Mania following use of ibogaine: A case series.

Ibogaine, a naturally occurring hallucinogen used illegally for addiction treatment, can trigger manic episodes even in people with no prior bipolar diagnosis. This case series reports three patients who developed mania after using unregulated ibogaine—two for self-treating addictions and one for psycho-spiritual purposes. No previous reports of ibogaine-induced mania exist in the literature. Clinicians encountering new-onset mania should inquire about substance use, especially ibogaine, given its growing popularity among vulnerable populations seeking addiction treatment. The authors advise discussing the lack of safety and efficacy data with patients considering ibogaine.

Study at a glance

Abstract

Ibogaine is a naturally occurring hallucinogen with postulated anti-addictive qualities. While illegal domestically, a growing number of individuals have sought it out for treatment of opiate dependence, primarily in poorly regulated overseas clinics. Existing serious adverse events include cardiac and vestibular toxicity, though ours is the first report of mania stemming from its use. To report on a case series of psychiatric emergency room patients whose unregulated use of ibogaine resulted in mania in three patients with no prior diagnosis of bipolar illness. Review and summarize charts of three cases. Relevant literature was also reviewed for discussion. Two cases of reported ibogaine ingestion for self-treatment of addictions, and one for psycho-spiritual experimentation resulted in symptoms consistent with mania. No prior reports of mania were found in the literature, and the literature suggests growing popularity of ibogaine's use. The three cases presented demonstrate a temporal association between ibogaine ingestion and subsequent development of mania. In light of these cases, clinicians faced with a new onset mania may benefit from careful substance use and treatment history, specifically regarding opiates. In the vulnerable and often desperate addiction population, in particular, the number of patients seeking this treatment appears to be growing. We advise clinicians to be prepared for discussing the safety, efficacy, and paucity of good data regarding ibogaine with patients who may be considering its use. (Am J Addict 2015;24:203-205).