Single case report: ibogaine treatment followed by 17 months off ketamine, cocaine and alcohol

The question

Can ibogaine, a plant-derived psychoactive compound, help someone with severe ketamine dependence stop using and stay stopped?

What they did

Doctors describe one 30-year-old man with a five-year history of heavy polysubstance use, including 2-3 grams of intranasal ketamine per day, plus cocaine and alcohol, alongside recurrent depression. Standard psychiatric treatment had not relieved his cravings. He took part in a 13-day residential program in Mexico where he received an 800 mg dose of ibogaine hydrochloride (10.1 mg/kg) plus two later 300 mg doses (3.8 mg/kg), with continuous medical and heart-rhythm (ECG) monitoring. He was followed for about 17 months with repeated drug tests and standard questionnaires, and received a further supervised ibogaine intervention about 11 months after the first.

What they found

The man reported that cravings for all substances stopped immediately after treatment. Over roughly 17 months of follow-up, repeated toxicology tests and questionnaires were consistent with continued abstinence from ketamine, cocaine, alcohol and other substances he had previously misused. His depression scores on the PHQ-9 questionnaire were in the 0-3 range, anxiety improved, and his quality-of-life score on the WHOQOL-BREF rose from 55 to 71. The authors say this is the first case of sustained abstinence in severe ketamine use disorder after ibogaine to be documented over time with repeated objective testing.

The fine print

This is one person, with no control group, no placebo and no blinding, so there is no way to separate the drug’s effect from motivation, the residential program, or the ongoing support he received. He also had a second ibogaine intervention partway through follow-up, which complicates interpretation. Ibogaine carries known heart-rhythm risks, which is why ECG monitoring was used; a single successful case says nothing about how often harms occur. This summary is based on the published abstract only.

What it means

A detailed single case suggests ibogaine is worth formally testing for ketamine dependence, but one person’s outcome cannot show whether the treatment works or how safe it is.

Evidence grade: Very low. This is a single case report with no control group or comparison, so it cannot show that ibogaine caused the outcome.

This summary is based on the study’s published abstract.