Fatalities Temporally Associated with the Ingestion of Ibogaine

Kenneth Alper, M.D

Ibogaine is a naturally occurring psychoactive plant alkaloid that is used globally in medical and nonmedical settings for opioid detoxification and other substance use indications. All available autopsy, toxicological, and investigative reports were systematically reviewed for the consecutive series of all known fatalities outside of West Central Africa temporally related to the use of ibogaine from 1990 through 2008. Nineteen individuals (15 men, four women between 24 and 54 years old) are known to have died within 1.5–76 h of taking ibogaine. The clinical and postmortem evidence did not suggest a characteristic syndrome of neurotoxicity. Advanced preexisting medical comorbidities, which were mainly cardiovascular, and/or one or more commonly abused substances explained or contributed to the death in 12 of the 14 cases for which adequate postmortem data were available. Other apparent risk factors include seizures associated with withdrawal from alcohol and benzodiazepines and the uninformed use of ethnopharmacological forms of ibogaine.


Kenneth Alper, M.D. is an Associate Professor of Psychiatry and Neurology at the New York University School of Medicine. He is an author of over 70 peer-reviewed publications, books and book chapters. Dr. Alper is the first editor of the only English language text on ibogaine, and organized and led an international conference on ibogaine at the NYU School of Medicine. His research on ibogaine and the iboga alkaloids has combined psychopharmacology and the methodology of medical ethnography. He coauthored multiple papers with Howard Lotsof, including a frequently cited case series on the use of ibogaine for the indication of heroin detoxification and a comprehensive description of the global settings of the use of ibogaine published in the Journal of Ethnopharmacology. Heffter Research Institute has recognized Dr. Alper’s work on ibogaine with its Public Service Award.

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