Ibogaine and its alkaloids reduce withdrawal symptoms and craving in substance use disorders, and may also improve depression and trauma-related symptoms. However, severe medical complications and deaths have been reported, linked to neuro- and cardiotoxic effects. Two fatalities occurred among 705 individuals across 24 studies, which included two randomized controlled trials and 17 open-label studies. Ibogaine's distinct psychoactive and somatic effects set it apart from classic hallucinogens like LSD and psilocybin. Rigorous medical monitoring is needed for safe application.
A systematic review compared resting-state cerebral blood flow patterns in first-episode psychosis (FEP), acute cannabinoid intoxication, and acute opioid intoxication. The evidence was highly conflicting within each condition, but some consistent findings emerged: both positive symptoms of FEP and depersonalization after cannabis administration were linked to increased activity in the anterior cingulate cortex, a key region of the default mode network. The review included 22 studies with 279 FEP participants or controls, 315 participants receiving cannabinoids, and 113 receiving opioids.