Ibogaine therapy

What ibogaine is

Ibogaine is an indole alkaloid extracted from the root bark of Tabernanthe iboga, a shrub native to Central West Africa. In traditional Bwiti practice it is used in initiatory and healing ceremonies at doses measured in grams. In modern clinical use it is typically administered as a single oral dose in the range of 10–20 mg/kg, producing a 24–36 hour experience with visionary content in the first ~8 hours followed by a prolonged reflective phase.

Mechanistically ibogaine is unusual: it interacts with NMDA, sigma-1, kappa-opioid, and serotonergic receptors, and increases expression of glial-cell-line-derived neurotrophic factor (GDNF). Its metabolite noribogaine has a long half-life (days) and is likely responsible for much of the post-dose anti-addictive effect.

Why ibogaine is different from other psychedelics

1. Indication: The strongest signal is in opioid use disorder — specifically, in dramatically reducing withdrawal symptoms and eliminating or blunting craving. No other psychedelic has this profile.
2. Duration: 24–36 hours of physical and psychological effect — far longer than psilocybin or MDMA, longer than ketamine, and fundamentally different from the 15–30 minute course of 5-MeO-DMT.
3. Cardiac risk: Ibogaine prolongs the cardiac QT interval, which can trigger torsades de pointes and sudden cardiac death. This is the defining safety issue of the field.

The evidence

Opioid use disorder

The clinical case for ibogaine in OUD rests largely on observational data from the Mexican and Costa Rican clinic environments, and a small number of FDA-authorized trials.

• Mash et al. (Freedom Centers program, 2018): open-label observational, 191 patients; 80% relapse-free at 1 month, with sustained improvement in depression and craving scores.
• Davis et al. (University of Miami, 2017, 2018): retrospective studies of 88 former patients, reporting reductions in opioid withdrawal and sustained abstinence rates beyond typical MAT benchmarks.
• Malcolm et al. (2018 meta-review): concluded that observational evidence is compelling but randomized controlled data are essentially absent — the situation SB 2308 / Texas IMPACT is designed to change.

Traumatic brain injury and PTSD (2024 Stanford data)

The Stanford MISTIC study (Magnesium-Ibogaine: The Stanford Traumatic Injury to the CNS protocol) was the pivot point for mainstream scientific interest. Cherian et al., published in Nature Medicine in January 2024, evaluated 30 US special operations veterans with a history of traumatic brain injury and repeated blast exposure. Participants received oral ibogaine plus intravenous magnesium at a clinic in Mexico run by Ambio Life Sciences, with pre- and post-treatment assessments at Stanford.¹

Key findings at one-month follow-up:

• PTSD symptoms reduced by 88%.
• Depression symptoms reduced by 87%.
• Anxiety symptoms reduced by 81%.
• Disability (WHODAS 2.0) improved from 30.2 (mild-to-moderate) to 5.1 (no disability).
• No serious cardiac adverse events — no bradycardia, tachycardia, clinically meaningful QT prolongation, or hemodynamic instability.

The magnesium co-administration is the key safety innovation — drawing on the Glick/Mash work that intravenous magnesium may buffer the QT-prolonging effect of ibogaine. The MISTIC protocol is being extended into larger trials.

Cardiac safety: the central issue

Responsible clinical practice today includes:

• 12-lead ECG before dosing; exclusion if baseline QTc is abnormal.
• Serum potassium and magnesium correction to mid-normal range before dosing.
• Intravenous magnesium co-administration (the MISTIC / Ambio protocol).
• Continuous cardiac monitoring during the first ~12 hours.
• Medical staff with ACLS-level training on site.

Participants are typically also screened for liver function, prior cardiac history, and medication interactions (particularly methadone, which itself prolongs QT and is typically converted to short-acting opioids well before dosing).

Legal status and the Texas IMPACT program

Ibogaine is Schedule I in the United States — no accepted medical use at the federal level. Research requires FDA IND authorization plus DEA Schedule I registration.

Texas appropriated $50 million in June 2025 via Senate Bill 2308, which Gov. Abbott signed at the Capitol on June 11. In December 2025, UTHealth Houston and UT Medical Branch at Galveston were announced as co-leads of the IMPACT (Ibogaine Medicine for PTSD, Addiction, and Cognitive Trauma) consortium, joining Baylor, UT Austin, Texas Tech, Texas A&M, and other institutions. The program will pursue FDA-authorized trials in opioid use disorder (UTHealth/UTMB), TBI (Baylor/UT Austin), and PTSD.²

Other state activity includes Arizona (HB 2871, $5M for ibogaine neuroscience research), Kentucky (2024 legislative interest ultimately not funded), and exploratory discussions in Colorado, Ohio, and West Virginia.

Internationally, ibogaine is unscheduled or permitted for medical use in several jurisdictions, including Mexico, Canada, New Zealand (regulated medicine since 2010), South Africa, and several European countries.

Active clinical trials

As of 2026 the main FDA-sanctioned programs are:

• Stanford MISTIC extension — magnesium-ibogaine for TBI/PTSD, expanding to ~120 participants.
• Texas IMPACT (consortium) — large-scale Phase 1/2 in multiple indications; enrollment 2026–2028.
• DemeRx DMX-1002 (ibogaine hydrochloride) — Phase 1/2a for opioid withdrawal, conducted in the United Kingdom.
• atai IBX-210 — IV ibogaine formulation in pre-Phase 1b development.
• ICEERS / Spain — ibogaine HCl for methadone-dependent patients, Phase 2.

How to actually access it

Clinical trials in the US. Check ClinicalTrials.gov for Texas IMPACT sites as they come online, and for any open Stanford MISTIC arms.

International clinics. The most-cited operators with medical infrastructure include Ambio Life Sciences (Mexico), Beond Ibogaine (Mexico), Clear Sky Recovery (Mexico), and Iboga Quest (Mexico). Cost typically ranges $6,000–$15,000+ per treatment. Verify in advance: pre-dose cardiac workup, on-site ACLS, magnesium protocol, medical staff credentials, and post-treatment integration.

Avoid categorically: any operator offering ibogaine without ECG screening, without on-site medical staff, with methadone-dependent patients not converted to short-acting opioids before dosing, or combining ibogaine with other psychedelics in a single session.

Preparation & integration

The post-ibogaine window — particularly the first 3–7 days after acute effects resolve — is characterized by low craving and unusual psychological openness, and is also when relapse risk re-emerges if structural supports are absent. Credible programs pair ibogaine with post-dose integration therapy and, for OUD patients, with transitions to longer-term treatment (naltrexone, peer support). See the integration therapy guide.