Ibogaine

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Final presentation for the Scaife Advanced Student Medical Seminar by Lyndsey Heise

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Ibogaine

  1. 1. IbogaineLyndsey HeiseSouthern Illinois UniversitySchool of Medicine
  2. 2.  Derived from the Iboga plant bark root Found in Gabon Used by traditional healers to induce “near-death experience”
  3. 3.  Ibogaine use in psychotherapy Leo Zeff •American psychologist •In 1960’s, used Ibogaine for “retrospective experience” during therapy
  4. 4.  Anti-addictive effects of Ibogaine discovered accidently Howard Lotsof (1943-2010) •Heroin addict •Researcher •Patent holder
  5. 5.  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
  6. 6. 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.
  7. 7. 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
  8. 8. Safety Concerns Indirectly linked to several sudden deaths Causes arrhythmias Long QT Syndrome Shown to damage Purkinje cells in rat cerebellums Bradycardia Hypotension
  9. 9. Legal Status Unscheduled EXCEPT for  US (determined schedule 1 in 1970; only 2 arrests since)  Belgium  Denmark  France  Sweden  Switzerland  Australia
  10. 10. Ibogaine Treatment Sites US (shhh!!) Mexico Canada UK Thailand New Zealand Brazil Venezuela Holland And many more….
  11. 11. 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.
  12. 12. 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.
  13. 13. 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.
  14. 14. 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
  15. 15. 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
  16. 16. 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.

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