Ibogaine treatment centres

Safety facts, with sources

What published research, regulators and harm-reduction services say about ibogaine. These are the questions to put to any centre. Nothing here makes any centre safe, and none of it is medical advice.

• Deaths: consecutive case seriesSerious risk

  A review of all known deaths outside West Central Africa temporally linked to ibogaine from 1990 through 2008 found 19 people who died within 1.5 to 76 hours of taking it. Pre-existing medical conditions, mainly cardiovascular, and/or other abused substances explained or contributed to 12 of the 14 deaths with adequate post-mortem data; seizures from alcohol and benzodiazepine withdrawal were another apparent risk factor. (Journal of Forensic Sciences, 2012)

• Later death countSerious risk

  A 2018 review gives a detailed update of 33 deaths known to have occurred after ibogaine, including 5 in the UK, and attributes serious adverse effects to undiagnosed health conditions and/or concomitant use of other drugs. (Progress in Brain Research, 2018)

• Mechanism of cardiac risk (hERG)Serious risk

  Therapeutic concentrations of ibogaine reduce currents through human hERG potassium channels, providing a mechanism by which it may generate life-threatening cardiac arrhythmias. A 2015 review links the accumulating reports of sudden death to this arrhythmia risk. (Addiction Biology, 2014; Molecules, 2015)

• QT prolongation measured in a clinical studySerious risk

  In a Dutch university study of 14 opioid-dependent patients given a single 10 mg/kg dose, maximum QTc prolongation averaged 95 ms (range 29 to 146 ms), half reached a QTc over 500 ms, and in 6 of 14 the QTc stayed above 450 ms beyond 24 hours. No torsades de pointes occurred, but severe transient ataxia (unable to walk unsupported) was seen in all patients. (Addiction, 2022)

• Overdose risk after treatmentSerious risk

  The GITA guidelines warn that ibogaine reduces accumulated opioid tolerance and increases sensitivity to opioids, so patients must understand their tolerance is reset to that of an opioid-naive person; using opioids or stimulants during or after treatment carries an acute risk of overdose. (Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)

• Methadone, buprenorphine and withdrawal seizuresSerious risk

  The GITA guidelines give specific transition rules for long-acting opioids such as methadone and buprenorphine, note that large methadone doses can themselves prolong the QT interval, and warn that stopping benzodiazepines or alcohol suddenly or within 72 hours before treatment may cause life-threatening seizures. (Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)

• Clinic death with inadequate monitoringSerious risk

  New Zealand's Health and Disability Commissioner found a clinic and its doctor in breach of patient rights after a 45-year-old woman died following ibogaine treatment: no written consent was obtained, no blood pressure was recorded after 9am on the second day of dosing, and the doctor left to go overseas, leaving sole monitoring to an assistant whose notes recorded observations such as 'Lying still'. She was found dead the next morning. (New Zealand Health and Disability Commissioner, 2015)

• ECG and electrolyte screeningWorth knowing

  The Global Ibogaine Therapy Alliance guidelines list prolonged QTc (over 450 ms in men, over 470 ms in women) among heart-related exclusions, give preferred potassium (4.5 to 5.5 mEq/L) and magnesium (1.5 to 2.5 mEq/L) ranges, and say a QTc over 500 ms during treatment requires immediate hospital transfer. (Global Ibogaine Therapy Alliance (Internet Archive copy), 2016)

• Magnesium co-administration (Stanford MISTIC)Worth knowing

  Stanford's open-label observational study gave ibogaine with magnesium, intended to mitigate the fatal-arrhythmia concern, to 30 male Special Operations veterans with mostly mild traumatic brain injury, and reported no unexpected or serious adverse events. The authors say controlled trials are still needed to establish safety. (Nature Medicine, 2024)

Programme lengths and published prices