How toxic is ibogaine?
Clinical toxicology (Philadelphia, Pa.) January 1, 2016 Ruud P. W. Litjens, Tibor M. Brunt 74 citations
Ibogaine, a psychoactive alkaloid from the African shrub Tabernanthe iboga, is unlicensed but used to treat addiction. It is metabolized mainly by CYP2D6 to noribogaine, which persists for days. Both compounds interact with multiple neurotransmitter systems. In rats, neurotoxicity occurs at doses above 25 mg/kg intraperitoneal, likely via excitotoxic effects on cerebellar Purkinje cells. Cardiotoxicity arises from blockade of hERG potassium channels, prolonging the QT interval and causing arrhythmias and sudden cardiac arrest. Twenty-seven fatalities have been reported; eight case studies show ventricular tachyarrhythmias in individuals without pre-existing heart conditions. Noribogaine appears at least as cardiotoxic as ibogaine. CYP2D6 polymorphism and concurrent medications increase risks. Without medical supervision, further deaths are likely.