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Published 28 August 2026

What an Ibogaine Treatment Actually Involves

The published protocols, hour by hour, and the gap none of them close. Every one stops monitoring inside the window in which people have died.

Three published protocols describe an ibogaine treatment, and they disagree with each other on the monitoring window, the exclusions and even the formula used to measure the heart’s electrical recovery. What they share is a gap: every one stops monitoring inside the window in which people have died.

Most descriptions of an ibogaine treatment come from the people selling it. This one is assembled from the three protocols that have been published in the scientific literature, and from what they disagree about.

Before you travel

Two things happen and the second is easy to underestimate.

Screening. The most detailed academic protocol required an ECG with the QTc below 450 milliseconds for men and 470 for women, potassium between 3.5 and 5.0, calcium and magnesium confirmed in range, liver and kidney function, and a pregnancy test. It excluded anyone on a QT-prolonging or CYP2D6-affecting medication, with methadone the single exception. Pre-treatment screening covers what those tests can and cannot detect.

A washout. You will be asked to stop things. The Nature Medicine study records what the provider required participants to discontinue: diuretics, CYP2D6-inhibiting medications, serotonergic medications, calcium channel blockers, beta-blockers, benzodiazepines, stimulants, corticosteroids and all psychiatric medications.

The washout is part of the intervention, and it has its own risk

For someone whose depression or anxiety is currently being held by a medication, stopping is not a formality. Discontinuing an antidepressant roughly triples the odds of relapse within a year in the anxiety and PTSD literature, and that figure comes from supervised, gradual, blinded discontinuation rather than from arranging international travel.

If you take a mood stabiliser, the numbers are starker still. Ibogaine and bipolar disorder sets them out.

And if you are on an opioid substitute, switching from a long-acting to a short-acting opioid beforehand is standard practice in the published protocols. That switch is itself a supervised clinical procedure.

The days themselves

The only detailed public timetable comes from the veteran study: arrival and screening on day one, preparation and an eight-hour fast on day two with dosing that evening, the experience across day three, integration on day four, departure on day five. Other published cohorts describe a clinic stay of three to six days.

The dose is given orally, usually in the evening. In the most-cited study the experience was self-guided, with participants spatially separated and wearing eye shades and no psychotherapy occurring during it. Ibogaine therapy explained covers what that means for a service sold as therapy.

What your body does

Two things are close to universal and neither is usually described in a sales conversation.

You will not be able to walk. In the Dutch hospital series, every one of the fourteen patients developed clinical cerebellar ataxia and was unable to walk without support. It peaks two to six hours after the dose. Most had recovered by 24 hours; five had not, and were clear a day later.

You will probably vomit. That matters beyond discomfort, because vomiting removes potassium, and low potassium lengthens the QT interval further. In every ibogaine fatality where potassium was measured it was low.

The veteran study records what was treated during the acute phase: headache in 40 per cent, nausea in 23, anxiety in 10, hypertension in 7 and insomnia in 3. All thirty had transient cerebellar signs resolving within 24 hours. Side effects sets out the full documented list.

Monitoring, and the gap every protocol leaves

This is the part to read twice.

ProtocolWhat it monitorsFor how long
Dutch university hospital12-lead ECG every 30 minutes, then hourly or four-hourly≥24 h, then a cardiologist decides
Caribbean series12-lead ECG and telemetry−1 h to 24 h
Veteran studyQTc monitored visually, continuous 5-lead12 to 16 h
The 2016 provider guidelines3-lead monitor12 to 24 h

Now the risk window. Deaths in the fatality series occurred between 1.5 and 76 hours after ingestion. The active metabolite has a half-life of 28 to 49 hours. In documented cases the QT interval has taken seven to twelve days to normalise.

No published protocol monitors for as long as the risk window it describes. The cardiology review of the subject is explicit: ibogaine should be permitted only under continuous electrocardiographic monitoring for an extended period that takes the metabolite’s longevity into account, and adverse events may occur several days after a single dose.

And screening does not close it either

In that Dutch hospital, with cardiac exclusions applied and ECGs every half hour, half the patients still exceeded a QTc of 500 milliseconds, and in six of fourteen the prolongation was still present beyond 24 hours. Eight of the fourteen needed a magnesium infusion.

That is the best-monitored ibogaine treatment ever published. It is the ceiling, not the floor.

What the protocols disagree about

Worth knowing, because a provider following one of them is not following the others.

They use different QT correction formulas, and the choice changes the number: the Dutch protocol used Fridericia and measured by hand, the others do not state which formula they used. They set different exclusion thresholds. One genotyped CYP2D6 as a research measure without using it to decide eligibility, one did not genotype at all. None of them used echocardiography.

And the difference in monitoring duration between the strictest and the loosest is a full day.

Leaving

The residential stay ends well before the drug does. That is the single most useful thing to hold on to from this page.

You will be discharged while the metabolite is still present at meaningful concentrations, often onto a flight. The published cohorts do not follow what happens in that period, because their monitoring has already stopped.

After treatment covers what is known about the weeks that follow, and how to evaluate a clinic turns everything on this page into questions with checkable answers.

Common questions

Typically arrival and screening, a day of preparation and fasting, a single dose in the evening, roughly a day of experience and severe loss of coordination, then integration conversations and departure. The published programmes run about five days.

The residential stay is usually three to six days. The drug's effects are not over when the stay is: the active metabolite has a half-life of one to two days and QT prolongation has taken a week to resolve.

That is the question to ask precisely. The published protocols monitor for 12 to 24 hours, and published deaths occurred up to 76 hours after dosing. Ask how many hours, how many ECG leads, and who is watching overnight.

Providers generally require it. One published protocol lists diuretics, CYP2D6-inhibiting drugs, serotonergic drugs, calcium channel blockers, beta-blockers, benzodiazepines, stimulants, corticosteroids and all psychiatric medications.

Usually not. In the Dutch hospital series every one of the fourteen patients was unable to walk without support, peaking two to six hours after the dose.

Sources

4 sources · How we source

  1. Safety of ibogaine administration in detoxification of opioid-dependent individuals

    Primary source · Addiction, 2022 · accessed 28 Aug 2026

  2. Magnesium-ibogaine therapy in veterans with traumatic brain injuries

    Primary source · Nature Medicine, 2024 · accessed 28 Aug 2026

  3. Ibogaine Detoxification Transitions Opioid and Cocaine Abusers Between Dependence and Abstinence

    Primary source · Frontiers in Pharmacology, 2018 · accessed 28 Aug 2026

  4. The anti-addiction drug ibogaine and the heart: a delicate relation

    Primary source · Molecules, 2015 · accessed 28 Aug 2026

Sources last verified 28 August 2026

Portrait of Wendy Tzou

Wendy Tzou

Medically reviewed 28 August 2026

About

Professor of medicine and director of cardiac electrophysiology at the University of Colorado School of Medicine, practising at UCHealth on the Anschutz campus in Aurora. Her clinical and research work is on atrial and ventricular arrhythmias and cardiac implantable devices, which is the field the cardiac pages on this site turn on.

  • Cardiac electrophysiology
  • Ventricular arrhythmia
  • QT prolongation
  • Cardiac implantable electronic devices

On this page

  • Before you travel
  • The days themselves
  • What your body does
  • Monitoring, and the gap every protocol leaves
  • What the protocols disagree about
  • Leaving

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