An analytical study of iboga alkaloids contained in Tabernanthe iboga-derived products offered by ibogaine treatment providers

Abstract Background Therapeutic properties of ibogaine in the treatment of addiction are attracting both clinicians and patients to its use. Since ibogaine is not an authorized medicine, the quality of these products is not always known, increasing the probability of adverse reactions. Objective This study collects different types of iboga-derived samples from treatment providers, vendors and online buyers to analyse their content. Methods Analysis of iboga products (n = 16) was performed using gas chromatography and mass spectrometry methods (GC/MS). Products included Iboga root bark, Total Alkaloids (TA), Purified Total Alkaloids (PTA HCl), ibogaine hydrochloride (ibogaine HCl) and one Voacanga africana root bark. Results The content of ibogaine was highly variable, ranging from 0.6% to 11.2% for products sold as iboga root bark, from 8.2% to 32.9% for products sold as TA, 73.7% for one sample sold as PTA and from 61.5% to 73.4% for products sold as ibogaine HCl. One sample did not show any iboga alkaloids. Other alkaloids and unknown substances were found in almost all samples. Discussion The purity of iboga products is highly variable. These results should be taken into consideration by suppliers and users, especially regarding correct dosing to avoid overdose, as well as potential interactions with other substances.

Ayahuasca: what mental health professionals need to know

Abstract Background Ayahuasca is a psychoactive ethnobotanical concoction that has been used for decades by indigenous groups of the Northwestern Amazon and by syncretic religious organizations for ritual and therapeutic purposes. In the last two decades, it is being used worldwide in evolving practices. Ayahuasca seem to therapeutic effects, but controlled studies are lacking. Moreover, its safety and toxicity are not completely understood. Objectives To present an overview of the effects of ayahuasca based on the most recent human studies. Methods Narrative review. Results Ayahuasca administration in controlled settings appears to be safe from a subjective and physiological perspective, with few adverse reactions being reported. More frequent adverse reactions occur in non-controlled settings. Prolonged psychotic reactions are rare and seem to occur especially in susceptible individuals. Ayahuasca showed antidepressive, anxiolytic, and antiaddictive effects in animal models, observational studies, and in open-label and controlled studies. Discussion Ayahuasca administration in controlled settings appear to be safe. Moreover, ayahuasca seem to have therapeutic effects for treatment-resistant psychiatric disorders that should be further investigated in randomized controlled clinical trials. However, medical complications and cases of prolonged psychotic reactions have been reported, and people with personal or family history of psychotic disorders should avoid ayahuasca intake.

Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): transcultural adaptation of the Brazilian version

Abstract Background DSM-5 introduced some modifications on Posttraumatic Stress Disorder (PTSD) criteria. The instruments developed for the assessment of aspects related to PTSD needed a reformulation, as was the case of the Posttraumatic Stress Disorder Checklist (PCL). Objectives To present the process of transcultural adaptation of the three forms of the PCL-5 to Brazilian Portuguese, as well as its face validity. Methods The procedure involved independent translations, a synthesis version, back translation by an independent translator, evaluation by the original author, analysis by an expert committee, and a pretesting study (10 subjects with/without experience of a traumatic situation). The last two steps formed the face validity procedure. Results The synthesis version was approved by the original author and the agreement percentage by the expert committee was excellent, with only two items showing < 90%. The pretesting study showed that the Brazilian version was well understood and linguistically and culturally accepted by the participants, which did not make significant suggestions for changes. Discussion Transcultural adaptation of the PCL-5 for Brazilian Portuguese followed a rigid and standardized procedure. Therefore, after having its face validity assessed by an expert committee and by the target population, it is apt to be used.

Ayahuasca e redução do uso abusivo de psicoativos: eficácia terapêutica? / Ayahuasca and reduction of the abusive use of psychoactives: therapeutic efficacy?

Trata-se de uma avaliação do possível papel do uso da ayahuasca, em contexto religioso, como auxiliar na redução do consumo abusivo de psicoativos, a partir de uma pesquisa de estudo de caso. Foi realizada uma entrevista aberta com uma usuária regular de cocaína, nicotina e álcool que abandonou este comportamento após entrar em contato com a ayahuasca num contexto ritualizado. O caso foi analisado à luz da comparação deste com a literatura existente sobre o assunto. Foi traçada uma relação entre o início do uso da ayahuasca e o abandono do uso de cocaína, nicotina e álcool pela entrevistada, a partir da avaliação das representações simbólicas e das descrições de suas primeiras experiências com a bebida.

This paper evaluates the possible role of the use of ayahuasca, in a religious context, as an auxiliary in the reduction of the abusive consume of psychoactives, using a case report research. An open interview with a regular consumer of cocaine, nicotine and alcohol, which abandoned this behavior after the encounter with the ritualized use of ayahuasca, was made. The case was analyzed comparing it with the literature on the subject. From the evaluation of the symbolic representations and the descriptions of her first experiences with the brew, a relation was constructed between the moment the interviewee began to use ayahuasca and the moment that she abandoned the use of cocaine, nicotine and alcohol.