The Anti-Addiction Drug Ibogaine and the Heart: A Delicate Relation

Ibogaine, a plant-derived indole alkaloid, shows promise for treating addiction by reducing drug craving and preventing relapse in both animals and humans, yet it is not a licensed therapeutic and raises safety concerns. Alarming reports of life-threatening complications and sudden deaths linked to ibogaine use have accumulated, likely due to its tendency to cause cardiac arrhythmias. This review summarizes current knowledge on ibogaine's cardiovascular effects and assesses the cardiac risks of its use in anti-addiction therapy. It also considers 18-methoxycoronaridine (18-MC), a less toxic ibogaine derivative with anti-addictive properties.

Study at a glance

Abstract

The plant indole alkaloid ibogaine has shown promising anti-addictive properties in animal studies. Ibogaine is also anti-addictive in humans as the drug alleviates drug craving and impedes relapse of drug use. Although not licensed as therapeutic drug and despite safety concerns, ibogaine is currently used as an anti-addiction medication in alternative medicine in dozens of clinics worldwide. In recent years, alarming reports of life-threatening complications and sudden death cases, temporally associated with the administration of ibogaine, have been accumulating. These adverse reactions were hypothesised to be associated with ibogaine’s propensity to induce cardiac arrhythmias. The aim of this review is to recapitulate the current knowledge about ibogaine’s effects on the heart and the cardiovascular system, and to assess the cardiac risks associated with the use of this drug in anti- addiction therapy. The actions of 18-methoxycoronaridine (18-MC), a less toxic ibogaine congener with anti-addictive properties, are also considered.