Ibogaine May Help With Addiction, But What Else?

Ibogaine: Beyond addiction treatment, explore its potential for treating depression and PTSD.

Overview: Ibogaine, a psychedelic alkaloid from the iboga plant, is gaining attention for its potential in treating addiction, particularly to opioids. Expanding research suggests its efficacy in depression and PTSD treatment. Ibogaine's mechanisms involve serotonin modulation, NMDA receptor blocking, and BDNF up-regulation. Studies show reductions in depression scores and PTSD symptoms. Future research may explore applications in anxiety, OCD, neurodegenerative diseases, and eating disorders. Despite its promise, ibogaine use poses serious health risks, emphasizing the necessity for medical supervision. Responsible use and ongoing research are vital for unlocking the full spectrum of ibogaine's therapeutic potential.

What is Ibogaine?

Ibogaine, a psychedelic alkaloid derived from the Tabernanthe iboga (iboga) plant native to Central West Africa, has garnered significant attention for its potential to address addiction. Alkaloids are naturally occurring organic compounds found in various plants, fungi, and animals, and they can have a wide range of biological activities.

Found in the roots of the iboga plant, Ibogaine induces powerful psychedelic and “oneiric” (dreamlike) experiences lasting approximately 18-36 hours. Historically, this plant has played a crucial role in rituals and initiatory rites, notably within the Bwiti religion, where it holds a sacred status.

In 1962, Howard Lotsof, grappling with heroin addiction, stumbled upon Ibogaine's unexpected anti-addictive properties. This discovery prompted scientific exploration into its therapeutic potential for substance abuse disorders. Beyond addiction, researchers are now delving into other conditions that Ibogaine may help treat.

However, it is important to acknowledge that Ibogaine use comes with substantial risks, particularly concerning serious heart complications when used without proper medical supervision. As we explore the potential benefits of Ibogaine, it’s crucial to emphasize the importance of cautious, supervised use, a sentiment strongly advocated by many researchers in the field.

What Else Can Ibogaine Treat? 

Animal studies and some clinical trials have shown promising results regarding ibogaine's potential in treating addiction, particularly to substances like opioids (e.g. heroin, fentanyl). Recently, it was announced that the US State of Kentucky is putting $42 million into psychedelic research, specifically ibogaine for opioid addiction.

Beyond its impact on addiction, some research indicates that ibogaine may also hold therapeutic promise for other mental health conditions, notably depression and post-traumatic stress disorder (PTSD).

While these findings are preliminary and further investigation is warranted, the multifaceted effects of ibogaine are prompting researchers to explore its potential applications beyond addiction treatment. 

Ibogaine for Depression

Interestingly, ibogaine was once marketed in France as an anti-depressant under the trade name Lambarene. Lambarene was prescribed widely in France from 1939 to 1966 before its sale was ultimately prohibited. It seems that ibogaine’s anti-depressant effects may have been known about for quite some time, at least among the French.

Studies investigating ibogaine treatment have reported associations with notable reductions in depression scores on commonly used depression scales. For example, research conducted by Dr. Deborah Mash and colleagues in 2000 and 2001 at the professor’s Healing Visions Institute located on the island of St. Kitts, reported significant and lasting reductions in depression scores after just a single dose administration of ibogaine. 

In a follow-up study, clinical outcomes were examined based on an open-label case series involving 191 human volunteers undergoing inpatient treatment for opioid or cocaine detoxification with medical supervision. Dr. Mash and her colleagues discovered correlations between ibogaine use and enhanced mood, along with noteworthy reductions in depression severity measured across three distinct depression scales.

Additionally, studies investigating the efficacy of ibogaine in opioid-dependent participants have shown sustained reductions in depression severity at 3, 6, and even 12-month follow-ups.

One study observed up-regulation of BDNF to be responsible for anti-depressant-like effects in ibogaine-injected rats. Interestingly, these effects were not reproduced by the widely prescribed anti-depressant drug fluoxetine (Prozac).

How Might Ibogaine Treat Depression?

There are two primary mechanisms that seem most likely to underlie ibogaine's potential antidepressant effects.

First, its strong affinity to the serotonin transporter enhances serotonin concentrations in the brain, a neurotransmitter linked to feelings of well-being and happiness.

Second, ibogaine's blocking of NMDA receptors, which is likely responsible for its dissociative effects, coupled with its ability to up-regulate Brain-Derived Neurotrophic Factor (BDNF), provides an additional plausible explanation. BDNF is a protein crucial for the growth, development, and maintenance of neurons in the brain. It plays a pivotal role in supporting the survival of existing neurons and encouraging the growth and differentiation of new ones.

In the context of improvements in depression, BDNF is believed to contribute by promoting synaptic plasticity — the ability of neurons to form new connections and adapt to changing circumstances. An increase in BDNF levels is associated with enhanced neuronal resilience, improved mood, and a potential defense against conditions like depression. 

Notably, the FDA-approved antidepressant ketamine also works by blocking NMDA receptors and also up-regulates BDNF.

Psilocybin, the active ingredient in magic mushrooms, is thought by some to alleviate depression by reducing hyperactivity in the default mode network (DMN), a brain network associated with negative thinking patterns. Other psychedelics, including ibogaine, have also shown potential in altering brain connectivity, and possibly promoting fresh perspectives and reducing depressive symptoms by doing so. 

A forthcoming collaboration between the Center for Psychedelic Research at Imperial College, London, and DemRx aims to explore whether DMN disruption contributes to ibogaine's lasting antidepressant effects through fMRI studies on healthy participants.

Additionally, the psychedelic, dreamlike experience induced by ibogaine is thought by many to play a crucial role in its therapeutic effects. The profound experience can enable individuals to reevaluate their lives, relationships, and perspectives, often leading to insights associated with improved mood and personal growth.

Users frequently regard the ibogaine experience as personally meaningful and transformative, often attributing it to their enhanced mood.

Ibogaine for Post Traumatic Stress Disorder (PTSD)

The potential of ibogaine to treat trauma-related psychological and cognitive impairment was recently investigated in a cohort of US Special Operations Forces (SOF) Veterans. Although SOF personnel experience symptoms of PTSD at rates similar to conventional forces veterans, they are exposed to substantially more combat scenarios and may be less likely to seek out professional treatment.

A single oral dose (10mg/kg) of ibogaine, administered in a group setting, was associated with scientifically significant reductions in  PTSD symptoms. 

96% of participants reported that the treatment program employed was considerably more effective than any conventional treatments they had tried in the past, with their symptoms no longer meeting the criteria for a diagnosis of PTSD after ibogaine treatment. 

How Might Ibogaine Treat PTSD?

Interestingly, 84% of participants in this study reported their experience to be one of the top five most personally meaningful experiences of their entire lives, rates similar to that seen in psilocybin research. The majority of participants reported that the treatment was spiritually significant and psychologically insightful, leading to desirable changes in the following markers of health: 

  • Sense of personal well-being
  • Mood 
  • Attitudes about oneself
  • Life satisfaction
  • Social relationships

These effects of the ibogaine experience likely play an important role in the drug’s ability to improve symptoms of PTSD. Furthermore, it’s believed that ibogaine treatment may allow patients to safely recall and reprocess trauma memories, inducing visionary experiences that encourage personal reflection into the causes of distress. 

The results of this study may be especially significant considering the considerable number of veterans suffering from PTSD and other mental health issues, not to mention the disproportionate rates of suicide among veterans. In 2019, the suicide rate among US veterans was over 50% higher than that of the general population.

Considering the high number of veterans that either drop out of conventional treatment programs or simply don't respond to them, as well as the poor efficacy of treatment offered by Veterans Affairs, further research on ibogaine therapy is needed. 

The Multidisciplinary Association for Psychedelic Studies (MAPS) recently published the results of their phase 3 clinical trials investigating the potential of MDMA-assisted therapy to treat severe PTSD. They garnered highly impressive results, with most participants in the studies no longer meeting diagnostic criteria for PTSD following treatment. .

Ibogaine, like MDMA, increases concentrations of both serotonin and dopamine in the brain, and has some similar subjective effects as MDMA. So, it certainly seems reasonable to suggest that ibogaine, in combination with supportive therapy, may also have efficacy as a treatment for PTSD and other trauma-related conditions.

The Future of Ibogaine Research

For now, ibogaine research is largely focused on its potential to treat addiction, as it arguably should be, considering the present opioid epidemic. The more scientific support ibogaine therapy receives as a treatment for addiction, the more we may learn about its potential to remedy other mental health conditions such as depression and PTSD, also. 

Ibogaine’s wide-ranging behavior in the brain, in conjunction with its ability to reliably produce deeply meaningful personal and spiritual experiences, may broaden the scope of its potential therapeutic uses. Studies reporting persistent positive changes in psychological, behavioral, and social functioning suggest exciting therapeutic promise. 

Should ibogaine therapy prove to re-organize complex brain networks in fMRI studies, we could soon see trials investigating its ability to treat some other medical conditions associated with DMN overactivity, such as anxiety and obsessive-compulsive disorder (OCD). 

In addition, ibogaine’s ability to significantly upregulate the release of BDNF may have important implications for the treatment of neuropathic pain and currently incurable neurodegenerative diseases like Parkinson's and Alzheimer's disease. 

Another possible application of ibogaine therapy is in the treatment of eating disorders such as anorexia nervosa and bulimia nervosa.

Previous research investigating the effects of the Amazonian plant-based brew ayahuasca on eating disorders reported reductions in eating disorder pathology, enhanced processing of painful memories, improved emotional regulation, and increased self-acceptance, as well as improvements in depression symptoms and psychological well-being. Improved mental well-being, which is commonly associated with greater outcomes in people with eating disorders, has also been reported in ibogaine research. 

In his comprehensive book ‘Iboga: The Root Of All Healing’, author Daniel Brett writes of having become frustrated at the lack of attention being focused on ibogaine’s ability to improve the lives of healthy people. After all, the iboga plant had been used for millennia by people in Central West Africa to enrich their lives with added meaning.

According to Brett, ibogaine offers everything that classic psychedelics like LSD and psilocybin do, including the ability to induce transcendent experiences, promote more awareness of nature, and lessen one’s fear of death. If this proves to be the case, we could see ibogaine being used for the betterment of well people in the future. 

A Final Cautionary Note

Importantly, while ibogaine has shown promising potential in treating addiction and shows encouraging signs for addressing other conditions, it is crucial to acknowledge the associated physical health risks. Notably, the compound's impact on cardiac function has been implicated in serious complications, emphasizing the need for cautious consideration.

Therefore, it is strongly advised that individuals contemplating ibogaine treatment do so under the guidance of qualified medical professionals. Responsible use, comprehensive medical assessment, and appropriate supervision help to mitigate potential risks and ensure the safety of those seeking the potential therapeutic benefits of ibogaine.

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Dr. Ana Holmes, Physican, Philadelphia, US

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