We look after you from the first conversation to the day you leave. Most of our work happens before anyone is accepted, and through the medicine days the team stays close. This page explains how: the medical and psychological evaluation, how we plan around your medicines, the team that stays with you day and night, and who ibogaine is not for. If you already have a question about a condition or a medicine, ask our medical team.
What are the risks of ibogaine?
The risk is not spread evenly, and who is at risk, and why, matters. Most published deaths involved something a medical evaluation is designed to catch: heart disease, other drugs in the body, liver disease, or withdrawal from alcohol or sedatives (Alper et al., 2012; MAPS, 2026). In the largest survey so far, a preprint with data from 11 clinics that follow published safety guidelines, 6 of 19,071 people treated died within 72 hours. All six were among the 10,382 people treated for opioid dependence, and none of the 8,689 people treated for other reasons died (Arns et al., 2026, preprint). If you are coming to us from opioids, we add some steps for you: a detox first, close medical follow-up through it, and a medicine day planned around how that detox goes. And whatever brings you here, the published reports also include deaths with no known heart disease and no other drug involved, one of them a healthy person with no history of drug use (MAPS, 2026). That is why careful screening lowers the risk; it does not remove it. What we watch most closely in the body is the rhythm of the heart, and it can be measured (Knuijver et al., 2022), so before anything else we look carefully at your heart, your medicines and your history. We know there is a risk, and we take it seriously. So we work to keep it as low as it can be: we say no when someone is not a candidate, we evaluate every case, we plan a detox first when it is needed, and we help you arrive well prepared. And on every medicine day our team is ready to respond, right here: a paramedical team is on site with an ambulance that carries a monitor-defibrillator that can also pace; after the full dose, everyone’s vital signs are taken every hour for the first 12 hours; and our physicians add a 12-lead cardiac monitor whenever, after the evaluation, they indicate it.
Most people feel very unsteady and nauseous for several hours, and this passes within about a day. Your own risks are talked through with you in the medical evaluation and in the informed consent, before you are accepted. More on the heart, and on who is at higher risk, is on the heart page; how we care for you is below; and the legal terms are in our medical and legal notice.
Who should not take ibogaine?
The 2016 clinical guideline and the 2026 MAPS Investigator’s Brochure exclude, or ask for a specialist’s review of, people with:
- heart disease or a long QTc at rest (more on the heart)
- low potassium or magnesium that has not been corrected
- significant liver or kidney disease
- a psychotic illness, treated bipolar disorder or epilepsy
- serious lung disease
- pregnancy
- medicines that lengthen the QT interval or slow the breakdown of ibogaine
Some of these rule treatment out; others call for case-by-case weighing by a medical team. How we decide is below.
Which medicines and drugs interact with ibogaine?
The ones that matter most are medicines that also lengthen the QT interval, such as methadone, buprenorphine, ondansetron, quetiapine and lithium, and medicines that block CYP2D6, the liver enzyme that clears ibogaine, such as paroxetine, fluoxetine and bupropion. Fentanyl, stimulants, alcohol, other antidepressants, benzodiazepines and diuretics also matter. Kratom and 7-OH have their own page.
Don’t stop or change any medicine on your own, and never stop benzodiazepines or alcohol suddenly. Each change is planned with a physician and can take days to months.
What do the guidelines recommend?
Before treatment: a resting 12-lead ECG; blood tests for potassium, magnesium, liver and kidney function and a blood count; a full medication and drug history checked with a urine test; and further heart tests when something points to a problem.
During treatment: heart-rhythm monitoring through the acute phase, regular checks of vital signs, trained staff, emergency equipment, a hospital within reach, and at least 72 hours of observation before discharge.
How does IbogaQuest screen and care for guests?
IbogaQuest has worked with ibogaine since 2009. We are a small residential ibogaine treatment centre in Tepoztlán, Morelos, Mexico. Most of our protocol happens before anyone is accepted: two physicians review every case, and we say no when someone needs care we cannot give here. And if something becomes complicated, the team is prepared and has a plan. Our primary physician, Dr. Juan Moller, is on site through the session day and the first night, and on every medicine day a paramedical team is here with an ambulance that carries a monitor-defibrillator that can also pace. After the full dose, everyone’s vital signs are taken every hour for the first 12 hours, and anyone for whom our physicians indicate it after the evaluation also goes on a 12-lead cardiac monitor. Someone from our team stays with you the whole way.
Before you arrive
- A certified clinical psychologist on our team does a psychological evaluation.
- You send a 12-lead ECG done no more than three months before treatment, and two physicians review it independently. We decline people with structural heart disease, heart failure, ventricular arrhythmias, unexplained fainting, or a family history of sudden death or congenital long QT. Borderline readings go to a cardiologist. Our limits are on the heart page.
- Blood tests include a blood count, liver and kidney function, potassium, sodium and calcium. Abnormal values are corrected before treatment, never during it.
- Blood pressure and a urinalysis are part of intake. A stress test may be required from age 60 or with specific conditions.
- A mild brain injury does not rule anyone out; POTS is assessed case by case.
- Psychiatric conditions are assessed case by case, with a report from your treating psychiatrist. We don’t automatically exclude psychosis, bipolar disorder or epilepsy; our physicians assess each case. Suicide risk is also always assessed case by case: the certified clinical psychologist on our team evaluates it, and she and our physicians decide.
Your medicines
Our two physicians and our senior ibogaine provider review every medicine you take, supplements and herbs included. Strong CYP2D6 blockers such as paroxetine, fluoxetine or bupropion rule out treatment until your own prescriber has tapered them safely and they have cleared; with some antidepressants that takes months. When slow metabolism is suspected, we lower the dose and raise it more slowly.
Methadone and buprenorphine are switched to a shorter-acting medicine well before treatment. Kratom and 7-OH need their own medical detox first. Benzodiazepines, alcohol, fentanyl and some psychiatric medicines may need a taper or a supervised detox first, planned with our medical team. Please don’t stop or cut down anything on your own. If stopping a medicine is not safe for you, we postpone or decline.
For five days before you arrive, we ask everyone to avoid quinine (tonic water included), grapefruit and alcohol. If that would be hard for you, tell us during intake. If you drink daily or heavily up to the retreat, you first do a week of medical detox, with IV fluids and its own protocol. It is a separate treatment, with its own cost. After it, you join the ibogaine retreat like everyone else.
When you arrive
Before the first dose, one of our physicians sees you in person with your whole file and gives final medical clearance. We test urine for drugs at intake, and take a new ECG when your history or vital signs call for it.
During treatment
The monthly retreat has two doses of ibogaine hydrochloride (HCl). On Tuesday comes the intensive dose (the flood), which starts with a test dose; on Friday, a booster. A nurse, a paramedic and an ibogaine provider from our team check each guest every hour, and close supervision generally lasts the first 12 to 24 hours. A nurse, a paramedic and two ibogaine providers are on site day and night for the whole retreat.
We examine every guest before the dose, and guests also go on a 12-lead cardiac monitor when our physicians indicate it after the evaluation (borderline vital signs, a borderline QTc or any other concern).
Staff help you every time you stand or walk until coordination returns, and watch your breathing, with oxygen and airway equipment at hand. On treatment days an ambulance is on site, with paramedics and a monitor-defibrillator. In an emergency, the paramedics stabilise the guest and take them, with a member of our team, to one of four hospitals: Hospital Morelos, Hospital Henri Dunant or Hospital San Diego in Cuernavaca, about 30 minutes away, or Centro Médico del Ángel in Cuautla, about 40 minutes away, when the road to Cuernavaca is busy. We choose among them by availability, traffic and distance, and at least three of the four have an intensive care unit.
Before you leave
You stay in the team’s care for at least 72 hours after the first dose. Before you leave, the team assesses you psychologically and physically, and a physician gives medical clearance. We explain, and give you in writing, that your tolerance to opioids is lower after treatment. There are two one-hour group sessions for preparation and integration. If you travel from abroad, travel medical insurance is a requirement.
The rest of the week is in the treatment week, step by step.
Questions worth asking any clinic – Which conditions would exclude me, and who decides? – Which tests do you need, and how recent must they be? – Do you plan my medicines with my own doctor? – How will my heart be watched, and for how long? – Who is on site at night, and is there a defibrillator? – Where would I be taken in an emergency?
Not sure whether a condition or a medicine affects you?
Whether it is for yourself or for someone close to you, ask our medical team before you apply: US 1 (802) 748 4600 · MX +52 (777) 450 1946. When the time is right for you, the application is here.
If you or someone close to you is in danger right now, call your local emergency number.
Frequently asked questions
Can I take ibogaine if I take antidepressants?
Many antidepressants interact with ibogaine, and some block the enzyme that clears it. Most need a taper with your prescriber, which can take weeks or months. Don’t stop or change any medicine on your own; our physicians plan it with you and your own doctor.
Should I stop benzodiazepines or alcohol before I come?
Not on your own, and never suddenly: your body has adapted to them, and coming off is done with medical support. Tell us what you take during intake. When it is needed, a taper or a supervised detox comes first.
Can I take ibogaine if I have bipolar disorder, a psychotic illness or epilepsy?
The 2016 guideline excludes them; the MAPS brochure reviews them case by case. There are no data showing that ibogaine is safe in these conditions. Our physicians assess each case, with a report from your treating psychiatrist.
Is ibogaine safe during pregnancy or breastfeeding?
There are no human studies. The 2016 guideline excludes pregnancy, and so did every study we read.
Related topics
- What the research on ibogaine says
- Ibogaine and the heart
- 7-OH, kratom and ibogaine
- Medically supported detox and pre-treatment care
- The treatment week, step by step
Medically reviewed by Dr. Juan Moller · Last reviewed 19 October 2026
Sources
- Global Ibogaine Therapy Alliance (2016). Clinical Guidelines for Ibogaine-Assisted Detoxification, v1.1. Library card
- MAPS (June 2026). Ibogaine Investigator’s Brochure, v1. Library card
- Knuijver T, et al. (2022). Addiction. Safety of a single dose in opioid detox. doi.org/10.1111/add.15448
- Marta CJ, et al. (2015). American Journal on Addictions. Mania after ibogaine use. doi.org/10.1111/ajad.12209
- Houenou J, et al. (2011). Journal of Clinical Psychopharmacology. A psychotic episode after iboga use. doi.org/10.1097/JCP.0b013e31822c6509
- Knuijver T, et al. (2018). Journal of Clinical Psychopharmacology. Persistent symptoms after treatment. doi.org/10.1097/JCP.0000000000000966
- Alper KR, Stajić M, Gill JR (2012). Fatalities temporally associated with the ingestion of ibogaine. Journal of Forensic Sciences 57(2):398–412. doi.org/10.1111/j.1556-4029.2011.02008.x
- Arns M, Shinozuka K, Barsuglia J (2026). Indication-stratified mortality risk of ibogaine treatment under contemporary safety protocols: A multisite analysis of 19,071 patients and updated systematic review of fatalities. Research Square, preprint (in review), not peer reviewed. doi.org/10.21203/rs.3.rs-9966269/v1
This page is general information, not medical advice. Treatment at IbogaQuest takes place only after a full medical evaluation. Medical and legal notice