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Researchers at Stanford University have conducted a visionary study examining a new treatment protocol called MISTIC: ‘Magnesium–Ibogaine: Stanford Traumatic Injury to the CNS protocol’. The study focused on 30 Special Operations Forces veterans with histories of traumatic brain injuries and combat exposure.
For many veterans returning from combat zones, the battle doesn't end when they come home. Traumatic brain injuries (TBIs) from blast exposures and combat can lead to devastating long-term effects, including post-traumatic stress disorder (PTSD), depression, anxiety, and increased risk of suicide. These injuries can also affect memory, attention, processing speed, and executive functions, significantly impacting quality of life. The statistics are sobering: although veterans represent only 6.4% of the population, they make up 20% of suicides in the United States. For those with combat-related TBIs, the risk is even higher. Available treatments often fall short, with first-line therapies showing only 20-40% success rates. This crisis has led some veterans to seek alternative treatments, including (as-yet unapproved by the FDA) entheogenic plant therapy with iboga.
One of the key innovations in this study was addressing ibogaine's primary safety concern: its effect on heart rhythm. Ibogaine can lengthen the Q-T interval - the time it takes for the heart's electrical system to reset between beats. When this interval becomes too long, it can lead to dangerous irregular heartbeats or even fatal cardiac arrhythmias. The research team's solution was to combine ibogaine with magnesium, which helps stabilize heart rhythm and protect against these dangerous Q-T interval changes. This approach wasn't entirely unheard of - magnesium is already used in medical settings to protect against Q-T prolongation caused by other medications - but its application with ibogaine was new. The protocol involved administering 1 gram of magnesium sulfate intravenously 1-2 hours before the ibogaine treatment, followed by a carefully measured oral dose of ibogaine (typically 2-3 mg per kg of body weight initially, with additional doses up to 14 mg per kg total over a two-hour period). Approximately 12 hours after the ibogaine administration, patients received another dose of magnesium sulfate. This approach allowed them to harness ibogaine's therapeutic benefits while significantly reducing its cardiac risks. The research team carefully monitored participants throughout the treatment, reporting no serious adverse effects.
With these safety protocols in place, the research team was able to focus on their primary objective: evaluating how the treatment affected the veterans' brain injury symptoms and overall quality of life. Through a comprehensive series of assessments conducted both immediately after treatment and one month later, they documented significant improvements across multiple measures of health and functioning. One month after treatment, participants showed:
- Substantial positive changes in daily functioning
- Dramatic reductions in PTSD symptoms
- Measurable decreases in depression and anxiety
- Enhanced cognitive performance, particularly in processing speed and executive function
- Perhaps most importantly, a remarkable reduction in suicidal thoughts
The authors claim that "this is possibly the first study to report evidence for a single treatment with a drug that can improve chronic disability related to repeated TBI from combat/blast exposures," (Cherian, et al., 2024). The improvements weren't just subjective - they were validated through rigorous neuropsychological testing.
While these results are promising, the researchers emphasize the need for larger, controlled clinical trials. However, for veterans who have struggled with available mainstream treatments, this study offers hope. The research suggests that even years after injury - the average time since military discharge in the study was nearly 8 years - significant improvement is possible.
The implications extend beyond veterans. This treatment could potentially help others suffering from repeated head trauma, including athletes and accident survivors. As research continues, this alternative approach might open new doors for treating brain injuries that have long been considered chronic and irreversible.
For people struggling with the aftermath of TBIs, this research represents more than just scientific progress - it represents hope. The study's success in combining magnesium with ibogaine to enhance safety while maintaining effectiveness could pave the way for more accessible treatment options in the future. While ibogaine remains classified as a Schedule I substance in the United States, this study's results make a compelling case for further research and potential policy reconsideration.
Click here to access the full journal article: https://www.nature.com/articles/s41591-023-02705-w#
Citation: Cherian, K.N., Keynan, J.N., Anker, L. et al. Magnesium–ibogaine therapy in veterans with traumatic brain injuries. Nat Med 30, 373–381 (2024). https://doi.org/10.1038/s41591-023-02705-w