Chemical class: alkaloid
Source: roots of the shrub Tabernanthe iboga
Historical Use: psychoactive extract used in rituals of West and Central Africa
Current Use: to reduce withdrawal and cravings for opiates, cocaine, alcohol and other substances of abuse
The effects of these alkaloids on neurochemical pathways are complex. They can:
(1) bind to nicotinic receptors with inhibition of catecholamine release
(2) increase levels of serotonin
(3) increase levels of dopamine
(4) affect glutamate release and uptake
Adverse effects:
(1) prolongation of the QT interval
(2) cardiac tachyarrhythmias
(3) seizures
(4) psychosis
(5) autonomic dysfunction
(6) sudden death
Differential diagnosis of toxic effects:
(1) substance abuse
(2) psychiatric and medical comorbidities
