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Medical disclaimer: This article is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before considering iboga or ibogaine.
The Honest Answer
Iboga is a powerful medicine. For properly screened participants working with trained, experienced practitioners, it can be profoundly safe and transformative. For individuals with certain heart conditions, specific medications, or unstable psychiatric diagnoses, it carries serious risks — including, in poorly managed cases, fatalities.
The difference between a safe iboga experience and a dangerous one is almost entirely determined by the quality of medical screening and the experience of the practitioners.
This guide will tell you everything you need to know, honestly about iboga safety.
The Primary Risk: Cardiac
Ibogaine, the primary alkaloid in iboga, prolongs the QTc interval an electrical measurement of heart function that appears on an electrocardiogram (ECG). QTc prolongation can trigger potentially fatal cardiac arrhythmias, particularly Torsades de Pointes, a life-threatening irregular heartbeat.
This risk is well documented. An analysis of ibogaine-related deaths found that the majority involved:
When these factors are properly screened and eliminated, the cardiac risk drops dramatically. The 2024 Stanford study of 30 veterans found zero serious cardiac adverse events, because participants underwent rigorous pre-screening including a specific magnesium protocol that further protects against QTc prolongation.
Who Should NOT Take Iboga: Complete Contraindications
Absolute Contraindications (Do Not Proceed)
Medications That Require Taper or Washout Before Iboga
The following medications must be safely reduced or discontinued under medical supervision before iboga is safe. Never stop any prescription medication abruptly without guidance from your prescribing doctor.
Conditions Requiring Extra Caution and Medical Evaluation
What Proper Medical Screening Looks Like
A responsible iboga retreat or clinic will require the following before accepting any participant:
Mandatory Tests
What Bwiti House's Screening Protocol Includes
At Bwiti House, no participant is accepted without complete medical clearance. Our protocol includes:
This process is not a formality. We decline participants whose screening results indicate unacceptable risk — because the safety of every person in our care is non-negotiable.
The 35-Year Safety Record
Bwiti House has been conducting iboga ceremonies with Western participants since 1990, making it one of the longest-running iboga retreat operations in the world. This 35-year track record, with thousands of initiations completed under Moughenda Mikala's guidance, represents a sustained safety record built on rigorous screening and authentic traditional practice.
The Bwiti tradition itself has practised with iboga for thousands of years. The tradition's accumulated knowledge about iboga preparation, dosing, ceremony structure, and participant monitoring is not incidental to safety, it is foundational to it.
Recognising an Unsafe Retreat
Red flags that suggest a retreat is not operating safely:
Frequently Asked Questions
Has anyone died from iboga?
Yes. There are documented cases of ibogaine-related deaths, the majority of which involve pre-existing cardiac conditions, concurrent drug use, or inadequate medical screening. When proper cardiac screening is performed and contraindicated medications are managed, the risk of serious adverse events is very low. Reputable centres have conducted thousands of sessions without serious cardiac events.
Is iboga safe for someone with a history of depression?
Depression itself is not a contraindication. The medications used to treat depression (particularly SSRIs and MAOIs) require careful management. Participants with depression who are not on contraindicated medications, or who have completed a safe medication taper, can typically participate safely.
Can I do iboga if I drink alcohol regularly?
Moderate social alcohol use is generally not a contraindication, but heavy alcohol use and alcohol use disorder require specific evaluation. Liver function is a key screening criterion — heavy drinkers often have elevated liver enzymes that need to be within safe range before iboga is appropriate.
What happens if something goes wrong during the ceremony?
Responsible retreat centres have emergency protocols and medical support on-site. Bwiti House operates with proximity to medical facilities and has trained staff who monitor participants throughout the ceremony. The continuous monitoring by the shaman and support team is one of the safety advantages of the traditional ceremonial setting over unsupervised use.
Is iboga safe for people over 50?
Age itself is not a contraindication. Cardiac health is the primary concern, and this is assessed via ECG regardless of age. Many participants in their 50s, 60s, and older have completed iboga ceremonies safely after proper medical clearance.
This article is for educational purposes only. It does not constitute medical advice. Consult a qualified healthcare provider before considering iboga or ibogaine treatment.
