Identifying setting factors associated with improved ibogaine safety: a systematic review of clinical studies.

Ibogaine, a psychoactive alkaloid from the west-African shrub Tabernanthe iboga, is increasingly sought in Western cultures for its claimed anti-addictive properties, though evidence remains preliminary. Its use often occurs without medical supervision in uncontrolled settings and has been linked to severe adverse events. This systematic review evaluated clinical studies of ibogaine, focusing on administration settings to identify criteria promoting safer use. Following PRISMA guidelines, searches in PubMed, Scielo, ClinicalTrials.gov, and Core.ac.uk retrieved clinical studies published through November 17, 2022; 12 sources were synthesized. The review concludes that controlled settings with trained professionals and equipment for rigorous medical, psychiatric, and cardiac monitoring are essential for patient safety.

Study at a glance

Abstract

Ibogaine is a psychoactive alkaloid derived from the west-African shrub Tabernanthe iboga. Western cultures are increasing the interest for the substance due to its claimed anti addictive properties, although the evidence supporting this effect is still preliminary. The use of ibogaine often occurs with no medical supervision in uncontrolled settings, and its use has been associated with several reports of severe adverse events. This review aims to evaluate the clinical studies of ibogaine, with a focus on administration settings, to elucidate specific criteria that may promote safer contexts for ibogaine use. A systematic review of the literature was conducted based on PRISMA guidelines. PubMed, Scielo, ClinicalTrials.gov and Core.ac.uk electronic databases were searched, and clinical studies published until November 17, 2022, were retrieved. The final synthesis included 12 sources. Information about general characteristics of the studies, adverse effects, screening of participants and setting characteristics were summarized and discussed. It is concluded that the use of controlled settings, supported by trained professionals and equipment allowing for rigorous medical, psychiatric, and cardiac monitoring, are essential to promote the safety of patients receiving ibogaine.