A review of human studies on ibogaine and its metabolite noribogaine found only three randomized controlled trials. In one pilot study, a single 1800 mg dose of ibogaine reduced cocaine craving versus placebo over up to 24 weeks in 20 adults. Noribogaine doses of 3-60 mg were safe in 36 healthy volunteers. In 27 opioid-dependent patients, noribogaine 60-180 mg caused dose-dependent QTc prolongation with non-significant reductions in withdrawal symptoms. Adverse effects include neurologic, psychiatric, and cardiac events, and fatalities have occurred with comorbidities. Microdosing protocols lack standardized definitions and are supported only by preliminary observational data. The authors conclude that clinical use cannot be recommended without larger, well-controlled trials due to cardiotoxicity and a narrow therapeutic margin.
An analysis of 500 high-engagement threads (12,852 comments) from the r/TherapeuticKetamine subreddit found that people primarily use ketamine for mood-related concerns (53%). Positive effects, most often improved emotional well-being (65%), were reported alongside adverse effects that were predominantly psychological or mood-related (56%). 70% of reported doses exceeded 149 mg, indicating a trend toward higher doses. Intravenous administration (40%) and sublingual troches (23%) were the most common routes. Concurrent use of prescribed psychotropics, cannabis, and psychedelics was also reported. The findings suggest substantial heterogeneity in individual experiences and underscore the importance of clinical monitoring for addiction potential and drug interactions.