In order to safely and successfully partake in an Ibogaine treatment, the following criteria, as shown in the Clinical Guidelines for Ibogaine-Assisted Detoxification, must be met:
Patient Criteria & Considerations for Ibogaine Treatment
In order to safely and successfully partake in an Ibogaine treatment, the following criteria, as outlined in the Clinical Guidelines for Ibogaine-Assisted Detoxification, must be met:
Inclusion Criteria
The therapeutic relationship begins during the initial contact with the patient, whether in person, by telephone or through other correspondence. This interaction is crucial for building trust and assessing the patient’s eligibility for ibogaine therapy.
Basic considerations for inclusion in therapy include:
1) Informed Consent: Patients must provide clear and informed consent. Ibogaine is generally ineffective for individuals not personally committed to the therapeutic process, which excludes those coerced into treatment through intervention-based models.
2) Understanding of Treatment: Patients should understand the basic scope of ibogaine treatment and its implications.
*Desire and Expectations: A strong desire to take ibogaine and realistic expectations about potential outcomes are necessary.
*Commitment to Process: Patients must be willing to adhere to provider and clinician requests, which include attending appointments, submitting a comprehensive application and completing preparation protocols thoroughly and honestly.
*Engagement with Services: Patients should take responsibility for engaging with referred services and continue with ongoing self-care.
*Acceptance of Responsibilities: Patients must accept the responsibilities outlined in the Ibogaine Patient’s Bill of Rights.
Application Process
Careful screening is essential to minimize risks associated with ibogaine-assisted detoxification. Each patient should undergo an assessment considering known psychological and biological risk factors prior to intake. Key components include:
1) Personal Information & Medical Overview:
– Name
– Personal contact information
– Emergency contact details
– Height and weight
– Assigned and preferred gender identity
– Complete history of accidents, hospitalizations, surgical procedures, and previous illnesses including heart conditions and psychiatric diagnoses.
2) Drug Use Profile:
– A thorough review of all medications (prescription and over-the-counter), street drugs, vitamins, supplements and herbs, including their dosages and usage patterns. Consideration of overdoses and at-risk behaviors is also important.
3) Medical Tests:
The following tests should be considered based on the medical history:
– Resting 12-lead electrocardiogram (ECG)
– Stress echocardiogram or 24-hour Holter monitor (if needed)
– Complete Metabolic Panel (Chem 12 or Chem 18)
– Complete Blood Count (CBC)
– Complete Thyroid Function Test
– Physical examination, if necessary
-Liver Function Tests
Absolute Exclusion Criteria
Patients should be excluded from ibogaine-assisted detox if they meet any of the following criteria due to significant associated risks:
Psychiatric Conditions:
– Schizophrenia
– Bipolar disorder (with hospitalization or medication)
– Depersonalization/Derealization Disorder
– Cerebellar dysfunction
– Epilepsy
– Psychosis or acute confused state
– Organic brain disease
– Dementia
Pre-existing Heart Conditions:
– Prolonged QTc Interval (450 ms for males, 470 ms for females)
– History of heart failure or enlarged heart
– Active blood clots, pulmonary embolism, or deep vein thrombosis
Major Respiratory Conditions:
– Emphysema
– Chronic Obstructive Pulmonary Disorder (COPD)
– Cystic Fibrosis
Other Health Concerns:
– Severe gastrointestinal issues (e.g., bleeding ulcer, leaky gut syndrome)
– Impaired kidney or liver function
– Pregnancy
Cardiac Risk Factors to Consider
If patients have any of the following conditions, a risk-benefit analysis by a knowledgeable cardiologist is necessary before considering ibogaine treatment:
– Borderline QTc interval
– Irregular heart rhythms (arrhythmias)
– History of heart attacks or congenital heart defects
– Significant family history of heart-related issues
Other Risk Factors
Additional non-cardiac-related risk factors to consider during the application phase include:
– Certain psychiatric conditions (e.g., PTSD, borderline personality disorder)
– No accessible veins for IV port access
– Irregular thyroid function
– Major respiratory conditions (e.g., sleep apnea)
– Obesity and eating disorders
– Chronic infectious diseases
Drug Interactions to Consider
Several common prescription medications and drugs of abuse can complicate treatment. Specific categories include:
– QT Prolonging Medications: These can increase the risk of lethal cardiac arrhythmias.
– Diuretics: Can lower potassium and sodium levels.
– Centrally Acting Drugs: Should be managed with extreme caution.
– Serotonin Increasing Medications: Risk of serotonin syndrome when combined with ibogaine.
Conclusion
Throughout this document, when calculating the period for discontinuing certain medications prior to treatment, consider at least four to seven times the listed half-life of the medication.