Mg-Ibogaine for Traumatic Brain Injury: A Summary

Since Nolan Williams’ (Stanford Medicine) presentation of early data and findings at the MAPS Psychedelic Science 2023 Conference in Denver, I’ve been awaiting this publication! What I was most excited and hopeful about was that this could be the first study showing a single treatment improving chronic disability from combat-related TBI, with a reduction in suicidal ideation, and improvements with as little as 1 month of treatment.

Traumatic Brain Injury (TBI) represents a considerable societal burden, both within the veteran community and the general population, underscoring the critical need for effective treatments. The impact of TBI extends beyond the immediate physical damage, affecting cognitive, emotional, and social functioning, thereby placing a significant strain on healthcare systems, families, and social support networks. Despite the prevalence and severity of TBI, current therapeutic strategies are predominantly pharmacological, aimed at managing symptoms rather than facilitating true neurological healing. This reality highlights a gap in medical science that my research fellowship sought to address (Cognitive and motor function effects of antipsychotics in traumatic brain injury: a systematic review of preclinical studies, Gabrielle Cataford, Pharm.D, Laurie-Anne Monton, Pharm.D, Stephanie Karzon, B.Sc., M.Sc., D. Williamson, et al., Hôpital du Sacré-Coeur de Montréal).

Throughout my work, I encountered a diverse array of treatments, each offering a glimpse of potential yet falling short of a comprehensive solution. The quest for an effective treatment for TBI remains a pressing issue, fueling my optimism that a breakthrough is on the horizon, promising not just symptom management but genuine recovery for those affected.

Effective therapy for Traumatic Brain Injury must integrate pharmacological interventions with mental health support, addressing not only the physical aftermath, but also the emotional trauma that often accompanies the injury. Mg-Ibogaine therapy, with its combination of medicinal treatment and integration therapy, has the potential to fulfill both these needs.

Iboga is a perennial rainforest shrub found in West Africa, in countries likes Gabon, Cameroon, and the Congo. Indigenous Peoples like the Bwiti have employed Iboga root bark in ceremonial practices for generations. During initiation rituals, iboga is consumed to enter introspective dream-like states, fostering connections with ancestors and seeking mystical revelations. The Iboga plant harbors numerous alkaloids with Ibogaine being the most renowned for its psychoactive effects.

Ibogaine is illegal in the US and much of Europe, but is legal in Mexico, Brazil, Costa Rica, South Africa, Gabon, New Zealand, and the Netherlands. However it seems that its availability varies across Canada and some European nations. It is mainly employed in the treatment of opioid and other severe drug addictions, but its use is also increasingly recognized for personal and spiritual growth. Recreational consumption of ibogaine is extremely rare. Ibogaine is more recently being researched for the treatment of Traumatic Brain Injury (TBI).

FYI: Alkaloids are a type of naturally occurring organic compound that contains basic nitrogen atoms. Alkaloids are produced by a large variety of organisms, including bacteria, fungi, plants, and animals, but they are most commonly found in plants. These compounds are known for their pharmacological effects and have been used in traditional medicine as well as modern pharmacology.

Although Ibogaine is extensively research, many other alkaloids within iboga require more understanding.

Most recent news: Colorado decriminalizes Ibogaine!

Below, you will find my summary of Magnesium–ibogaine therapy in veterans with traumatic brain injuries, published in Nature Medicine earlier this January 2024.

Study Focus: Investigated safety and efficacy of MISTIC for Special Operations Veterans (SOVs) with Traumatic Brain Injury (TBI) and repeated blast/combat exposures.

Baseline Conditions: Participants experienced high levels of disability, PTSD, depression, and anxiety.

Post-Treatment Outcomes:
-Significant reduction in psychiatric symptoms with large effect sizes.
-Benefits sustained at 1-month follow-up (this is awesome)
-Continued improvement in disability measures.
-High rates of psychiatric symptom remission and response.
-Neuropsychological Testing (NPT)

Results: Improvements in processing speed and executive function; no negative changes observed.

Safety: No serious or unexpected adverse events; management of adverse events uncomplicated.

Significance of Study:
-First study showing a single treatment improving chronic disability from combat-related TBI
-No FDA-approved treatment for chronic sequelae of combat-related TBI.
-Reduction in suicidal ideation (SI) observed, crucial given TBI's link to increased suicide risk

Contextual Findings:
Consistent with other studies showing benefits of psychedelic treatments in various psychiatric disorders.
MDMA, psilocybin, LSD, and ayahuasca shown improvements in depression and anxiety.

Study Limitations:
-Not a randomized controlled trial (RCT).
-Participants self-selected and traveled internationally for treatment.
-Possible influence of expectancy and complementary therapeutic approaches.

Challenges in Placebo-Controlled RCTs:
-Difficulty in blinding due to ibogaine's unique effects.
-NPT analysis suggests improvements not solely due to placebo.

Further Considerations:
-NPT potentially sensitive to practice effects, but measures were taken to minimize this.
-Improvements observed in cognitive domains less likely to be influenced by practice effects.

Additional Research Needed:
-Controlled studies to parse out specific therapeutic benefits.
-Long-term data to assess durability of effects.
-Study limitations include modest sample size and homogeneity of participants (mostly white men from elite military units).

Preliminary Conclusions:
-MISTIC potentially effective for transdiagnostic psychiatric symptoms post-TBI.
-Effective even years after military discharge
-Ibogaine administered safely with appropriate precautions.
-Further trials needed to confirm findings and explore broader applicability.

Study link: Mg-Ibogaine Therapy in Veterans with TBIs.

Authors: Kirsten N. Cherian, Jackob N. Keynan, Lauren Anker, Afik Faerman, Randi E. Brown, Ahmed Shamma, Or Keynan, John P. Coetzee, Jean-Marie Batail, Angela Phillips, Nicholas J. Bassano, Gregory L. Sahlem, Jose Inzunza, Trevor Millar, Jonathan Dickinson, C. E. Rolle, Jennifer Keller, Maheen Adamson, Ian H. Kratter & Nolan R. Williams.

Sources on Ibogaine:
https://maps.org/ibogaine/
https://thethirdwave.co/psychedelics/ibogaine/
https://psychedelicmedicineassociation.org/compounds/ibogaine/