IbogaineLyndsey HeiseSouthern Illinois UniversitySchool of Medicine
Derived from the Iboga plant bark root Found in Gabon Used by traditional healers to induce “near-death experience”
Ibogaine use in psychotherapy Leo Zeff •American psychologist •In 1960’s, used Ibogaine for “retrospective experience” during therapy
Anti-addictive effects of Ibogaine discovered accidently Howard Lotsof (1943-2010) •Heroin addict •Researcher •Patent holder
An indole alkoloid Structure very similar to serotonin Appears to have a novel mechanism of action NMDA (glutamate) antagonist Agonist at mu- and kappa- opioid receptors Serotonin and dopamine uptake inhibitor Potent non-competitive antagonist at nicotinic receptors
Theories behind Ibogaine He and colleagues injected alcoholic rat VTAs directly w/ Ibogaine and observed ↓ alcohol seeking behavior Consistent cocaine or morphine exposure- ↓ GDNF GDNF into VTA leads to ↓ alcohol seeking behavior Ibogaine ↑ expression of GDNF mRNA Anti-GDNF antibodies ↓ effects of Ibogaine He, D., McGough, N., Raindranathan, A., Jeanblanc, J., Logrip, M., Phamluong, K., ….. Ron, Dorit. (2005). Glial cell line-derived neurotrophic factor mediates the desirable actions of the anti-addiction drug Ibogaine against alcohol consumption. Journal of Neuroscience, 25, 619–628.
After Ingestion Acute phase (4-8 hours) Hallucinations (“awakened dream”; EEG shows REM-like patterns) Ataxia Nausea/vomiting Tremors Reflective phase (8-20 hours) Calmer, acute symptoms largely cease Often reflect on visions presented in previous phase
Safety Concerns Indirectly linked to several sudden deaths Causes arrhythmias Long QT Syndrome Shown to damage Purkinje cells in rat cerebellums Bradycardia Hypotension
Legal Status Unscheduled EXCEPT for US (determined schedule 1 in 1970; only 2 arrests since) Belgium Denmark France Sweden Switzerland Australia
Ibogaine Treatment Sites US (shhh!!) Mexico Canada UK Thailand New Zealand Brazil Venezuela Holland And many more….
So, how effective is Ibogaine? Difficultto determine since so little research In 1993, the FDA approved a human trial but the doses were subclinical and it was suspended shortly thereafter.
Alper/Lotsof Trial (1962-1993) 41 patients; several treated more than once in a short period for a total of 52 treatments 38 of 41 patients had opioid dependency 10 of 41 had other drug or alcohol dependency 25 of 41 patients had complete resolution of opioid withdrawal symptoms in 24 hours 15 (29%) – drug cessation <2 months 15 (29%) – drug cessation 2-6 months 7 (13%) – drug cessation 6 months-1 year 10 (19%) – drug cessation >1 year 5 (10%) – could not be trackedAlper, K., Lotsof, H., Frenken, G., Luciano, D., & Bastiaans, J. (1999). Treatment of acute opioid withdrawal with Ibogaine. The American Journal on Addictions, 8, 234-242.
More Studies Anti-addictive effects have been shown in lab animals with drugs, alcohol, nicotine, and even food. Anti-infective properties shown with various viruses, yeast, and even parasites.
Why so little clinical research? Many think it will be poorly tolerated because of its fairly severe psychedelic effects. $$$! Little to gain- since it come from natural source, it cannot be patented. Difficult to do double blind study. Dangerous
Documentaries Facing the Habit (2007) Directed by Magnolia Martin I’m Dangerous with Love (2009) Directed by Michel Nigroponte Ibogaine: Rite of Passage (2004) Directed by Ben Deloenen Detox or Die (2004) Directed by David Graham Scott
References Hevesi, D. (2010, February 17). Howard Lotsof Dies at 66; Saw Drug Cure in a Plant. The New York Times. Retrieved from http://www.nytimes.com/2010/02/17/us/17lotsof.html. Depoortere, H. (1987). Neocortical rhythmic slow activity during wakefulness and paradoxical sleep in rats. Neuropsychobiology, 18, 160-168. Alper, K., Lotsof, H., & Kaplan, C. (2008). The Ibogaine medical subculture. Journal of Ethnopharmacology, 115, 9-24. Alper, K. (2001). Ibogaine: a review. The Alkaloids, 56, 1- 38.