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

1. Ibogaine
Lyndsey Heise
Southern Illinois University
School of Medicine

2.  Derived from the Iboga plant bark root
 Found in Gabon
 Used by traditional healers to induce
“near-death experience”

3.  Ibogaine use in psychotherapy
Leo Zeff
•American psychologist
•In 1960’s, used Ibogaine for “retrospective
experience” during therapy

4.  Anti-addictive effects of Ibogaine discovered
accidently
Howard Lotsof (1943-2010)
•Heroin addict
•Researcher
•Patent holder

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. 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. 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. Safety Concerns
 Indirectly
linked to several sudden deaths
 Causes arrhythmias
 Long QT Syndrome
 Shown to damage Purkinje cells in rat
cerebellums
 Bradycardia
 Hypotension

9. Legal Status
 Unscheduled EXCEPT for
 US (determined schedule 1 in 1970; only 2
arrests since)
 Belgium
 Denmark
 France
 Sweden
 Switzerland
 Australia

10. Ibogaine Treatment Sites
 US (shhh!!)
 Mexico
 Canada
 UK
 Thailand
 New Zealand
 Brazil
 Venezuela
 Holland
 And many more….

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. 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 tracked
Alper, 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. 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. 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. 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. 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.