline are traditionally taken. Future research should investigate why naturalistic use of different psychedelics is associated with different substance use disorder effects.

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“…These innovations are only the beginning of psychopharmacology, and as research progresses, even more, exciting and effective treatments for psychiatric disorders will likely be discovered. In the present mini thematic issue, Mosca et al [ 3 ] conducted a systematic review that evaluated the use of ibogaine/noribogaine in the treatment of substance use disorders, and the results demonstrated some efficacy of ibogaine in the treatment of substance use disorders, but the cardiotoxicity and mortality of such drug were worrying and deserving further tolerability studies. Besides, Di Nicola et al evaluated the effect of extended-release trazodone on clinical and functional features in 100 patients with Major Depressive Disorder comorbid with Alcohol Use Disorder.…”

mentioning

confidence: 99%

Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: A Systematic Review of the Current Literature

Cited by 8 publications

References 91 publications

From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

From Taboo to Treatment: The Emergence of Psychedelics in the Management of Pain and Opioid Use Disorder

The association between naturalistic use of psychedelics and co-occurring substance use disorders

Rethinking ‘Innovation’ in Psychiatry with Older and Newer Treatments: From Bench to Benchside

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