Ibogaine, a compound from the African shrub Tabernathe iboga, has been used for centuries in West African rituals and has shown potential for treating addiction and depression. Human trials indicate it can rapidly relieve acute withdrawal symptoms, but results vary on long-term abstinence and toxicity. Multiple treatments may lead to considerable abstinence, but the drug carries a risk of lethal heart arrhythmias due to QT prolongation.
Classic hallucinogens are powerful psychoactive substances with a long history of human use, integral to prehistorical and aboriginal cultures and belief systems. They were later condemned and repressed by evolving civilizations, only to be rediscovered in the 20th century. Their use spread to the general culture, especially among youth during the politically tumultuous 1960s, and was seen as causing cultural upheaval and a public health crisis. After decades of quiescence, rigorous controlled research on hallucinogens has resumed. This chapter covers their historical background, neuropharmacology, cultural use, risks of adverse events and addiction, the recent renaissance of research, and models for optimal use and future implications.