“Herbal seizures” – atypical symptoms after ibogaine intoxication: a case report

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Abstract

Introduction

Misuse of various new psychotropic substances such as ibogaine is increasing rapidly. Knowledge of their negative side effects is sparse.

Case presentation

We present a case of intoxication with the herbal substance ibogaine in a 22-year-old white man. After taking a cumulative dose of 38 g (taken in two doses), he developed visual memories, nausea and vomiting. He developed a generalized tonic–clonic seizure with additional grand mal seizures. He was treated with midazolam and levetiracetam. Extended drug screenings and computed tomography and magnetic resonance imaging findings were all negative.

Conclusions

Knowledge of the side effects of ibogaine has mainly come from reports of cardiovascular complications; seizures are rarely mentioned and experimental findings are inconsistent. It seems that ibogaine acts like a proconvulsive drug at high doses.

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Most cited references 25

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Sleep-dependent theta oscillations in the human hippocampus and neocortex.

Jose L. Cantero, Joseph Madsen, Robert Stickgold … (2003)

Hippocampal theta waves recorded during rapid eye movement (REM) sleep are thought to play a critical role in memory consolidation in lower mammals, but previous attempts to detect similar theta oscillations in the human hippocampus have been unsuccessful. Using subdural and depth recordings from epileptic patients, we now report the first evidence of state-dependent hippocampal theta waves (4-7 Hz) in humans. Unlike the continuous theta in rodents, however, these oscillations were consistently observed during REM sleep in short (approximately 1 sec) bursts and during transitions to wake in longer epochs. Theta waves were also observed in the basal temporal lobe and frontal cortex during transitions from sleep to wake and in quiet wakefulness but not in REM, and they were not coherent with hippocampal theta oscillations. The absence of functional coupling between neocortex and hippocampus during theta periods indicates that multiple theta generators exist in the human brain, and that they are dynamically regulated by brain state. Gamma oscillations were also present during REM theta bursts, but the fluctuations in gamma power were not associated with theta phase, pointing out another significant difference between rodent and human theta properties. Together, these findings suggest that the generation mechanisms of theta oscillations in humans might have evolved from tonic to phasic in hippocampus during REM sleep and extended from hippocampus to cortex, where they appear in certain wakefulness-related states.

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The ibogaine medical subculture.

H S Lotsof, K Alper, C Kaplan (2008)

Ibogaine is a naturally occurring psychoactive indole alkaloid that is used to treat substance-related disorders in a global medical subculture, and is of interest as an ethnopharmacological prototype for experimental investigation and possible rational pharmaceutical development. The subculture is also significant for risks due to the lack of clinical and pharmaceutical standards. This study describes the ibogaine medical subculture and presents quantitative data regarding treatment and the purpose for which individuals have taken ibogaine. All identified ibogaine "scenes" (defined as a provider in an associated setting) apart from the Bwiti religion in Africa were studied with intensive interviewing, review of the grey literature including the Internet, and the systematic collection of quantitative data. Analysis of ethnographic data yielded a typology of ibogaine scenes, "medical model", "lay provider/treatment guide", "activist/self-help", and "religious/spiritual". An estimated 3414 individuals had taken ibogaine as of February 2006, a fourfold increase relative to 5 years earlier, with 68% of the total having taken it for the treatment of a substance-related disorder, and 53% specifically for opioid withdrawal. Opioid withdrawal is the most common reason for which individuals took ibogaine. The focus on opioid withdrawal in the ibogaine subculture distinguishes ibogaine from other agents commonly termed "psychedelics", and is consistent with experimental research and case series evidence indicating a significant pharmacologically mediated effect of ibogaine in opioid withdrawal.

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Ibogaine in the treatment of substance dependence.

Thomas Brown (2013)

Ibogaine is a psychoactive alkaloid derived from Tabernanthe iboga, a plant used in initiatory rituals in West Central Africa. Largely because of ibogaine's status as a Schedule I substance in the U.S., the development of ibogaine's use in the treatment of drug addiction took place outside conventional clinical and medical settings. This article reviews the history of ibogaine's use in the treatment of drug addiction, and discusses progress made towards, and obstacles blocking, the establishment of controlled clinical trials of ibogaine's efficacy. Preclinical research has generally supported anecdotal claims that ibogaine attenuates withdrawal symptoms and reduces drug cravings. Concerns about ibogaine's safety, as well as a dearth of solid data from human studies, have hampered progress in its development as an approved medication. This article outlines major findings from preclinical studies, discusses concerns about ibogaine's safety, and details previous and ongoing research on ibogaine's use as an anti-addictive treatment for humans.

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Author and article information

Contributors

Helge H. Müller: +49 441 9515-1505 , helge.mueller@karl-jaspers-klinik.de

Journal

Journal ID (nlm-ta): J Med Case Rep

Journal ID (iso-abbrev): J Med Case Rep

Title: Journal of Medical Case Reports

Publisher: BioMed Central (London )

ISSN (Electronic): 1752-1947

Publication date (Electronic): 31 October 2015

Publication date PMC-release: 31 October 2015

Publication date Collection: 2015

Volume: 9

Electronic Location Identifier: 243

Affiliations

[ ]Medical Campus University of OldenburgSchool of Medicine and Health Sciences Psychiatry and Psychotherapy, University Hospital Karl-Jaspers-Klinik , Hermann-Ehlers-Strasse 7, Bad Zwischenahn, D-26160 Germany

[ ]Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany

[ ]Department of Neurology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany

[ ]Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany

[ ]Epilepsy Center, Department of Neurology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany

[ ]Department of Forensic Medicine, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany

[ ]Department of Internal Medicine, Klinikum Forchheim/Friedrich-Alexander Universität Erlangen-Nuremberg, Erlangen, Germany

Article

Publisher ID: 731

DOI: 10.1186/s13256-015-0731-4

PMC ID: 4628299

PubMed ID: 26518760

SO-VID: dea1e028-63ea-4492-845b-ee1b751dbad4

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 5 May 2015

Date accepted : 8 October 2015

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ScienceOpen disciplines: Medicine

Keywords: ibogaine misuse,intoxication,reactive seizures,side effects

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ScienceOpen disciplines: Medicine

Keywords: ibogaine misuse, intoxication, reactive seizures, side effects

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“Herbal seizures” – atypical symptoms after ibogaine intoxication: a case report

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Abstract

Introduction

Case presentation

Conclusions

Related collections

ScienceOpen Clinical Case Reports Collection

Most cited references 25

Sleep-dependent theta oscillations in the human hippocampus and neocortex.

The ibogaine medical subculture.

Ibogaine in the treatment of substance dependence.

Author and article information

Contributors

Journal

Affiliations

Article

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Comments

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Cited by 6

Most referenced authors 176