Stanford Medicine researchers find that ibogaine, a plant-based
psychoactive compound, safely led to improvements in depression, anxiety and
functioning among veterans with traumatic brain injuries.
For military veterans, many of the deepest wounds of war are invisible:
Traumatic brain injuries resulting from head trauma or blast explosions are a
leading cause of post-traumatic stress disorder, anxiety, depression and
suicide among veterans. Few treatments have been effective at diminishing the
long-term effects of TBI, leaving many veterans feeling hopeless.
Now, Stanford
Medicine researchers have discovered that the plant-based psychoactive drug
ibogaine, when combined with magnesium to protect the heart, safely and
effectively reduces PTSD, anxiety and depression and improves functioning in
veterans with TBI. Their study, published online in Nature
Medicine, includes detailed data on 30 veterans of U.S. special forces.
“No other drug has ever been able to alleviate the functional and neuropsychiatric symptoms of traumatic brain injury,” said Nolan Williams, MD, an associate professor of psychiatry and behavioral sciences. “The results are dramatic, and we intend to study this compound further.”
Alternatives
Traumatic brain injury is defined as a disruption in the normal functioning
of the brain resulting from external forces – such as explosions, vehicle
collisions or other bodily impacts. The trauma associated with TBI can lead to
changes in the function and/or structure of the brain, which, in turn,
contributes to neuropsychiatric symptoms.
Hundreds of thousands of troops serving in Afghanistan and Iraq have
sustained TBIs in recent decades, and these injuries are suspected of playing a
role in the high rates of depression and suicide seen among military veterans.
With mainstream treatment options not fully effective for some veterans,
researchers have sought therapeutic alternatives.
Ibogaine is a naturally occurring compound found in the roots of the
African shrub iboga, and it has been used for centuries in spiritual and
healing ceremonies. More recently, it has gained interest from the medical and
scientific communities for its potential to treat opioid and cocaine addiction,
and research has suggested that it increases signaling of several important
molecules within the brain, some of which have been linked to drug addiction
and depression. Since 1970 ibogaine has been designated as a Schedule I drug,
preventing its use within the U.S., but clinics in both Canada and Mexico offer
legal ibogaine treatments.
“There were a handful of veterans who had gone to this clinic in Mexico and were reporting anecdotally that they had great improvements in all kinds of areas of their lives after taking ibogaine,” Williams said. “Our goal was to characterize those improvements with structured clinical and neurobiological assessments.”
Capturing ‘before and after’
Williams and his colleagues at Stanford Medicine teamed up with VETS, Inc.,
a foundation that helps facilitate psychedelic-assisted therapies for veterans.
With support from VETS, 30 special operations veterans with a history of TBI
and repeated blast exposures, almost all of whom were experiencing clinically
severe psychiatric symptoms and functional disabilities, had independently
scheduled themselves for treatment with magnesium and ibogaine at a clinic in
Mexico.
Before the treatment, the researchers gauged the participants’ levels of
PTSD, anxiety, depression and functioning based on a combination of
self-reported questionnaires and clinician-administered assessments.
Participants then traveled to a clinic in Mexico run by Ambio Life Sciences,
where under medical monitoring they received oral ibogaine along with magnesium
to help prevent heart complications that have been associated with ibogaine.
The veterans then returned to Stanford Medicine for post-treatment assessments.
“These men were incredibly intelligent, high-performing individuals who
experienced life-altering functional disability from TBI during their time in
combat,” Williams said. “They were all willing to try most anything that they
thought might help them get their lives back.”
At the beginning of the study, participants were experiencing clinically significant levels of disability as measured by the World Health Organization Disability Assessment Scale 2.0, which assesses disability in six functional domains, including cognition, mobility, self-care, getting along, life activities and community participation. In addition, 23 met the criteria for PTSD, 14 for an anxiety disorder and 15 for alcohol use disorder. In their lifetimes, 19 participants had been suicidal and seven had attempted suicide.
Life-changing results
On average, treatment with ibogaine immediately led to significant
improvements in functioning, PTSD, depression and anxiety. Moreover, those
effects persisted until at least one month after treatment – the endpoint of
the study.
Before treatment, the veterans had an average disability rating of 30.2 on
the disability assessment scale, equivalent to mild to moderate disability. One
month after treatment, that rating improved to 5.1, indicating no disability.
Similarly, one month after treatment participants experienced average
reductions of 88% in PTSD symptoms, 87% in depression symptoms and 81% in
anxiety symptoms relative to how they were before ibogaine treatment. Formal
cognitive testing also revealed improvements in participants’ concentration,
information processing, memory and impulsivity.
“I wasn’t willing to admit I was dealing with any TBI challenges. I just
thought I’d had my bell rung a few times – until the day I forgot my wife’s
name,” said Craig, a 52-year-old study participant from Colorado who served 27
years in the U.S. Navy. “Since [ibogaine treatment], my cognitive function has
been fully restored. This has resulted in advancement at work and vastly
improved my ability to talk to my children and wife.”
“Before the treatment, I was living life in a blizzard with zero visibility
and a cold, hopeless, listless feeling,” said Sean, a 51-year-old veteran from
Arizona with six combat deployments who participated in the study and says
ibogaine saved his life. “After ibogaine, the storm lifted.”
Importantly, there were no serious side effects of ibogaine and no instances of the heart problems that have occasionally been linked to ibogaine. During treatment, veterans reported only typical symptoms such as headaches and nausea.
Lessons for PTSD, depression and anxiety
Williams and his team are planning further analysis of additional data
collected on the veterans but not included in the current study, including
brain scans that could help reveal how ibogaine led to improvements in
cognition. They also hope to launch future studies to further understand how
the drug might be used to treat TBI.
However, they think ibogaine’s drastic effects on TBI also suggest that it
holds broader therapeutic potential for other neuropsychiatric conditions. “In
addition to treating TBI, I think this may emerge as a broader neuro-rehab
drug,” Williams said. “I think it targets a whole host of different brain areas
and can help us better understand how to treat other forms of PTSD, anxiety and
depression that aren’t necessarily linked to TBI.”
Source: https://med.stanford.edu/news/all-news/2024/01/ibogaine-ptsd.html
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