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Identifying setting factors associated with improved ibogaine safety: a systematic review of clinical studies

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Abstract

Ibogaine is a psychoactive alkaloid derived from the west-African shrub Tabernanthe iboga. Western cultures are increasing the interest for the substance due to its claimed anti addictive properties, although the evidence supporting this effect is still preliminary. The use of ibogaine often occurs with no medical supervision in uncontrolled settings, and its use has been associated with several reports of severe adverse events. This review aims to evaluate the clinical studies of ibogaine, with a focus on administration settings, to elucidate specific criteria that may promote safer contexts for ibogaine use. A systematic review of the literature was conducted based on PRISMA guidelines. PubMed, Scielo, ClinicalTrials.gov and Core.ac.uk electronic databases were searched, and clinical studies published until November 17, 2022, were retrieved. The final synthesis included 12 sources. Information about general characteristics of the studies, adverse effects, screening of participants and setting characteristics were summarized and discussed. It is concluded that the use of controlled settings, supported by trained professionals and equipment allowing for rigorous medical, psychiatric, and cardiac monitoring, are essential to promote the safety of patients receiving ibogaine.

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Funding

This research was conducted at the Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. JMR and JASR received funding from CAPES, Brazil. JEH is recipient of CNPq (Brazil) 1A productivity fellowship. RGS is Fellow of the Programa Nacional de Pós-Doutorado, Brazil (PNPD/CAPES). Research was supported in part by grants from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).

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Authors and Affiliations

  1. Department of Neuroscience and Behavior, Faculdade de Medicina de Ribeirão Preto, RibeirãoPreto Medical School, University of São Paulo, Hospital das Clínicas, Terceiro Andar, Av. Bandeirantes, 3900, Ribeirão Preto, São Paulo, SP, Brazil

    Juliana Mendes Rocha, José A. S. Reis, José Carlos Bouso, Jaime E. C. Hallak & Rafael G. dos Santos

  2. International Center for Ethnobotanical Education, Research, and Service (ICEERS), Barcelona, Spain

    José Carlos Bouso, Jaime E. C. Hallak & Rafael G. dos Santos

  3. Department of Psychology and Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Tarragona, Spain

    José Carlos Bouso

  4. National Institute for Translational Medicine (INCT-TM), CNPq, Ribeirão Preto-São Paulo, Brazil

    Jaime E. C. Hallak & Rafael G. dos Santos

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  1. Juliana Mendes Rocha
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  2. José A. S. Reis
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  4. Jaime E. C. Hallak
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  5. Rafael G. dos Santos
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Correspondence to Rafael G. dos Santos.

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Rocha, J.M., Reis, J.A.S., Bouso, J.C. et al. Identifying setting factors associated with improved ibogaine safety: a systematic review of clinical studies. Eur Arch Psychiatry Clin Neurosci 273, 1527–1542 (2023). https://doi.org/10.1007/s00406-023-01590-1

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