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Cited by 38Psychedelics and Drug StudiesSubstance Abuse Treatment and OutcomesAlkaloids: synthesis and pharmacology

A case report SPECT study and theoretical rationale for the sequential administration of ibogaine and 5-MeO-DMT in the treatment of alcohol use disorder

Barsuglia, Joseph P., Polanco, Martin, Palmer, Robert, Malcolm, Benjamin J., Kelmendi, Benjamin, Calvey, Tanya·2018·Progress in Brain Research
DOI 10.1016/bs.pbr.2018.08.002
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Abstract

Ibogaine is a plant-derived alkaloid and dissociative psychedelic that demonstrates anti-addictive properties with several substances of abuse, including alcohol. 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring psychedelic known to occasion potent mystical-type experiences and also demonstrates anti-addictive properties. The potential therapeutic effects of both compounds in treating alcohol use disorder require further investigation and there are no published human neuroimaging findings of either treatment to date. We present the case of a 31-year-old male military veteran with moderate alcohol use disorder who sought treatment at an inpatient clinic in Mexico that utilized a sequential protocol with ibogaine hydrochloride (1550mg, 17.9mg/kg) on day 1, followed by vaporized 5-MeO-DMT (bufotoxin source 50mg, estimated 5-MeO-DMT content, 5-7mg) on day 3. The patient received SPECT neuroimaging that included a resting-state protocol before, and 3 days after completion of the program. During the patient's ibogaine treatment, he experienced dream-like visions that included content pertaining to his alcohol use and resolution of past developmental traumas. He described his treatment with 5-MeO-DMT as a peak transformational and spiritual breakthrough. On post-treatment SPECT neuroimaging, increases in brain perfusion were noted in bilateral caudate nuclei, left putamen, right insula, as well as temporal, occipital, and cerebellar regions compared to the patient's baseline scan. The patient reported improvement in mood, cessation of alcohol use, and reduced cravings at 5 days post-treatment, effects which were sustained at 1 month, with a partial return to mild alcohol use at 2 months. In this case, serial administration of ibogaine and 5-MeO-DMT resulted in increased perfusion in multiple brain regions broadly associated with alcohol use disorders and known pharmacology of both compounds, which coincided with a short-term therapeutic outcome. We present theoretical considerations regarding the potential of both psychedelic medicines in treating alcohol use disorders in the context of these isolated findings, and areas for future investigation.

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  • In a case study, a patient with alcohol dependence treated with ibogaine hydrochloride followed by vaporized 5-MeO-DMT showed post-treatment increases in brain perfusion in bilateral caudate nuclei, left putamen, right insula, as well as temporal and occipital cortex and cerebellum relative to baseline.

    “Relative to baseline perfusion SPECT imaging, there were post-treatment increases in brain perfusion in bilateral caudate nuclei, left putamen, right insula, as well as temporal and occipital cortex and cerebellum.”

    From Molecular and Functional Imaging Studies of Psychedelic Drug Action in Animals and Humans. (2021) · cites this paper as [143]

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Authors
Barsuglia, J. P., Polanco, M., Palmer, R., Malcolm, B. J., Kelmendi, B., & Calvey, T.
Affiliations
  • Yale University (US)
  • Western University of Health Sciences (US)
  • University of the Witwatersrand (ZA)
Corresponding author
Barsuglia, Joseph P.
ORCID
Venue
Progress in Brain Research
Publisher
Elsevier
Published
2018
Volume
242
Pages
121-158
ISSN
0079-6123 (ISSN-L)
DOI
10.1016/bs.pbr.2018.08.002
OpenAlex
W2898270213
Cited by
38
References
29
Citations by year
2026: 4 · 2025: 5 · 2024: 7 · 2023: 11 · 2022: 3 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 1
FWCI
14.28
Type
book chapter
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Progress in brain research (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Alkaloids: synthesis and pharmacology
Keywords
ibogaine, 5-MeO-DMT, alcoholism, psychedelic therapy, cerebral perfusion, caudate nucleus, putamen, insula, alcohol craving, military veterans, mystical experience
MeSH terms
Adult, Alcoholism, Brain, Dose-Response Relationship, Drug, Hallucinogens, Humans, Ibogaine, Male, Methoxydimethyltryptamines, Time Factors, Tomography, Emission-Computed, Single-Photon

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