Rare but relevant: Ibogaine and cardiovascular complications-prolonged QT interval and ventricular arrhythmias.
Addiction (Abingdon, England) January 20, 2026 Tibor Markus Brunt 2 citations
Ibogaine, a psychoactive alkaloid, reduces craving and withdrawal symptoms in opioid and cocaine-dependent individuals through multiple pharmacological mechanisms, as shown by observational, open-label, and limited randomized placebo-controlled trials. However, it poses a rare but clinically significant cardiotoxic risk: QTc prolongation and potentially fatal ventricular arrhythmias like Torsades des Pointes, which have occurred at therapeutic doses even in people without pre-existing cardiac conditions. Large interindividual variability in CYP2D6 metabolism may increase cardiovascular risk for some. Recent safety efforts include different dosing, cardiovascular monitoring, and developing ibogaine analogues that retain anti-addictive effects without cardiotoxicity in preclinical models. Future treatment should occur under controlled medical supervision with CYP2D6 genotyping and rigorous cardiac monitoring.