Iboga (Tabernanthe iboga)

Iboga (Tabernanthe iboga) is a shrub that grows natively in West Africa, where it is used in healing, spiritual and initiation rituals by people native to this region.

The shrub's root contains ibogaine, a psychoactive alkaloid thought to be responsible for iboga's dream-like hallucinogenic effects.

Ibogaine is currently being synthesised and extracted for use in addiction treatment and other areas of mental health research.

Effects

  • Whereas small doses of iboga may have a mild stimulant and focus-enhancement effect – similar to caffeine – high doses have long-lasting hallucinogenic effects,

  • The Bwiti believe iboga is a tool for connecting with the ancestors and spirit, and many users report having spiritual and mystical experiences while under the influence. Users commonly report intense visual experiences, often immersive and dream-like in nature, and a heightened awareness of their personal challenges, traumas, and patterns of behavior. 

  • Physical effects of iboga can include stimulation, changes in heart rate, muscle spasms, spontaneous body sensations, nausea, dizziness, and dehydration. 

Dosage

On Erowid Experience Vaults, users have reported using between 200-300 mg for sub-perceptual iboga doses and between 1-8 g for a psychoactive dose. 

According to the International Center for Ethnobotanical Education, Research, and Service (ICEERS), 200 mg of bark extract was previously used medically to induce neuromuscular stimulation for patients.

In clinical addiction management, ibogaine doses have ranged from 5 mg/kg body weight in minor treatments up to 30 mg/kg in intense poly-substance addiction management. However, most ibogaine treatment centres generally won't administer more than 20 mg/kg to patients because of safety concerns around higher doses.

Duration

  • In the body, ibogaine is broken down into noribogaine, which has an estimated half-life of 28-49 hours. As such, some people may experience iboga's short-term effects for up to two days. 

  • Because it can take a while for the body to digest the plant matter of the iboga root, it could take between one to three hours for the effects to kick in. 

  • The ibogaine experience is said to have two distinct phases. The visionary phase, described as a lucid or active dream, is first and extends for the first 4 to 6 hours. The introspective phase follows for the next 8 to 20 hours and is characterised by self-reflection and evaluation. In clinical practice, the second phase is where clients explore emotional issues and behavior patterns that underlying their addictions and other psychological problems.

Dangers

What not to mix with 

In the body, ibogaine is broken down by an enzyme called cytochrome P450 2D6 (CP4502D6). Using other drugs which interact with this enzyme alongside ibogaine could therefore cause ibogaine to accumulate and increase the risk of dangerous side effects. 

Since ibogaine can cause irregular heartbeat rhythms, which is clinically indicated by a prolonged QT interval on an electrocardiogram, other drugs which also prolong the QT interval could also increase the risk for dangerous side effects on the heart.

During ibogaine treatments, providers will instruct their patients to come off any medication that could be CP450-interacting or QT-prolonging. These medications can include:

  • Antidepressants 

  • Antiarrhythmics

  • Antifungal

  • Antihistamines

  • Quinine (Antimalarial)

  • Antipsychotics

  • Some antibiotics

Food and drinks that contain bergamottin and bergamot oil have CYP2D6 inhibiting effects and could increase the risk of ibogaine. These include grapefruits, grapefruit, lime, parsley, certain types of jam, and Ealy Grey tea.

What are the dangers?

  • Ibogaine blocks hERG potassium channels in the heart, which are essential for maintaining the heart's electrical activity. Disrupting hERG can cause abnormal heart rhythms (arrhythmia), which can lead to heart failure and death in severe cases. 

  • Ibogaine, and other compounds in iboga, also interact with many other channels and neurotransmitters in the body, which can cause physical side effects that include:

    • Seizures

    • Slowed heart rate (bradycardia)

    • Decreased blood pressure

    • Difficulty breathing

    In addition, the altered state experience induced by iboga could put users at risk for a psychedelic crisis. You can learn more about this risk and practices for mitigating it under our website's general psychedelic risks and harm-reduction section.


How can the risks be minimised?

  • Because of iboga's fatal risks, it's critical you avoid using this medicine until you've consulted with a qualified iboga practitioner or healthcare provider. 

  • The Clinical Guidelines for Ibogaine-Assisted Detoxification, the authors outline all patients with the following diseases should be excluded from ibogaine treatment:

    • Psychiatric conditions: schizophrenia, bipolar, depersonalization disorder, cerebellar dysfunction, epilepsy, psychosis, organic brain disease, dementia

    • Pre-existing heart conditions: prolonged QTc interval, history of heart failure, blood clots

    • Respiratory conditions: low oxygen levels, emphysema, chronic obstructive pulmonary disorder, cystic fibrosis

    • Gastrointestinal conditions: bleeding ulcer, leaky gut syndrome

    • Other: abnormal blood test results, impaired kidney or liver function

  • Regarding iboga's psychological risks, having the correct set and setting will likely decrease the risk of a psychedelic crisis. For more information, please read our general psychedelic 

  • risks and harm-reduction advice. 

  • A safe environment with a trusted trip-sitter or guide present can help mitigate the risk of negative outcomes caused by impulsive decision-making and behaviour linked to impaired judgement.

What are the potential benefits?

Addiction treatment: Clinical studies find ibogaine can significantly decrease cravings, substance use, and withdrawal symptoms in patients with opioid use disorder (OUD), often with a more efficacious and longer-lasting effect compared to conventional treatment. 

Ibogaine treatment for alcoholism research is also underway. 

Overcoming trauma: Iboga can help users face up to their and explore their traumas, aiding insight and emotional healing. This effect is important in iboga's anti-addiction effects, since addiction can often manifest from unresolved trauma. 

In one clinical trial, patients with post-traumatic stress disorder (PTSD) had decreased PTSD symptoms following ibogaine treatment. Patients also had reduced depression, anxiety, and suicidal ideation.  

Mood disorders: Treatment centres offer ibogaine for mood disorders such as anxiety and depression. There's no clinical trial research supporting iboga to treat mood disorders to date. However, one case report described reduced depression, anxiety, and hopelessness associated with bipolar depression after microdosing ibogaine. 

Spiritual growth: Iboga is regarded as a highly sacred plant. Within the Bwiti tradition in Gabon, large doses of iboga are used to initiate communication with ancestors and spiritual beings. Research on other psychedelics shows spiritual and mystical components of psychedelic journeys can increase the chance for positive therapeutic outcomes.

Parkinson's disorder: Ibogaine increases the production of the growth factors BDNF and GDNF in the brain. These factors may help restore neurological damage and recover symptoms associated with Parkinson's disease. Though there's no clinical evidence supporting iboga for Parkinson's disease, one research video report documents a patient with markedly improved symptoms following ibogaine treatment. 

Weblinks

  • Traditional use of iboga in West Africa: https://doubleblindmag.com/ibogaine-and-iboga/

  • Importance of iboga conservation: https://chacruna.net/iboga_conservation/

    • Ibogaine guidelines - a clinical guide to ibogaine treatment, including uses, patient criteria, safety, and contraindicated drugs: https://ibogaineguidelines.com/

    • Is iboga/ibogaine right for me? https://www.iceers.org/interested-in-taking-ibogaine/

    • Ibogaine for Parkinson's disease: https://wayofleaf.com/psychedelics/ibogaine-for-parkinsons-disease

  • https://onlinelibrary.wiley.com/doi/pdf/10.1111/dar.13587 

  • https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/j.1749-6632.2000.tb05213.x

  • https://www.sciencedirect.com/science/article/abs/pii/B9780123985187000067

  • https://psychedelic.support/resources/iboga-ibogaine-harm-reduction/

  • https://www.tandfonline.com/doi/pdf/10.1080/17425255.2021.1944099

  • https://pubmed.ncbi.nlm.nih.gov/28581738/

Credit to Dr Andrew Gibson for contributing his medical expertise and background in harm-reduction to the process of making this content.