Iboga (Tabernanthe iboga)

Cardiac risk first. Ibogaine, the best-known compound from iboga, has been linked to dangerous heart rhythm problems and sudden deaths. A toxicology review reported 27 fatalities after ibogaine ingestion and 8 case reports in which ibogaine appeared to cause ventricular tachyarrhythmias and a prolonged QT interval (an electrical delay in the heartbeat) in people with no known heart condition or family history. [1] If someone has taken iboga or ibogaine and has fainting, chest pain, a racing or irregular heartbeat, seizures or trouble breathing, call 911 (US) or local emergency services. In the US, Poison Help is 1-800-222-1222: poisoning, what to do first. This page gives no preparation or use instructions and does not help identify the plant.

What it is

Tabernanthe iboga Baill. is an accepted species name in the family Apocynaceae. [2] A GOV.UK-listed forest-products chapter describes it as an understory shrub of the lowland tropical forests of the Congo Basin, with alkaloids in the root cortex, of which ibogaine is attracting the most interest. [3] A chemistry review describes the iboga alkaloids as a class first found in the roots of this plant, "a sacred plant to the people of Gabon". [4]

Plant, compound and tradition are different things

• Iboga is the plant, including the root bark that holds the alkaloids.
• Ibogaine is one isolated alkaloid. It is metabolized mainly by the CYP2D6 enzyme into noribogaine, which remains at clinically relevant concentrations for days. [1] See ibogaine: compound guide and iboga vs ibogaine.
• Bwiti is a religious tradition. The forest-products chapter links it to Gabon, Equatorial Guinea and southern Cameroon. [3] Taking an isolated compound in a clinic or alone is not the same as the tradition. See Iboga and Bwiti traditions.

NIDA groups ibogaine with drugs that, while having psychedelic properties, affect a different spectrum of brain activity than classic psychedelics. [5]

Cultural significance and conservation

A Chacruna Institute article describes iboga as a cultural keystone species integral to Bwiti, practiced in Gabon and to a lesser extent in other Central African countries. We do not describe ceremonies. The same article reports concerns about sustainability from rising demand, deforestation and difficult political and economic conditions. It states that the IUCN Red List lists the species as "least concern", but that detailed biological assessments are not available. It also reports that Gabon declared iboga a national treasure in 2000 and, as of 2019, restricted its export. [6] The forest-products chapter likewise says there were no official data on harvesting or trade and that sustainability had been questioned. [3] What this means: outside demand can affect a plant that matters to specific communities. See Indigenous traditions, ethics and conservation.

What research shows

Evidence labels: promising but limited, insufficient evidence, preclinical (cells or animals only), evidence of harm. Most research concerns purified ibogaine, not the plant or traditional preparations.

• Substance use disorders: promising but limited. A systematic review of 24 studies including 705 people given ibogaine or noribogaine found two randomized double-blind trials, one other double-blind controlled trial and 17 open-label studies or case series. The authors say the data suggest benefit for withdrawal and craving, but they also report severe medical complications and deaths linked to heart and nervous system toxicity, and call for rigorous studies in medical settings. [7] Open-label designs have no blinded comparison group.
• Veterans with brain injury: insufficient evidence. An open-label study of 30 special operations veterans gave ibogaine with magnesium and reported improved disability, PTSD, depression and anxiety scores at one month and no unexpected or serious adverse events. Authors call for controlled trials. [8]
• Funding note. The author of an invited review that describes open-label benefit discloses patents on an ibogaine metabolite and ownership in a company developing ibogaine. [9]
• Neurotoxicity: preclinical. Rat studies showed damage to cerebellar cells, and relevance to people is unclear. [1]
• Iboga plant or root bark as a treatment: Proper evidence not found in the controlled studies we read.

Risks and who should be especially careful

• Deaths. A forensic review of 19 deaths between 1.5 and 76 hours after ibogaine found that existing medical problems, mainly cardiovascular, or other substances explained or contributed to death in 12 of 14 cases with enough data. [10]
• Poison service data. Over ten years, the UK National Poisons Information Service received enquiries about seven patients; all had symptoms and six showed signs of heart toxicity, including cardiac arrest and torsades de pointes. Four had taken the root bark. [11]
• Medicines. CYP2D6 differences can change ibogaine blood levels, which matters with other medicines that use the same enzyme. [1] See how interactions work.
• Quality. Reviewers note that people still use iboga extract, root scrapings and ibogaine hydrochloride with limited medical supervision, calling these "risky experiments". [1] We found no analytical data on products and give no content figure.
• Pregnancy, children, other conditions: Proper evidence not found specific to iboga in the sources we read. Support for drug or alcohol problems: substance use support and urgent help.

Legal status

Not legal advice; laws change. In the United States, ibogaine, with the plant name Tabernanthe iboga listed as an alternate name, is on the federal Schedule I list. [12] In the UK, ibogaine is described as not licensed. [11] Gabon's export restriction is reported above. Other countries: not verified. See legal status by country.