Ibogaine Adverse effects
One of the first noticeable effects of large-dose ibogaine ingestion is ataxia, a difficulty in coordinating muscle motion which makes standing and walking difficult without assistance. Xerostomia (dry mouth), nausea, and vomiting may follow. These symptoms may be long in duration, ranging from 4 to 24 hours in some cases. Ibogaine is sometimes administered per rectum to avoid nausea and vomiting.
Ibogaine causes long QT syndrome at therapeutic doses, apparently by blocking hERG potassium channels in the heart.
Work in the laboratory of Mark Molliver at Johns Hopkins indicated degeneration of cerebellar Purkinje cells observed in rats given substantially larger dosages of ibogaine than those used to study drug self-administration and withdrawal. However, subsequent research found no evidence of neurotoxicity in the primate or mouse at dosages that produced cerebellar degeneration in the rat, and it has been suggested that cerebellar degeneration might be a phenomenon limited to a single species. The FDA was aware of Molliver’s work at the time it approved a Phase 1 study in which humans received ibogaine in 1993. Neuropsychological examination revealed no evidence of degenerative changes in a woman who had received four separate doses of ibogaine ranging between 10 and 30 mg kg over a 15-month interval before her death due to a mesenteric artery thrombosis with small bowel infarction 25 days after her last ingestion of ibogaine. A published series of fatalities temporally associated with the ingestion of ibogaine found no evidence suggesting a characteristic syndrome of neurotoxicity.