While reviewing the bibliography for the Popik/Skolnick review article,
"Pharmacology of Ibogaine and Ibogaine-Related Alkaloids",
< http://www.***.com/ ;, I noticed a citation for Problems of
Drug Dependence 1997:  Proceedings of the 59th Annual Scientific Meeting
(CPDD), NIDA Research Monograph # 178.  This Monograph is relatively technical
but, can be obtained from the National Clearinghouse for {*filter*} and Drug
Information, POB 2345, Rockville, MD 20845-234 or by calling 1 800 729-6686 or
1 301 368-2600.  

There were seven abstracts on ibogaine in the monograph.

The one that brought my attention to the need of providing various treatment
notes was an article titled, "Actions and Interactions with {*filter*} in the
Rhesus Monkey" by Aceto, Bowman and Ji.

Specifically, the authors state, "When ibogaine and {*filter*} were given
together, an increased incidence of tremors occurred.  In addition, two monkeys
receiving the high dose ibogaine-{*filter*} regimen convulsed." [8mg/kg ibogaine
sc & 1mg/kg {*filter*} iv] (my brackets).  

<snip>

"The results suggest that treatments of compulsive {*filter*} abusers with
ibogaine (acutely) may have adverse consequences"  

I believe by acutely it is to mean simultaneously.

This information should be provided to any {*filter*} or stimulant using persons
being treated with ibogaine and any person(s) providing treatment should be
aware that concurrent ibogaine/{*filter*} use may be of danger to the patient.
Ibogaine will also potentiate the effect(s) of opiate narcotics and ibogaine
and opiates should not be taken simultaneously.

In addition to any direct interaction of ibogaine with {*filter*} or opiates, a
notice of warning should be provided to any patient being treated for use of
{*filter*}, narcotics or other {*filter*} that, they may be more sensitive to those
{*filter*} after treatment with ibogaine.  Whether pharmacologically correct or not,
it should be told to the patient that ibogaine treatment may reduce their
tolerance to opiates and/or make them more sensitive to stimulants after
treatment.  This is in addition to the dangers of drug interaction while taking
ibogaine.

I would suggest a written warning to patients:

"WARNING:  If you as a patient are going to go back to drug use after ibogaine
treatment, please be aware they you may be more sensitive to other {*filter*},
should use less, and may be more at risk to OD either for reasons of
interaction or for lack of tolerance to the amount of {*filter*} you previously
used."

This is posted to inform persons offering ibogaine treatment of potential
medical risks and to advise patients of those risks.

Basic operating regs re ibogaine treatment in self-help groups has been that
MINIMALLY the patients have no {*filter*} or {*filter*} use as of midnight before
treatment with ibogaine scheduled for 8 AM - 10 AM and if methadone is used,
methadone should be administered no less then 24 hours prior to ibogaine
administration.  In a hospital environment the patient is maintained on
controlled doses of narcotics for at least two days prior to ibogaine therapy
and no {*filter*} or other stimulants are provided at all.  This allows the
patient to be well rested and limits plasma levels of {*filter*} of abuse that might
offer potential dangerous interaction with ibogaine.

Benzodiazepines within normal dose ranges have shown no overt negative effects
in ibogaine treated patients and have been used as antianxiety agents or to
assist in sleeping.  It has been reported that some persons prefer to
administer melatonin.  Melatonin has been proposed to have advantage over
benzodiazepines in terms of abuse potential particularly in cases where the
substance(s) are used to assist in overcoming long-term decreased sleep effects
of ibogaine.  Any persons who can report on actual experiences of melatonin
use, post ibogaine, would be welcome to do so.

PS  Persons should review < http://www.***.com/ ;