Ibogaine: Therapeutic Potential, Cardiac Safety, and Translational Perspectives in the Treatment of Substance Use Disorders—A Scoping Review
Molecules February 4, 2026 Monica Patrícia Esperança, N. N. S. Gomes, Maria Graça Campos 1 citation
Substance Use Disorder (SUD) causes about 600,000 deaths yearly, mainly from opioid use. Current treatments are limited because they target only isolated brain processes and fail to address key mechanisms like glutamatergic hyperactivity, low dopamine in reward pathways, and dysfunction in control networks, leading to high relapse rates. Ibogaine, an alkaloid from the Tabernanthe iboga plant, has re-emerged as a candidate due to its ability to modulate multiple pathways linked to addiction. However, its clinical use is hindered by fragmented evidence, lack of regulatory frameworks, inconsistent product quality, and cardiac safety concerns. This scoping review synthesizes preclinical and clinical data on ibogaine for SUD, focusing on withdrawal, craving, dose-response, and cardiac risks, and outlines conditions for further investigation.