Ibogaine is the primary alkaloid in Tabernanthe iboga root bark. It’s a perennial plant native to the tropical rainforests of West Central Africa. It has been used in traditional African medicine for centuries. It induces profound mental, emotional, and spiritual experiences. In the West, it has been more recently recognized for its well-established anti-addictive properties. Numerous studies link ibogaine administration with reductions in drug cravings, in symptoms of withdrawal, and in return to opioid use (Barsuglia et al., 2018; Mash, 2023). The benefits it offers to reduce opioid addiction are likely related to the complex actions of ibogaine at the brain’s opioid receptors.
Ibogaine has truly revolutionized the treatment of opioid addiction. Multiple open-label trials of hundreds of patients have discovered that a single dose administration of ibogaine reduced the use of prescription opioids and heroin. A single administration of ibogaine reduced opioid craving, insomnia, and depressed mood for several weeks after treatment. Ibogaine also reduced the major symptoms of opioid withdrawal.
What Other Conditions Might Ibogaine Treat?
Some recent studies suggest that ibogaine might also reduce the symptoms of post-traumatic stress disorder, multiple sclerosis (MS), neuropathic pain disorder, traumatic brain injury, and Parkinson’s disease. I know that such a broad list of potential effects suggests that ibogaine is too good to be true. Ibogaines beneficial effects, if they can be substantiated, might be explained by the ability of ibogaine to act on so many different neurotransmitter systems in the brain, including glutamate, serotonin, Sigma receptors, and acetylcholine nicotinic receptors.
A recent article focused on the potential mechanisms that allow ibogaine to facilitate remyelination and lead to improved clinical outcomes in MS and opioid use disorder.
Recent research has discovered that ibogaine can upregulate protein and gene expression in MS patients leading to the remyelination of white matter as well as facilitate its repair. Patients with MS lose their white matter, which is called a myelin sheath and is made by specialized cells in the brain. The loss of the myelin sheath around axons underlies the array of symptoms associated with MS. The loss of the myelin sheath leads to the failure of some nerve fibers throughout the brain and body to carry electrical signals to their targets. The absence of electrical signals in vulnerable pathways causes MS patients to suffer with clumsiness, loss of balance and coordination, difficulty with cognitive function, muscle stiffness and muscle spasm, and vision changes.
Opioids are particularly harmful to the white matter in the brain. Chronic opioid administration reduces the levels of proteins that are critical to the health of myelin. In humans, the extent of white matter damage worsens with an increase in the duration of exposure to opioids. Unfortunately, any opioid is capable of producing damage—even methadone, which is used during most addiction recovery therapies. Long-term heroin use produces a spongiform degeneration of white matter characterized by large vacuoles and axonal spheroids that indicate the loss of myelin, astrocytes, and oligodendrocytes.
In Summary
Numerous clinical trials indicate that ibogaine can upregulate markers of myelination under conditions of both opioid use disorder or MS. Ibogaine’s ability to produce these beneficial changes in the brain depend upon its complex actions at multiple neurotransmitter receptors. These complex actions reduce the glutamate toxicity and correct some metabolic processes leading to long-lasting neuroplasticity that facilitates neuronal repair and remyelination. Ibogaine joins a growing list of psychedelic drugs that have been discovered to potentially produce beneficial effects on brain health and mood.