One of the first noticeable effects of large-dose ibogaine ingestion is
ataxia, a difficulty in coordinating muscle motion which makes standing and walking difficult without assistance.
Xerostomia (dry mouth),
nausea, and vomiting may follow. These symptoms may be long in duration, ranging from 4 to 24 hours in some cases. Ibogaine is sometimes administered by
enema to help the subject avoid vomiting up the dose. Psychiatric medications are strongly contraindicated in ibogaine therapy due to adverse interactions. Some studies also suggest the possibility of adverse interaction with heart conditions. In one study of canine subjects, ibogaine was observed to increase
sinus arrhythmia (the normal change in heart rate during respiration).[SUP]
[6][/SUP] Ventricular
ectopy[SUP][
disambiguation needed][/SUP] has been observed in a minority of patients during ibogaine therapy.[SUP]
[7][/SUP] It has been proposed that there is a risk of QT-interval prolongation following ibogaine administration.[SUP]
[8][/SUP] This risk was further demonstrated by a case reported in the
New England Journal of Medicine documenting
prolonged QT interval and
ventricular tachycardia after initial use.[SUP]
[9][/SUP]
There are 12 documented fatalities that have been loosely associated with ibogaine ingestion.[SUP]
[10][/SUP] Exact determinations of the cause of death have proven elusive due to the quasi-legal status of ibogaine and the unfamiliarity of medical professionals with this relatively rare substance. No autopsy to date has implicated ibogaine as the sole cause of death. Causes given range from significant pre-existing medical problems to the co-consumption of drugs such as opiates which are potentiated by ibogaine. Also, because ibogaine is one of the many drugs that are partly metabolized by the
cytochrome P450 complex, caution must be exercised to avoid
foods or drugs that inhibit CP450, in particular foodstuffs containing
bergamottin or
bergamot oil, common ones being grapefruit juice[SUP]
[11][/SUP] and
Earl Grey tea.