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Death related to consumption of Rauvolfia sp. powder mislabeled as Tabernanthe iboga.

Thomas Gicquel, Chloé Hugbart, Françoise Le Devehat, Sylvie Lepage, Alain Baert, Renaud Bouvet, Isabelle Morel

Forensic science international September 1, 2016 DOI: 10.1016/j.forsciint.2016.06.014 via PubMed

Summary

AI-generated from the abstract

A 30-year-old woman died after consuming a powder she bought online that was labeled as iboga (Tabernanthe iboga). Analysis of the powder found no ibogaine but instead contained toxic alkaloids—ajmaline, yohimbine, and reserpine—which are characteristic of Rauvolfia plant species. Blood concentrations were 109.1 ng/mL ajmaline, 98.2 ng/mL yohimbine, and 30.8 ng/mL reserpine; bile concentrations were much higher. The death was attributed to ingesting a substantial quantity of crushed Rauvolfia roots combined with concomitant drug withdrawal.

Study at a glance

Characteristics Case report Peer reviewed
Sample size 1
Population 30-year-old woman who died after ingesting a mislabeled herbal product bought online
Topics Ibogaine
Keywords Ajmaline Rauvolfia Reserpine Yohimbine
Citations 20
Key finding A powder sold online as Tabernanthe iboga contained no ibogaine but instead toxic Rauvolfia alkaloids (ajmaline, yohimbine, reserpine), and their ingestion led to the woman's death.

Abstract

Powdered roots of iboga (Tabernanthe iboga) contain ibogaine, an alkaloid that has been used to treat addictions. We report the case of a 30-year-old woman who died after ingesting a powder labeled as Tabernanthe iboga she had bought online. Analysis of the powder revealed the absence of ibogaine but the presence of toxic alkaloids (ajmaline, yohimbine and reserpine) found in Rauvolfia sp. plant species. An original and specific LC-MS/MS method developed to quantify ajmaline, yohimbine and reserpine showed respective concentrations of 109.1ng/mL, 98.2ng/mL and 30.8ng/mL in blood, and 1528.2ng/mL, 914.2ng/mL and 561.2ng/mL in bile. Moreover, systematic toxicological analyses of biological samples showed the presence of oxazepam at therapeutic concentration and cannabinoids. Death could be attributed to ingestion of a substantial quantity of crushed roots of Rauvolfia in association with concomitant drug withdrawal.

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