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Drug Interactions of Ibogaine

Ibogaine History:
Ibogaine is obtained from herb iboga which is commonly found in western African countries. It is a very costly treatment. In these countries, it was used in their old traditional rituals for the sake of spiritual discovery because it’s a brain stimulant so it causes some near to death condition which is considered as spiritual discovery by the natives.
Mechanism of action:
Ibogaine mechanism of action is not clear but some of its actions are as follows:
Blocking serotonin transporter:
Ibogaine blocks the reabsorption of serotonin from the transporters of serotonin which is quite similar to the action of antidepressants.
Blocking dopamine transporter:
Ibogaine blocks dopamine transporter which results in a higher level of dopamine in the body.
Blocking nicotinic acetylcholine receptor:
Blocking nicotinic acetylcholine receptor it maintains a healthy level of acetylcholine for a long period of time in the body.
Blocking the NDMA receptor:
Ibogaine blocks the NDMA receptor which is responsible for hallucinations.
Effect on Opioid receptor:
It does not block the opioid receptor and because of this it does not cause a reduction in pain but it enhance the pain-relieving effect of opioids.
Drug Interactions of Ibogaine
Ibogaine is metabolized and excreted by liver majorly so it has a lot of drug-drug interactions and drug-food interactions. Ibogaine is metabolized by liver enzyme cytochrome p450 which is responsible for the metabolism of a large number of drugs and food items.
Drug interaction with anticholinergic drugs:
Anticholinergic drug effects can be decreased by the intake of ibogaine that’s because ibogaine also has some effects on the brain and heart. One of the common side effects of ibogaine is xerostomia and anticholinergic also causes dryness of mouth so it can cause a synergistic effect. So anticholinergic drugs like atropine and other antidepressants should be used with caution in patients taking ibogaine.
Drug interactions with Cholinergic drugs:
Ibogaine has some similar effects like Cholinergic drugs so it can cause elevated side effects or possible synergism when Cholinergic drugs and ibogaine are taken together
Drug interaction with anti-arrhythmia drugs:
Ibogaine causes arrhythmias so when taken with anti-arrhythmic drugs like metoprolol, propafenone causes an interaction and the effect of anti-arrhythmic drugs will be minimized.
Drug interactions with antipsychotics and antidepressant:
Ibogaine causes brain stimulation so whenever it is used with any drug which affects the brain it will cause interaction.
Some common drugs which have interaction with ibogaine:
Anti-arrhythmic drugs like timolol malate, propafenone
Antidepressants like duloxetine, escitalopram, desipramine, paroxetine
Antipsychotics like pimozide, risperidone.
Side effects of Ibogaine:
Ibogaine can cause a number of side effects when it is being taken in high quantities through the mouth.
Effect on Heart:
On a high intake of a dose, it can cause irregular heartbeat, arrhythmias,
Dryness of mouth:
It can cause dryness of mouth called xerostomia.
A very common side effect of ibogaine is the ataxia which is actually the uncontrolled movement of muscles which makes it difficult to stand and walk properly.
Sudden death:
A number of fatalities have occurred in patients with heart or liver disease.

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