- Researchers
report that the psychoactive drug ibogaine seems to promote both
structural and psychological improvements in brain health.
- In
a study, veterans who used the drug reported decreases in PTSD, anxiety,
and depression as well as improvements in brain function.
- The
precise mechanism by which ibogaine works to treat TBI remains unclear,
however.
A relatively obscure
psychoactive drug could hold promise for treating traumatic brain injuries (TBI),
according to a new study. involving military veterans.
Researchers from
Stanford University in California report that the plant-based psychoactive
drug ibogaine,
when combined with magnesium to protect the heart, can safely and effectively
reduce post-traumatic stress disorder (PTSD), anxiety, and depression as well as
improve functioning in veterans with TBI.
The drug seems to
increase the brain’s ability to heal itself after suffering traumatic injuries,
which can result in both structural and functional changes in brain function, according
to Dr. Nolan Williams, a study author and an associate professor of
psychiatry and behavioral sciences at Stanford.
“There is a physical
effect and a psychological effect,” Williams told Medical News Today.
Details from
the traumatic brain injury drug study
The study, published in
the journal Nature Medicine, focused on a group of 30 Gulf War veterans who had
sought ibogaine treatment at a clinic in Mexico.
Treatment with ibogaine, which is derived from an African shrub called iboga,
is legal in Mexico and Canada but illegal in the United States, where it has
been classified by the Drug Enforcement Administration as a schedule I
controlled substance since 1970.
The 30 special
operations veterans all had clinically significant levels of disability related
to a history of TBI and repeated blast exposures.
Researchers reported
that treatment with ibogaine reduced the veterans’ average rating on a
disability assessment scale from about 30 — equivalent to mild to moderate disability
— to about 5 one month after treatment, indicating no disability.
Participants also
experienced average reductions of 88% in PTSD symptoms, 87% in depression
symptoms, and 81% in anxiety symptoms.
The researchers added
that cognitive testing further revealed improvements in participants’
concentration, information processing, memory, and impulsivity.
“No other drug has ever
been able to alleviate the functional and neuropsychiatric symptoms of
traumatic brain injury,” said Williams in a statement.
Dr. John Krystal, the chair of Yale University’s Department of Psychiatry in
Connecticut as well as a professor of psychiatry, neuroscience, and psychology
who was not involved in the study, told Medical
News Today that the findings
“are very encouraging in suggesting the possibility of achieving significant
improvement across many neuropsychiatric symptom domains from a single ibogaine
treatment.”
“It is remarkable that
response rates approached 100 percent and remission rates exceeded 80 percent,”
said Krystal. “I believe [the study] justifies further research on the safety
and effectiveness of ibogaine as a treatment, but it does not yet support
implementation of ibogaine in clinical practice.”
Limitations
to the study on ibogaine
Krystal did point out
that the study group was small, not representative of the population at large,
and that researchers did not compare the findings to a control group, among
other limitations to the research.
“A big question
complicating interpretation of the results is, ‘What is the nature of the
pathology that is responding to ibogaine?,’” he added. “We can’t tell from this
study whether symptoms associated with TBI, PTSD, depression, anxiety
disorders, or substance use disorder responded particularly well to ibogaine.
It could be any or all of these conditions.”
“The improvement in the
[cognitive disability] scores could be related to improvement in TBI, but it
also could be related to improvement in PTSD and depression, both of which are
associated with cognitive and functional impairment,” explained Krystal. “Thus,
although all of the patients had TBI, we cannot infer that ibogaine is an
effective treatment for TBI from this study.”
Williams agreed,
telling Medical News Today that “nobody really knows” how ibogaine works,
although he said the drug seems to improve neuroplasticity — the ability of
neural networks in the brain to change through growth and reorganization.
This action could be
related to ibogaine’s known effect. on release of
Glial cell Derived Neurotrophic Factor (GDNF), a protein involved in promoting
the survival and differentiation of neurons in the brain’s dopamine system.
Traumatic
brain injuries common among veterans
Many U.S. military
veterans have sustained. traumatic brain
injuries in combat, including hundreds of thousands who served in Afghanistan
and Iraq.
These injuries are
believed to play a role in depression and suicide among military veterans.
The Stanford study was
conducted in partnership with VETS Inc., a foundation that helps facilitate
psychedelic-assisted therapies for veterans.
“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.”
Stanford researchers
reported that study participants had no serious side effects from the ibogaine
therapy. Magnesium was included in the treatment regimen to preclude the known
risk of ibogaine use causing cardiac arrhythmia, said Williams.
However, Lea McMahon, a licensed professional counselor and the chief
clinical officer at Symetria Recovery, which operates addiction treatment
centers in Illinois and Texas, cautioned that while ibogaine is not considered
to be physically addictive, “there is still a risk of misuse which can have
serious consequences.”
“Self-administration is
potentially dangerous and it’s important to remember that this is a controlled
substance which has yet to be approved for therapeutic treatment in many
countries,” McMahon, who was not involved in the study, told Medical News Today.
McMahon called for a
“measured approach” in using ibogaine to treat brain disorders or other
conditions.
“Although there is
evidence which suggests ibogaine can be helpful for supporting recovery from
substance or alcohol use disorders, the majority of this is anecdotal,” she
noted. “Ibogaine has been known to cause adverse reactions and cardiac
problems, and in some cases has been linked to unexplained deaths.”
Future
research on traumatic brain injuries
Planned followup
research at Stanford will include analysis of brain scans and other data collected
during the study that could shed further light on how ibogaine improved brain
function.
Williams said the study
findings indicate that the drug also could play a role in treating other
neuropsychiatric conditions.
“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,” he said.
Krystal cited a
“significant need for treatments to address the functional impact of TBI.”
“Even mild traumatic
brain injuries, like head injuries that are associated with only a brief loss
of consciousness, can produce functional impairments, including pain and
cognitive impairment,” he said. “With more severe injury, more severe
functional and cognitive impairments are seen, along with complication,
including epilepsy.”
Currently, TBI treatment
includes medications such as antidepressants for mood symptoms, stimulants for
cognitive impairments, and anticonvulsants and muscle relaxants for seizures
and pain, according to Krystal.
Other psychedelic drugs,
such as psilocybin and ketamine, also appear to have
the ability to “stimulate the restoration of synaptic connections in neurons
that are otherwise viable,” noted Krystal.
“Ibogaine is a very
complicated drug [that] acts on many neural targets in the brain,” he said.
“The mechanisms through which ibogaine acts appear to overlap somewhat with
psychedelics and ketamine, as well as MDMA, although the list of
potential brain targets is quite large… While [ibogaine] might work for
symptoms associated with a wide range of diagnoses, in order to become an
FDA-approved treatment, it needs to be shown to be safe and effective for
specific diagnostic groups [like] TBI, PTSD, depression, alcohol use disorder,
etc.”
No comments:
Post a Comment