China
Africa
Explore chapters and articles related to this topic
Nutraceutical Intervention for Treatment of Alcoholism and Drinking Problems
Published in Raj K. Keservani, Anil K. Sharma, Rajesh K. Kesharwani, Nutraceuticals and Dietary Supplements, 2020
Both T. iboga and Voacanga africana are perennial shrubs innate to Central Africa and belongs to family Apocynaceae. They are largely used in customary African medicine. The root bark of T. iboga comprises ibogaine as its major alkaloid, although Ibogaine is one of some naturally occurring alkaloids found in V. africana. The psychoactive indole alkaloid known as ibogaine is used to treat cravings of alcohol, cocaine, heroin, and methamphetamine. Ibogaine is present in the root bark of Tabernanthe iboga that acts on the serotonin, dopamine, and opioid receptors to decrease substance cravings. The stimulating, fatigue-, thirst-, and hunger-ameliorating effects of ibogaine are well known since times immemorial. The preclinical evidence indicates that ibogaine considerably affect morphine and cocaine after self-administration in rodents. Recently, ibogaine has been testified to markedly decrease voluntary liquor consumption in alcohol-preferring rats. The dropping effect of ibogaine on alcohol intake was detected only when ibogaine was injected intraperitoneally or intragastrically and not subcutaneously, suggesting that the bioactive principle of ibogaine could be a metabolite produced by the liver. It has been found that ibogaine can be toxic in high doses, so an ibogaine analog, known as 18-methoxycoronaridine, has been developed to produce the same antiaddiction effects as ibogaine but without the toxic side effects. Iboga acts on the neurotransmitters that control drinking behavior and helps to reduce cravings and subdue extreme drinking (Carai et al., 2000).
Changes in Withdrawal and Craving Scores in Participants Undergoing Opioid Detoxification Utilizing Ibogaine
Published in Journal of Psychoactive Drugs, 2018
Benjamin J. Malcolm, Martin Polanco, Joseph P. Barsuglia
Ibogaine, a psychoactive and psychedelic alkaloid found in the root bark of Tabernanthe iboga or bark of Voacanga africana, has a complex pharmacokinetic and pharmacodynamic profile that is not completely understood (Jenks 2002). Ibogaine exhibits significant affinity for targets in many neurotransmitter systems. Affinities and Ki values less than 10 μM were found at κ opioid receptors, N-methyl-d-aspartate (NMDA) glutamatergic receptors, dopamine and serotonin reuptake pumps, σ-1 and σ-2 receptors, as well as nicotinic receptors (Litjens and Brunt 2016). Ibogaine is converted to noribogaine by the cytochrome P450 isoenzyme CYP2D6. There is significant heterogeneity within humans regarding metabolic capacity of CYP2D6. There are also drugs that inhibit the enzyme’s metabolic capacity, creating potentially significant drug-drug interactions. One study found a 26-fold increase in peak plasma concentrations of ibogaine and a 66-fold increase in the area under the curve (AUC) or total drug exposure in patients that took ibogaine after being pretreated with a CYP2D6 inhibitor (paroxetine 20 mg) compared with a placebo (Glue et al. 2015b). This study exemplifies the role of CYP2D6 in the pharmacokinetics of ibogaine and its likely impact on efficacy and safety parameters of ibogaine use (Glue et al. 2015b; Litjens and Brunt 2016). In persons exhibiting the most common CYP2D6 phenotype (extensive metabolizers), the half-life of ibogaine was found to be 7.45 hours (Mash et al. 2001).