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Ibogaine in the Treatment of Heroin Withdrawal (2001)

Ibogaine in the Treatment of Heroin Withdrawal (2001)

  1. Jatelka
    The Alkaloids. Chemistry and biology, 2001, Vol.56, pp.155-71

    Mash, D C ; Kovera, C A ; Pablo, J ; Tyndale, R ; Ervin, F R ; Kamlet, J D ; Hearn, W L


    Ibogaine, is a naturally occurring, psychoactive indole alkaloid derived from the roots of the rain forest shrub Tabernanthe iboga. Indigenous peoples of Western Africa use ibogaine in low doses to combat fatigue, hunger, and thirst, and in higher doses as a sacrament in religious rituals (1). The use of ibogaine for the treatment of drug dependence has been based on anecdotal reports from groups of self-treating addicts that the drug blocked opiate withdrawal and reduced craving for opiates and other illicit drugs for extended time periods (2-4). Preclinical studies have supported these claims and provided proof-of-concept in morphine-dependent rats (5,6). While ibogaine has diverse CNS effects, the pharmacological targets underlying the physiological and psychological actions of ibogaine in general, or its effects on opiate withdrawal in particular, are not fully understood. Pharmacological treatments for heroin addiction currently employ two treatment strategies: detoxification followed by drug-free abstinence or maintenance treatment with an opioid agonist. Because agonist maintenance with methadone usually has the goal of eventual detoxification to a drug-free state, the use of medications to facilitate this transition is a clinically important treatment strategy. Anecdotal reports suggest that ibogaine has promise as an alternative medication approach for making this transition (4). Ibogaine has an added benefit to other detoxification strategies in that the treatment experience seems to bolster the patient’s own motivational resources for change.