Combating substance abuse with ibogaine: pre- and posttreatment recommendations and an example of successive model fitting analyses.

Ibogaine, an alkaloid from the African shrub Tabernanthe iboga, has been used medicinally and ceremonially in West Central Africa. Anecdotal reports and recent studies suggest it alleviates withdrawal symptoms and reduces drug cravings. However, articles typically neglect psychological and environmental factors that could improve treatment outcomes. This review proposes theory-driven pretreatment and posttreatment recommendations to enhance ibogaine's effectiveness. It also demonstrates, through reanalysis of published results, the value of successive model fitting analyses to examine associations between pretreatment variables and posttreatment outcomes. To aid future reviews, the authors recommend a minimum set of patient- and treatment-related variables be included in all ibogaine studies with human participants.

Study at a glance

Abstract

Ibogaine is an indole alkaloid derived from the root bark of the African shrub Tabernan the iboga and it has been used for many years as a medicinal and ceremonial agent in West Central Africa. Furthermore, both anecdotal observations and recent studies suggest that ibogaine alleviates withdrawal symptoms and reduces drug cravings. Although ibogaine articles typically include information bearing on the duration of drug abstinence following treatment, little if any attention is given to the psychological and environmental factors that might facilitate a positive treatment outcome. Hence, a major purpose of the present review is to suggest a number of theory-driven, pretreatment and posttreatment recommendations that have good potential for enhancing ibogaine's effectiveness. The second major purpose of this review is to demonstrate, through a reanalysis of previously published results, the utility of conducting successive model fitting analyses on ibogaine treatment data. Such analyses are useful for determining both the strength and form of the association between pre-ibogaine treatment variables and post-ibogaine treatment outcomes. Finally, in order to facilitate future quantitative reviews, the authors recommend that a minimum set of patient- and treatment-related variables be included in all ibogaine publications involving human participants.