Ibogaine

Abstract Ibogaine, a psychoactive indole alkaloid from the Tabernanthe iboga plant, exhibits complex pharmacokinetics, including nonlinear kinetics. With a rich history in Central African Indigenous cultures, it has spiritual and ritualistic significance, notably in the Bwiti tradition. Despite limited clinical evidence, ibogaine shows particular promise in the treatment of substance use disorder, depression, post-traumatic stress disorder, and broadly in palliative care, demonstrating sustained therapeutic effects over time. Side effects range from mild to severe, including cardiotoxicity. Dosage varies widely, and guided administration, coupled with extra-pharmacological factors, improves safety. Legal status fluctuates globally, hindering widespread acceptance. Future directions involve controlled trials, legalization efforts, and synthetic analogs such as tabernanthalog, reflecting the evolving landscape of ibogaine in medicine.