Back To LibraryTranscript:
00:00 Introduction
This overview is longer than usual, so if you want to skip to a particular section, feel free to do so.
Ibogaine is a psychedelic with prominent dreamlike effects, making it distinct from common psychedelics. It has historically been used as a stimulant at lower doses, but it's most widely known for its high-dose effects. For many people, the higher doses have been useful as a treatment for drug addiction. Ibogaine can be found in multiple plants, the most important of which is Tabernanthe iboga.
00:28 Effects
The positive effects of ibogaine include stimulation, euphoria, spiritual and personal insight, closed and open-eye visuals, mood lifts, and greater sexual desire. Its negative effects can include anxiety, insomnia, tremor, nausea, vomiting, dry mouth, reduced muscular control, bradycardia, and hypo- or hypertension.
There are a few uses of the drug which have been notably important. First, at low doses, the drug functions as a somewhat recreational stimulant, and it also has aphrodisiac qualities. People in areas like Gabon and Cameroon used it to combat fatigue, hunger, and thirst. It was also taken to promote sexual activity, and it was considered quite effective in this regard.
In Gabon and surrounding areas, iboga is still taken for religious purposes. The drug puts people in perceived contact with entities, ancestors, and their own autobiographical memories. While not part of the same religious context, people outside of Africa have also taken ibogaine for similar reasons. It seems to fairly reliably bring up memories and provide a more objective overview of one's life. This allows it to be taken for spiritual purposes and for personal insight. Not everyone experiences those effects, but a dreamlike autobiographical journey is more common with ibogaine than with other psychedelics.
Open-eye visuals are normally minimal, with the closed-eye effects being more pronounced. Some minor visual alterations may occur with your eyes open, and they appear more when you're in a dark environment. Seeing flashes of light, colors on your surroundings, and minor psychedelic-like alterations is about the extent of the open-eye effects.
The most well-known use for ibogaine is in the treatment of addiction. It seems to interrupt both psychological and physical dependence, particularly with opioids, but also with alcohol, cocaine, and other substances. Based on the evidence we have, it does seem to alleviate withdrawal and craving at least for a week or two. There are some reports of ibogaine changing someone's attachment to drugs for months and even years after a single use, but those reports are less common.
Following an ibogaine session, aftercare is important, which could include additional ibogaine use or other forms of addiction therapy. A single use of ibogaine is rarely a cure for addiction, but it does help people enter a useful psychological state. The alleviation of withdrawal occurs around one hour after administration, and this effect is seen for the majority of opioid-dependent users. Some of ibogaine's effects can mimic withdrawal, however, such as nausea, trouble sleeping, vomiting, and feelings of coldness.
We don't know how effective ibogaine is for addictions in general. One opinion from Howard Lotsof was that around 10% are cured after one dose, 10% are resistant to the effects, and everyone else is somewhere in between. For those people, they do receive positive effects, but more treatment, often with ibogaine, is necessary. The percentages may not be accurate, but those groups encompass the usual responses to ibogaine therapy.
A lot of interest now exists regarding how the drug could be used multiple times to increase its efficacy. There are a few ways it may be taken after the initial treatment: first, a booster dose under one gram may be taken a few days later; second, boosters in the same dosing range may be used every few weeks or months to maintain a useful psychological state; and third, ibogaine could be used daily at 25 to 50 milligrams. This may continue to combat psychological dependence and could be particularly effective in those with ongoing depression or pain. In these cases, users tend to cycle their use by periodically taking breaks. Using it for too long might lead to insomnia and a persistent uncomfortable stimulation, possibly due to a buildup of noribogaine.
Compared to the basic addiction treatment with a single dose, these kinds of treatments have even less research to support them. Nevertheless, using ibogaine for addiction is promising. The drug lasts for 24 to 36 hours when taken orally, and it begins working in about 45 minutes. Stimulation and mood changes can persist for another 12 hours.
There are generally three distinct effect periods when a full hallucinogenic dose is taken. The first period lasts for four to eight hours, and begins one to three hours after administration. During this time, there are dreamlike visualizations which are strongest with eyes closed. It can feel like a detached form of lucid dreaming, and there is a focus on autobiographical content. Entities and regular psychedelic effects are occasionally reported. People tend to feel like they're floating, and there may be flashes of light. While the dreamlike visualizations can be intense, users normally feel somewhat detached, giving them a more objective view of what's going on.
The second period begins four to ten hours after administration and is characterized by cognitive evaluation. People tend to be focused on their lives and the experiences they had during the first period. This is when addicts are most likely to decide they should stop using their drug of choice. Users may feel emotions like regret, anger, sadness, etc. This is the most difficult period in terms of emotional response, and it lasts for eight to twenty hours. The third period includes some introspection and mood changes but is largely made up of stimulation and insomnia. Users are awake for at least 24 hours but can normally sleep within 48 hours. Occasionally there will be more persistent insomnia, including a reduction in sleep time for weeks. If the insomnia doesn't quickly disappear, it normally subsides in seven to ten days.
05:49 Pharmacology & Chemistry
Ibogaine is one of dozens of iboga alkaloids found in Tabernanthe iboga and other plants. It makes up 80% of the alkaloid content in iboga root bark, and the concentration varies. Noribogaine, the main psychoactive metabolite, is another important drug in this discussion. Tonnes of mechanisms have been identified at this point. We still don't fully know how ibogaine works. Among the possible contributing actions are: serotonin release and reuptake inhibition, dopamine reuptake inhibition, NMDA antagonism, kappa opioid agonism, sigma-2 agonism, nicotinic antagonism, and muscarinic agonism. Not all of those have been completely supported, and different actions may provide different noticeable effects.
There are other receptors that ibogaine and noribogaine bind to, but it's not clear if or how they are relevant. Mu-opioid agonism and antagonism aren't supported by much, but ibogaine does seem to modulate opioid agonist activity. Some effects may come from promotion of glial-derived neurotrophic factor. Up-regulation of GDNF could result in maintenance and repair of dopamine neurons. That action is conceivably relevant to the addiction-related effects. Some evidence exists for an inhibition of dopamine release in areas relevant to addiction, which is yet another addiction-related action. One of the negative parts of ibogaine pharmacology is that it inhibits hERG cardiac potassium channels. This is connected with cardiac safety issues. As such, it is avoided in drug development and is something to be aware of, as it increases the risk of arrhythmia and death.
07:21 How it’s used
Because there are a few ways ibogaine is used, different dosing schemes need to be discussed. When taken for opioid dependence, 15 to 25 milligrams per kilogram is common, which is 900 to 1,500 milligrams for a 130-pound person. If you're taking it for psychedelic or therapy purposes, 8 to 12 milligrams per kilogram is used. That comes out to 500 to 700 milligrams. Smaller amounts are taken for stimulation, euphoria, and appetite reduction. Those effects are achieved with under 50 milligrams per day. People occasionally use the drug daily at between 20 and a couple hundred milligrams. The most common dosing range appears to be 20 to 50 milligrams per day. Daily dosing may be used to enhance the impact of an earlier ibogaine experience.
The dosing is more complicated when using iboga or an extract. Iboga root bark varies in potency from 1 to 7 percent alkaloids and is often 2 to 4% ibogaine. A total alkaloid extract tends to contain 15 to 20 percent alkaloids, meaning the dose is 3 to 6 grams for psychedelic purposes.
08:25 History
Iboga and similar plants have been used for centuries. We don't actually know how long it's been used, but use was first recorded during the 1800s in the Gabon, Cameroon, and Congo region. Its stimulant actions were well recorded during the 1800s, but we know the hallucinogenic effects were also employed. Depending on the group, ibogaine is taken in animist, ancestor worship, and syncretic Christian belief systems. People believe it can show them the reality of life after death and help them maintain contact with their ancestors and cultural identity. In some practices, the initiates are truly viewed as having been reborn following ceremonial practices that last days or weeks.
Origin stories claim it was first taken by boars, monkeys, and other animals. Pygmies then became interested in the plant and spread its use. The first published description of iboga appeared in 1864, based on a sample sent by Griffon du Bellay (a surgeon) from Gabon to France. It was described as follows: "In small quantities it is an aphrodisiac and a stimulant of the nervous system; warriors and hunters use it constantly to keep themselves awake during night watches." It was also described as “not toxic except at high doses.”
During the 1800s, the natives described it as closer to alcohol than caffeine, but it wasn't as impairing. Father Joseph Henry Neu provided an account of its ceremonial use in 1885. He stated: "Most Europeans [living in Gabon] have heard about this plant, used in fetishistic ceremonies. The natives use an infusion of iboga root scrapings as a potent philter that enables one to discover hidden things and to tell the future. The one who drinks it falls into a deep sleep during which he is obsessed by uninterrupted dreams which, until the time that he awakens, he takes to be actual events."
Professor Henri Baillon described samples of the plant from Gabon and the French Congo in 1889. He called it Tabernanthe iboga. French and Belgian explorers described iboga's effects, including its stimulant and aphrodisiac qualities, during the mid-1800s. In the late 1800s, the Gabonese Fang formed the Bwiti religion, which prominently features iboga. By 1901, there were studies confirming its stimulant action in animals. One report also suggested it could cause hallucinations.
During the early 1900s, the use of iboga grew partly due to the natives opposing colonial power. Germans had taken notice of its use in Cameroon and may have been fine with iboga since it could boost productivity among native workers. Bwiti practices were criticized by Christians around this time. People turned to Bwiti rituals as an alternative to the colonial system, though Bwiti membership remained around 10% of the Fang population. Between the 1930s and 1950s, Bwiti was suppressed by French colonial forces, though the use of iboga didn't go away.
In Europe, the drug was recommended for various purposes in the early to mid-1900s. Between 1901 and 1905, it was reported as useful for asthenia or low energy at 10 to 30 milligrams per day. It was sold as a stimulant in France between 1939 and 1966 under the name Lambarene. Tablets with that name contained 200 milligrams of iboga extract, providing eight milligrams of ibogaine. Users were instructed to take two to four tablets each day for fatigue, depression, and recovery from infectious disease.
Another product known as Iperton was available in Europe and was sold as a tonic and stimulant. It contained both 40 milligrams of iboga extract and 10 milligrams of belladonna extract. Other capsules with 100 to 200 milligrams of extract were also on the market. Lambarene was the most popular ibogaine product due to its stimulant effects. It was even used by athletes like mountaineers, cyclists, and long-distance runners during the post-World War II period.
French volcanologist Haroun Tazieff described how Lambarene was useful during an expedition: "I hastened, ‘doped up’ on Lambarene, and jumped from one boulder to the next with renewed agility. I took another Lambarene… Within ten minutes everything was in order, and in turn I climbed up without any difficulty."
Research was also taking place in the U.S. Harris Isbell, an important doctor who worked for the US government, administered ibogaine to eight already detoxed morphine addicts in 1955. He gave them up to 300 milligrams, but because they were already off their drug of choice, the core anti-addictive effects weren't recorded.
Between the 1950s and 1960s, it was investigated by Leo Zeff, a psychologist, and Claudio Naranjo, a psychiatrist, for psychotherapy. Naranjo would later describe the drug as causing waking dreams and therefore operating differently than classical psychedelics. He received a French patent for the psychotherapeutic use of ibogaine at four to five milligrams per kilogram in 1969. Ibogaine was described as a “nontoxic drug that clarifies thoughts and permits a very thorough introspection while preserving the patient's emotional character which is indispensable for the stimulation of thought and imagination.”
Howard Lotsof gave a description of the drug's anti-addiction effects during the early 1960s. While experimenting with ibogaine and other hallucinogens, he found it alleviated heroin withdrawal and removed his desire to use the drug. He wasn't looking for a heroin dependence treatment, but he inadvertently found one. From 1962 to 1963, Lotsof operated S&L Laboratories, which ordered various drugs including ibogaine. Ibogaine was administered to 20 people, seven of whom were heroin dependent, at doses up to 19 milligrams per kilogram. Every dependent user reported a lack of withdrawal and craving, and five of the seven didn't take heroin for at least six months. The FDA and law enforcement eventually forced S&L Laboratories to close.
Lotsof remained committed to promoting ibogaine during the rest of his life, touting it as a “simple and effective medicinal means to cure almost all addictions”. A nonprofit organization known as the Dora Weiner Foundation was formed by Lotsof in 1982, but he ended up doing more with ibogaine through NDA International, a private company formed in 1986. He traveled to Europe and Gabon looking for sources of ibogaine, and he filed patents for the use of ibogaine in opioid, cocaine, amphetamine, alcohol, nicotine, and polysubstance dependence.
Coverage of ibogaine for addiction showed up in Overthrow, a yippie magazine, in 1985. Mainstream sources covered it later in the 1980s and 1990s. NDA began working with researchers at Erasmus University in the Netherlands. This led to a paper showing it did have efficacy in opioid dependence in animals. Dozens of people were given ibogaine in the early 1990s in the Netherlands, yielding some encouraging data.
A clinical trial protocol was created by NIDA and approved by the FDA. It was going to use 150 or 300 milligrams compared to placebo, but NIDA abandoned the project in 1995 due to safety concerns. This was despite efforts from groups like ACT UP and Cures Not Wars, who put pressure on the government in favor of ibogaine research. During the 1990s, there were treatment centers all over the world which collectively treated thousands of people. Many of the facilities also provided the drug for non-addiction therapeutic purposes.
With the help of the Internet, information spread through resources like the ibogaine mailing list, which was formed in 1997. Currently, ibogaine remains uncontrolled in much of the world, and centers in Mexico, South Africa, and Canada have received a bit of attention. Those centers tend to cater to addiction, particularly opioid addiction, but they may also cover other uses. Ibogaine itself is normally used instead of the root bark or an extract. Despite having been discussed as an addiction cure for much of its early history, it is now recognized as a helpful tool more than an actual cure.
Iboga continues to be used by Bwiti practitioners and is normally taken in thin strips for chewing or in a powder. It's most often used in Gabon and Cameroon. Bwiti has grown in the region partly as an alternative to other religions and modern changes. More recently, the medical community has become interested in 18-MC, an ibogaine-like drug that could potentially have anti-addictive effects while being safer.
16:33 Legal Status (Check your local laws!)
Ibogaine is controlled in the US and other countries including France, Australia, Denmark, Sweden, and Switzerland. It is usually uncontrolled elsewhere, including in Mexico and Canada.
16:45 Safety
Dozens of deaths from ibogaine have been confirmed throughout history, but we also know how to reduce the risks. In most of the deaths, other medical problems or electrolyte imbalances are present, suggesting those factors are very important. The fatalities tend to involve some form of cardiac issue, and they sometimes occur up to 72 hours after use. Ibogaine can prolong the QT interval, which puts someone at risk for arrhythmias and heart failure. This is from its inhibition of hERG channels in the heart, which affect repolarization and therefore cardiac activity. Even though that action exists regardless of the user, the health risk is clearly increased if you already have some form of cardiovascular susceptibility.
Users need to make sure their electrolyte levels are in check and that their ECG reveals no abnormalities. Because seizure activity has also been reported, those susceptibilities should be kept in mind as well. QT prolongation may last for a few days after the drug is used, which makes monitoring for up to three days useful. The cardiotoxicity seems to be greatest over two grams. As little as eight milligrams per kilogram has contributed to death, albeit with pre-existing cardiovascular issues.
There are some hypotheses in this area that suggest the greatest cardiovascular risk is in the pre- and post-peak periods. Whether or not that is true isn't clear, but it's believed by some that the stress of the experience combined with other forms of excitement could increase the chance of a negative response. General overdoses may include fainting, respiratory failure, seizures, cardiovascular problems, and hypothermia. A slowing of the heart rate is often noted without issue, but severe bradycardia can appear in overdose.
Temporary psychological problems are possible after ibogaine, but they're pretty rare, particularly in therapeutic settings. The effects are usually manageable, though emotionally difficult experiences can occur. Using the root bark is more dangerous due to potency variation. Ibogaine may be present at 1 to 6%, and there have been cases where powder contains over 7%. As such, dosing with ibogaine itself is better. When it comes to combinations, all other drugs should be avoided with full hallucinogenic doses, and it is particularly important to be off opioids and stimulants.