The Efficacy and Safety of Ibogaine Treatment for Substance Use Disorders - A Narrative Review

Ibogaine, an indole alkaloid from the Tabernanthe iboga plant, shows promise for reducing withdrawal and cravings in opioid, cocaine, and alcohol use disorders by modulating serotonin, dopamine, and glutamate systems. However, serious safety risks, especially cardiotoxicity with QT prolongation and potentially fatal arrhythmias, limit its use. Further large-scale randomized controlled trials are needed to better assess its efficacy and safety.

Study at a glance

Abstract

Introduction and aim of the study. Substance use disorders, including opioid, cocaine, and alcohol dependence, represent a significant global health challenge with high relapse rates despite existing treatments. Ibogaine, a naturally occurring indole alkaloid derived from Tabernanthe iboga, has attracted increasing scientific interest due to its reported ability to reduce withdrawal symptoms and cravings. Our study aims to evaluate the efficacy and safety of ibogaine in the treatment of substance use disorders and to determine its therapeutic potential. Materials and methods. The paper is based on an analysis of studies available in databases such as PubMed, Google Scholar, and other scientific databases. Observational studies, retrospective surveys, controlled trials, and review papers on the use of ibogaine in the context of opioid, cocaine, and alcohol dependence were used. Conclusions. Ibogaine, due to its modulation of serotonergic, dopaminergic, and glutamatergic neurotransmitter systems, shows promising potential in the treatment of substance use disorders. However, serious safety concerns exist, particularly cardiotoxicity manifesting as QT prolongation and potentially fatal arrhythmias. It is advisable to conduct further large-scale randomized controlled trials aimed at a more thorough evaluation of the efficacy and safety of ibogaine in the treatment of addiction.