Cardiac arrest after ibogaine intoxication

Summary & key facts

Researchers describe a 61-year-old man who took a large, nonprescribed dose of the psychedelic drug ibogaine to try to stop opioid addiction. Within hours he developed severe vomiting, very low potassium, and a life‑threatening fast heart rhythm that needed an electric shock to restart normal rhythm. His heart electrical tracing showed extreme prolongation of the QT interval, which took seven days to return to normal. The case shows that ibogaine can cause serious, delayed heart problems, especially when given without medical supervision.

Key facts:

• A 61-year-old man took about 5.6 grams of ibogaine, an estimated dose of 65–70 mg per kilogram of body weight.
• Six to twelve hours after taking it he had heavy vomiting and diarrhea, became less conscious, and was taken to the emergency room.
• On arrival his heart was beating at about 270 beats per minute in a dangerous rhythm that required immediate defibrillation.
• After the shock, his ECG showed massive prolongation of the QT interval, with corrected QT values as high as about 700 milliseconds.
• His blood potassium was very low at 2.4 mmol per liter, which can help trigger dangerous heart rhythms and likely contributed to the event.
• Doctors found no underlying structural heart disease after scans and tests, so they diagnosed the event as ibogaine-induced QT prolongation with secondary low potassium that triggered the rhythm problem.
• It took seven days for the QT interval to return to normal, which matches the long half-life of ibogaine’s active metabolite and means heart risk can last several days.
• The authors warn that ibogaine preparations sold outside medical settings can have unpredictable doses and that nonmedical clinics often give it without cardiac monitoring.

Abstract

Ibogaine is a psychoactive herbal medication with alleged antiaddiction properties. We report a case of ibogaine intoxication mimicking Long-QT syndrome resulting in ventricular flutter and nearby cardiac arrest. A 61-year-old man experienced massive QT prolongation and ventricular flutter at a rate of 270 beats per minute requiring defibrillation after ingestion of a large dose of Ibogaine. The ingested dose of 65-70 mg/kg represents the highest survived ibogaine dose reported to date. As a result of the long plasma half-life of ibogaine, it took 7 days for the patient's QT interval to normalize.

Topics

Cardiac electrophysiology and arrhythmias Ion channel regulation and function Neurotransmitter Receptor Influence on Behavior

Categories

Cardiology and Cardiovascular Medicine Health Sciences Medicine

Tags

Anesthesia Cardiology Defibrillation Ingestion Internal medicine Medicine Pharmacology QT interval

Substances

Ibogaine

Conditions & symptoms

Addiction Chronic Pain Depression Substance abuse disorder Addiction or harmful habbits