Ibogaine/Noribogaine in the treatment of Substance Use Disorders: a systematic review of the current literature

Background: Ibogaine and noribogaine are psychedelic substances with dissociative properties naturally occurring in plants of the Apocynaceae family. Research has shown their efficacy in treating substance use disorders (SUD), particularly in opiate detoxification, but their efficacy and toxicity are still unclear. Objective: This review aims to assess the anti-addictive role of ibogaine and evaluate its side effects. Methods: A systematic literature review was conducted on the 29 th of November 2021 using PubMed, Scopus and Web of Science databases through the following search strategy: ("Ibogaine" OR "Nori-bogaine") AND ("SUD" OR "substance use disorder" OR "craving" OR "abstinence" OR "withdraw-al" OR "addiction" OR "detoxification") NOT animal NOT review NOT "vitro." The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed for data gathering purposes. Research methods were registered on PROSPERO (CRD42021287034). Results: Thirty-one articles were selected for the systematic revision, and two were considered for analysis. The results were organised according to the type of study: case reports/case series, random-ised-controlled trials (RCTs), open-label, survey and observational studies. The main outcomes were related to the anti-addictive effect of ibogaine and its cardiac toxicity. A meta-analysis of side effects was conducted using RevMan 5.4 software, showing a significant risk of developing headaches after ibogaine/noribogaine treatment. Conclusion: The results show some efficacy of ibogaine in the treatment of SUDs, but its cardiotoxi-city and mortality are worrying. Further studies are needed to assess its therapeutic efficacy and actual safety.