Ibogaine

Ibogaine is a psychoactive indole alkaloid found naturally in the roots of Tabernanthe iboga, a shrub native to Central Africa. It has a long history of use in Bwiti spiritual ceremonies and has been explored in modern contexts as a potential treatment for substance use disorders. Reports have described reduced withdrawal symptoms and cravings in some individuals, but ibogaine is not approved as a medical treatment for addiction in most countries.

Chemically, ibogaine is a complex plant-derived compound with a broad pharmacology. It interacts with multiple neural targets, including antagonism of NMDA receptors and effects on serotonin and dopamine systems, as well as activity at kappa opioid and sigma receptors. Its primary metabolite, noribogaine, has a longer half-life and is thought to contribute to longer-term effects related to addiction pathways. The overall pharmacology is characterized by polypharmacology and a prolonged, variable duration of action.

Safety and regulation are central considerations. Ibogaine can cause serious adverse events, particularly cardiac arrhythmias associated with QT interval prolongation, and has been linked to deaths in some treatment contexts. Other effects can include ataxia, tremor, nystagmus, and vomiting. Because of safety concerns and limited high-quality evidence for sustained benefit, ibogaine remains unapproved for addiction treatment in many jurisdictions, and access is typically restricted to specialized clinics under medical supervision or is tightly regulated in certain countries.

Research status remains inconclusive. Some preliminary studies report benefits for withdrawal and cravings, but rigorous randomized trials are scarce, and concerns about safety and study design persist.