The drug company Atai Life Sciences is spending millions to research the compound, and congressional lawmakers from both parties are pushing the government to advance research into ibogaine for substance abuse, post-traumatic stress disorder and other health problems of mind
For Dr. Deborah Mash, a professor of neurology at University of Miami who started studying ibogaine in the early 1990s, the rising interest was a validation of his belief that the compound could help alleviate the opioid crisis. “Ibogaine is not a silver bullet, and it won’t work for everyone, but it’s the most powerful addiction interrupter I’ve ever seen,” he said.
Researchers are also studying ibogaine’s ability to treat other difficult mental health problems. One small study published earlier this year in the journal Nature Medicine found that military veterans with traumatic brain injuries who underwent a session of ibogaine therapy experienced marked improvements in disability, psychiatric symptoms and cognition.
No adverse effects were reported in the 30 study participants, who were followed for one month. There was no control group.
Dr. Nolan Williams, the study’s lead author, said the results are especially noteworthy given the lack of treatment options for traumatic brain injuries.
“These are the most dramatic drug effects I’ve seen in an observational study,” said Dr. Williams, who is the director of Brain Stimulation Lab at Stanford University.
He and other researchers are quick to recognize the limitations of the existing science on ibogaine therapy. “Without a greenlight to conduct studies from the FDA, you can’t do the kind of randomized trials that are the gold standard for clinical studies,” said Dr. Williams.
Ibogaine is known to induce arrhythmia, or an irregular heartbeat, which in severe cases can lead to fatal cardiac arrest.
Other researchers are more skeptical of its potential as a widely accessible anti-addiction therapy. William Stoops, a professor of behavioral science at the University of Kentucky who specializes in substance use disorders, said ibogaine’s heart risks make it a poor candidate for regulatory consideration.
Even if ibogaine were to receive approval from the Food and Drug Administration, the deteriorating health of many long-term opioid users, many of whom have cardiovascular problems, would make them ineligible for treatment. , said Dr. Stoops. And the high cost of administering ibogaine in a medically supervised setting will further reduce the pool of potential patients, he added. “Access will be restricted to how many people can benefit?” he asked.
The National Institute on Drug Abuse, part of the National Institutes of Health, has begun funding study (those are not trials involving humans) with ibogaine analogues, chemically related compounds that can provide therapeutic benefits without health risks. The director of the agency, Dr. Nora Volkow, who has long been intrigued by ibogaine’s anti-addiction potential — and wary of its heart risks.
But current treatments for opioid use disorder, such as methadone and buprenorphine, aren’t perfect, he says, and half of all patients stop taking them after six months.
“In addition to existing effective drugs, there is a need for treatment options other than those we currently have,” said Dr. Volkow. “We need to disrupt the way we do things and explore what science is showing us.”
The FDA said it could not comment on whether it would support future ibogaine studies, noting that federal law prohibits the agency from commenting on prospective ones. investigation of drug applications.
