Fatalities temporally associated with the ingestion of ibogaine.

Between 1990 and 2008, nineteen individuals died within 1.5 to 76 hours after taking ibogaine, a plant alkaloid used for opioid detoxification. The deaths did not show a characteristic pattern of nerve damage. In 12 of the 14 cases with sufficient autopsy data, advanced preexisting medical conditions—mainly heart disease—or the presence of other abused drugs explained or contributed to the death. Additional risk factors included seizures from alcohol or benzodiazepine withdrawal and use of unregulated traditional forms of ibogaine.

Study at a glance

Abstract

Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications. All available autopsy, toxicological, and investigative reports were systematically reviewed for the consecutive series of all known fatalities outside of West Central Africa temporally related to the use of ibogaine from 1990 through 2008. Nineteen individuals (15 men, four women between 24 and 54 years old) are known to have died within 1.5-76 h of taking ibogaine. The clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity. Advanced preexisting medical comorbidities, which were mainly cardiovascular, and/or one or more commonly abused substances explained or contributed to the death in 12 of the 14 cases for which adequate postmortem data were available. Other apparent risk factors include seizures associated with withdrawal from alcohol and benzodiazepines and the uninformed use of ethnopharmacological forms of ibogaine.