Rankings / Mood, Anxiety & Stress
Ibogaine
Mood, Anxiety & Stress · Iboga alkaloid / NMDA antagonist + kappa-opioid
Tier C-
High-risk evidence profile
Bottom line
Read Off Label grades Ibogaine as C- (4.0/10) based on weak-moderate evidence, high benefit magnitude, and a high-risk safety profile.
Its high-risk evidence profile reflects a Safety score of 2/10; reported benefits and harms can differ by indication, dose, route, duration, and population.
Highly cardiotoxic — real deaths from treatment-related arrhythmias.
Studied, labeled, or reported-use context: 10-25 mg/kg for opioid detox in clinic settings (medically supervised) — Schedule I US; legal in Mexico, Costa Rica, Portugal, some other countries; Gabon/Cameroon sacrament; not individualized guidance.
What the evidence says
Highly cardiotoxic — real deaths from treatment-related arrhythmias. Requires ECG monitoring, exclusion of QT-prolonging meds, crash cart. Kentucky 2024 approved funding research for opioid use disorder. Stanford Nolan Williams 2024 TBI study in Special Forces veterans showed striking symptom improvements. Unsupervised exposure has produced fatal arrhythmias; clinical protocols use ECG screening and continuous monitoring.
Mechanism
Multi-target: NMDA antagonism, kappa-opioid agonism, nicotinic antagonism, sigma-2 activity; active metabolite noribogaine; used for opioid dependence interruption
Studied, labeled, or reported dose & route
10-25 mg/kg for opioid detox in clinic settings (medically supervised)
This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.
Citations
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Common questions
- What does the evidence show about Ibogaine's effects?
- Read Off Label rates the evidence for Ibogaine as Weak-Moderate and the benefit magnitude as high, producing an overall grade of C- (4.0/10). Highly cardiotoxic — real deaths from treatment-related arrhythmias.
- What safety findings are reported for Ibogaine?
- Ibogaine has a high risk profile in the database. HIGH (cardiotoxicity — QT prolongation, deaths from arrhythmia; extensive drug interactions; several days of intense psychedelic experience) Legal status: Schedule I US; legal in Mexico, Costa Rica, Portugal, some other countries; Gabon/Cameroon sacrament.
- What does the low Safety score for Ibogaine represent?
- The Safety score is 2/10. It records the substantial harms described for one or more use contexts; the Benefit score, indication, dose, route, duration, population, and legal status remain separate parts of the evidence profile.
- What doses or routes are reported for Ibogaine?
- 10-25 mg/kg for opioid detox in clinic settings (medically supervised) This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
- How does Ibogaine work?
- Multi-target: NMDA antagonism, kappa-opioid agonism, nicotinic antagonism, sigma-2 activity; active metabolite noribogaine; used for opioid dependence interruption
This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.