The anti-addictive drug ibogaine modulates voltage-gated ion channels and may trigger cardiac arrhythmias

Ibogaine, an alkaloid from the African shrub Tabernanthe iboga, has psychoactive properties and is being studied as a potential treatment for opioid, stimulant, alcohol, and nicotine addiction. However, its complex interactions with many cellular targets raise significant safety concerns. Beyond neurotoxic effects, ibogaine may harm the heart: several sudden deaths after use have been reported, possibly due to cardiac arrhythmias. In one case, a woman experienced a severely prolonged QT interval and ventricular tachyarrhythmias after taking ibogaine.

Study at a glance

Abstract

Background Ibogaine is an alkaloid derived from the African shrub Tabernanthe iboga. Psychoactive properties of ibogaine have been known for decades, but more recently the drug has received much attention because of its promising “anti-addictive” actions. Thus, ibogaine and its derivatives are being studied as potential treatment for opioid and stimulant abuse, as well as for alcoholism and smoking. Because ibogaine has a complex pharmacology and is known to interact with numerous different cellular targets, its potential to generate adverse effects is significant. Besides the expected neurotoxic actions, ibogaine may e.g. also affect the heart. Thus, several cases of sudden death after ibogaine use were reported, which have been hypothesised to be related to cardiac arrhythmias. In accordance, a severely prolonged QT interval of the electrocardiogram and ventricular tachyarrhythmias were observed in a woman after she had taken ibogaine.