Medication Development of Ibogaine as a Pharmacotherapy for Drug Dependencea.
Annals of the New York Academy of Sciences – May 01, 1998
Source: PubMed
Summary
Ibogaine, derived from the roots of the Tabernanthe iboga shrub, shows promise as a potential treatment for cocaine addiction. Anecdotal evidence suggests that a single dose can alleviate withdrawal symptoms and reduce cravings significantly. A safety study is underway involving participants with cocaine dependency to evaluate ibogaine's safety and pharmacokinetics. This Phase I trial will analyze data from 40 individuals to explore dosage effects and metabolism, laying the groundwork for future efficacy trials in addressing addiction.
Abstract
The potential for deriving new psychotherapeutic medications from natural sources has led to renewed interest in rain forest plants as a source of lead compounds for the development of antiaddiction medications. Ibogaine is an indole alkaloid found in the roots of Tabernanthe iboga (Apocynaceae family), a rain forest shrub that is native to equatorial Africa. Ibogaine is used by indigenous peoples in low doses to combat fatigue, hunger and in higher doses as a sacrament in religious rituals. Members of American and European addict self-help groups have claimed that ibogaine promotes long-term drug abstinence from addictive substances, including psychostimulants and cocaine. Anecdotal reports attest that a single dose of ibogaine eliminates withdrawal symptoms and reduces drug cravings for extended periods of time. The purported antiaddictive properties of ibogaine require rigorous validation in humans. We have initiated a rising tolerance study using single administration to assess the safety of ibogaine for the treatment of cocaine dependency. The primary objectives of the study are to determine safety, pharmacokinetics and dose effects, and to identify relevant parameters of efficacy in cocaine-dependent patients. Pharmacokinetic and pharmacodynamic characteristics of ibogaine in humans are assessed by analyzing the concentration-time data of ibogaine and its desmethyl metabolite (noribogaine) from the Phase I trial, and by conducting in vitro experiments to elucidate the specific disposition processes involved in the metabolism of both parent drug and metabolite. The development of clinical safety studies of ibogaine in humans will help to determine whether there is a rationale for conducting efficacy trials in the future.