Ibogaine — Dissociative psychedelic / sigma-1 agonist / NMDA antagonist / opioid receptor modulator

The Stanford 2023 study by Nayak et al. (Nature Medicine) was landmark — veterans with TBI and PTSD showed dramatic improvements in PTSD scores, anxiety, and disability at 1-month follow-up after single ibogaine treatment. This is not purely addiction medicine; neurological benefits are being actively investigated. The cardiac risk is the primary barrier to widespread use — every ibogaine provider must have cardiac resuscitation capacity.

Overview

This page is part of Hormonaly's evidence-graded compound library. All clinical claims are linked to peer-reviewed sources via our dual-layer citation verification pipeline.

Compound Class

Dissociative psychedelic / sigma-1 agonist / NMDA antagonist / opioid receptor modulator

Mechanism of Action

Multi-target: NMDA antagonism (anti-addictive memory extinction), kappa-opioid receptor agonism (dysphoric purge), sigma-1 receptor agonism (neuroprotection), serotonin transporter inhibition, and noribogaine (active metabolite) binds opioid receptors for 48-72h providing extended anti-craving effect. FDA Breakthrough Therapy designation for opioid use disorder (2023). The noribogaine metabolite provides days-long afterglow that consolidates addiction interruption. Mechanism is distinct from all other addiction treatments.

Regulatory Status

Schedule I USA; legal medical use in Mexico, Netherlands, some other countries; FDA Breakthrough designation allows IND trials

Evidence Level

Moderate — Stanford 2023 (n=30) showed 80% success in opioid detox; FDA Breakthrough 2023; Phase 2 trials ongoing