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Meta-Analysis
. 2023;21(11):2178-2194.
doi: 10.2174/1570159X21666221017085612.

Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: A Systematic Review of the Current Literature

Alessio Mosca  1 , Stefania Chiappini  1   2 , Andrea Miuli  1 , Gianluca Mancusi  1 , Maria Chiara Santovito  1 , Francesco Di Carlo  1 , Mauro Pettorruso  1 , John M Corkery  2 , Carlos Canessa  3 , Giovanni Martinotti  1   2 , Massimo Di Giannantonio  1
Affiliations
Meta-Analysis

Ibogaine/Noribogaine in the Treatment of Substance Use Disorders: A Systematic Review of the Current Literature

Alessio Mosca et al. Curr Neuropharmacol. 2023.

Abstract

Background: Ibogaine and noribogaine are psychedelic substances with dissociative properties naturally occurring in plants of the Apocynaceae family. Research has shown their efficacy in treating substance use disorders (SUD), particularly in opiate detoxification, but their efficacy and toxicity are still unclear.

Objective: This review aims to assess the anti-addictive role of ibogaine and evaluate its side effects.

Methods: A systematic literature review was conducted on the 29th of November 2021 using PubMed, Scopus and Web of Science databases through the following search strategy: ("Ibogaine" OR "Noribogaine") AND ("SUD" OR "substance use disorder" OR "craving" OR "abstinence" OR "withdrawal" OR "addiction" OR "detoxification") NOT animal NOT review NOT "vitro." The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed for data gathering purposes. Research methods were registered on PROSPERO (CRD42021287034).

Results: Thirty-one articles were selected for the systematic revision, and two were considered for analysis. The results were organised according to the type of study: case reports/case series, randomised- controlled trials (RCTs), open-label, survey and observational studies. The main outcomes were related to the anti-addictive effect of ibogaine and its cardiac toxicity. A meta-analysis of side effects was conducted using RevMan 5.4 software, showing a significant risk of developing headaches after ibogaine/noribogaine treatment.

Conclusion: The results show some efficacy of ibogaine in the treatment of SUDs, but its cardiotoxicity and mortality are worrying. Further studies are needed to assess its therapeutic efficacy and actual safety.

Keywords: Ibogaine; addiction; noribogaine; psychedelics; substance use disorder; withdrawal symptoms.

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Conflict of interest statement

J.C. is a member of the UK’s Advisory Council on the Misuse of Drugs’ Novel Psychoactive Substances and Technical Committees. G.M. has been a consultant and/or a speaker and/or has received research grants from Angelini, Doc Generici, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Servier and Recordati. A.M., S.C., F.D.C., G.Ma., M.P., A.Mi., and C.C. have nothing to declare. M.D.G. has been a consultant and/or a speaker and/or has received research grants from Angelini, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, Servier, and Recordati..

Figures

Fig. (1)
Fig. (1)
PRISMA flow diagram.
Fig. (2)
Fig. (2)
Forest plot: Risk of developing nausea after ibogaine treatment in SUD.
Fig. (3)
Fig. (3)
Forest plot: Risk to develop visual impairment after ibogaine treatment in SUD.
Fig. (4)
Fig. (4)
Forest plot: Risk to develop a headache after ibogaine treatment in SUD.
Fig. (5)
Fig. (5)
Funnel plot for publication bias (headache).
Fig. (6)
Fig. (6)
Funnel plot for publication bias (nausea).
See this image and copyright information in PMC

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