Magnesium-ibogaine therapy in veterans with traumatic brain injuries.

Jean-Marie Batail, Ian H Kratter, Maheen Adamson, Jennifer Keller, C E Rolle, Jonathan Dickinson, Trevor Millar, Gregory L Sahlem, Nicholas J Bassano, Angela Phillips, Jose Inzunza, John P Coetzee, Or Keynan, Ahmed Shamma, Randi E Brown, Afik Faerman, Lauren Anker, Jackob N Keynan, Kirsten N Cherian, Nolan R Williams

Journal: Nature medicine 2024;30(2):373-381

PMID: 38182784

Abstract

Traumatic brain injury (TBI) is a leading cause of disability. Sequelae can include functional impairments and psychiatric syndromes such as post-traumatic stress disorder (PTSD), depression and anxiety. Special Operations Forces (SOF) veterans (SOVs) may be at an elevated risk for these complications, leading some to seek underexplored treatment alternatives such as the oneirogen ibogaine, a plant-derived compound known to interact with multiple neurotransmitter systems that has been studied primarily as a treatment for substance use disorders. Ibogaine has been associated with instances of fatal cardiac arrhythmia, but coadministration of magnesium may mitigate this concern. In the present study, we report a prospective observational study of the Magnesium-Ibogaine: the Stanford Traumatic Injury to the CNS protocol (MISTIC), provided together with complementary treatment modalities, in 30 male SOVs with predominantly mild TBI. We assessed changes in the World Health Organization Disability Assessment Schedule from baseline to immediately (primary outcome) and 1 month (secondary outcome) after treatment. Additional secondary outcomes included changes in PTSD (Clinician-Administered PTSD Scale for DSM-5), depression (Montgomery-Åsberg Depression Rating Scale) and anxiety (Hamilton Anxiety Rating Scale). MISTIC resulted in significant improvements in functioning both immediately (P < 0.001, Cohen's d = 0.74) and 1 month (P < 0.001, d = 2.20) after treatment and in PTSD (P < 0.001, d = 2.54), depression (P < 0.001, d = 2.80) and anxiety (P < 0.001, d = 2.13) at 1 month after treatment. There were no unexpected or serious adverse events. Controlled clinical trials to assess safety and efficacy are needed to validate these initial open-label findings. ClinicalTrials.gov registration: NCT04313712 .

© 2024. The Author(s).

Address: Brain Stimulation Lab, Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA.; Palo Alto University, Palo Alto, CA, USA.; Brain Stimulation Lab, Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA.; Polytrauma Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.; Ambio Life Sciences, Vancouver, British Columbia, Canada.; WRIISC-WOMEN & Department of Rehabilitation, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.; Department of Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.; Brain Stimulation Lab, Department of Psychiatry & Behavioral Sciences, Stanford School of Medicine, Stanford, CA, USA. [email protected].; Department of Radiology, Stanford School of Medicine, Stanford, CA, USA. [email protected].
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