Ibogaine: Ibogaine therapy as a method of care treatment for opioid dependence

Abstract

Abstract Ibogaine has been used as a botanical preparation from the root bark of Tabernanthe iboga for over one hundred years, both as a crude preparation and as semisynthetic ibogaine. Extracts derived from this plant have a long history of traditional medicinal and ceremonial use in Western Africa. Ibogaine is a polypharmacology drug that acts on several neurotransmitter systems, including biogenic amines (dopamine and serotonin [5-HT]), and peptidergic (opioid), cholinergic (neuronal nicotinic), and glutamatergic systems. The UK Medicines and Healthcare Products Regulatory Agency (MHRA) recently granted approval to commence subject enrolment in a Phase 1/2a clinical trial of ibogaine. The Phase 1 part of the study will provide an assessment of safety at escalating doses of ibogaine, while the randomized, placebo-controlled Phase 2 part of the study is designed to provide proof of concept in patients who seek to detoxify from opioids. While there are no other ongoing GLP clinical trials in the United States or elsewhere, there is a large amount of information on the clinical use of ibogaine. These reports demonstrate that the drug not only helps manage the physical symptoms of opioid withdrawal, but also the behavioural aspects of addiction that drive relapse.