An overlooked anesthetic that may help treat traumatic brain injury
An overlooked anesthetic that may help treat traumatic brain injury
By Saga Briggs | Published: 2025-03-24 17:45:00 | Source: Health – Big Think
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Anyone familiar with drugs has heard of magic mushrooms, LSD, or even MDMA. But ibogaine, the psychoactive compound found in the Central African shrub tabernanthe ibogamay not be on many people’s radars. Researchers have begun testing its effectiveness in treating mental health disorders, in the same way that scientists study the classic psychedelic, with one surprising discovery Notarized In 2024 by a research team at Stanford University: The psychedelic may also be able to help treat traumatic brain injuries.
Ibogaine remains a Schedule I substance in the United States, although it has shown promising results in treating addiction and PTSD since the 1960s. However, safety concerns remain, including reports of arrhythmia and deaths among retreat participants in recent years.
Traditions and treatments
Ibogaine has been used for centuries by indigenous people in Gabon, in central Africa, in initiation rituals. It was identified by Westerners in the late 19th century, transported to France and used as an ingredient in an anti-addictive stimulant called Lambarene. Clinical researchers began formally studying it in the 1960s, and it spread to detox and treatment centers across Europe and the Americas in the 1990s, when research stopped due to health and safety concerns.
Since the early 2000s, an increasing number of ibogaine retreats have sprung up around the world, while controlled clinical trials have remained virtually non-existent. There has been a great deal of controversy over the safe and effective use of ibogaine since the 2010 death of a retreat participant led to the closure of a clinic in Mexico, where ibogaine remains unregulated. Since then, as well I mentioned By Matha Busby Rolling Stone magazineA spate of deaths has raised questions about how responsibly these retreats operate, and whether clinical science can shed some light on best practice.
The promise of traumatic brain injury
Current research has positioned ibogaine as a promising treatment for opioid addiction, PTSD, and — as of last year — brain injuries. In the first study of its kind, it was conducted by a research team from Stanford University Published results in January 2024 detailing the safety, tolerability, and effectiveness of ibogaine for treating traumatic brain injury (TBI) in military veterans.
Of the 30 special operations vets who received the treatment, nearly all experienced some level of immediate symptom relief. After one month of treatment, veterinarians reported an average of 88% reduction in PTSD symptoms, 87% reduction in depression symptoms, and 81% reduction in anxiety symptoms, compared to pretreatment. Notably, they also experienced improvements in cognitive function, including focus, information processing, memory, and impulsivity.
The vets had traveled to a clinic in Mexico to receive treatment, and were evaluated before and after their sessions.
“It was a reasonably risky decision,” Nolan Williams, an assistant professor of psychiatry and behavioral sciences at Stanford University School of Medicine, told Big Think. “The follow-up study that a lot of people told me wasn’t the most obvious scenario for this — trying to evaluate people at Stanford, have them go to Mexico, come back, and get re-evaluated.”
But for Williams, who is in the final stages of submitting an application to the FDA, it is a meaningful first step toward reviving scientific research on ibogaine. It could also be a big step forward for TBI, a difficult disease to treat. It is defined as any brain injury that results from severe physical trauma, and can appear in any number of places in the brain, resulting in any number of effects, depending on where the injury occurs.
“If you have a TBI in your visual cortex, you will have cortical blindness. If you have a TBI in your mood regulatory circuits, you will have depression. Blindness and depression are very different, but they are both a result of TBI in this case.”
This is what makes TBI so difficult to treat.
“It’s very difficult to design a treatment for a problem that has such a broad repertoire of presentations. But if you have a compound that seems to restore or turn back time on plasticity and restore function, it doesn’t matter where the outcome was.”
That’s what his team is starting to see with ibogaine. “Neuroanatomically specific areas may be irrelevant to the therapeutic effect, whereas something like local brain stimulation (which I’m a big fan of) would only be relevant to the areas it stimulates.”
How does ibogaine treatment work?
Even in 2025, some ideas about psychedelic mechanisms of action will be overly simplistic, such as the idea that one type of neurotransmitter needs to target one type of receptor.
“It’s very unlikely that the brain works that way, that you only need to hit one system,” Williams told Big Think. “Ibogaine hits many different systems at the same time. That’s the difference between playing one instrument and having an orchestra. An orchestra is a kind of simultaneous activation of multiple neurotransmitter systems at the same time that are probably working in concert with each other.”
Ibogaine affects several key chemicals in the brain, including serotonin, dopamine, and glutamate. It also appears to enhance the brain’s ability to grow and adapt by increasing levels of something called BDNF, a protein that supports brain health. Beyond biology, the drug can trigger intense dream-like experiences, which many users describe as deeply meaningful or transformative.
Williams says this may be part of the reason ibogaine has shown promise in treating PTSD.
“It’s a kind of emotional reappraisal drug in early life. You look at these salient emotional memories, you retrieve them, you re-understand them. Like Christmas carol In the movie Scrooge, where he goes back and sees his childhood, you see it from a third-person perspective. And that’s really what I think he does.”
However, it is up for debate how important a dream-like state is in the treatment of traumatic brain injury specifically.
Since the study was released, Williams’ team has evaluated data showing that ibogaine treatment, at least initially, may help reverse aging in the brain to some extent, although these findings have not yet been peer-reviewed. These effects, which also include cortical thickening and alterations in the emotion regulation system, appear to be permanent, lasting up to a year.
To date, there has been no prospective trial using anesthetic to treat traumatic brain injury. With several papers under review and grant applications in progress, Williams is “just trying to move forward with this.” To date, there has been no trial where the drug has been administered in the United States, he says, because of some of the heart risks associated with ibogaine. “It’s rare, but the FDA is aware of it.”
Meanwhile, initiatives in other states are on the move, with the Texas Ibogaine Initiative calling for $50 million in state funding to launch the first FDA-approved clinical trials of ibogaine in the United States.
“My mission and our mission is to be able to educate people about this psychoactive plant medicine that certainly shows an amazing ability to return people to normalcy,” former Texas Gov. Rick Perry said in a statement. interview At the Joe Rogan Experience in January. “To literally give their lives back.”
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