In Sickness and in Health – Ibogaine’s Promise for the Aging Brain

A Conversation with Clinical and Research Psychologist, Dr. Joseph Barsuglia

In 2015, while Dr. Joseph Barsuglia was working in the addiction treatment program at the VA Hospital in Los Angeles, he heard of a plant from Africa that quelled the craving for opioids. One year later, he arrived at the Crossroads Treatment Center in Mexico, where Dr. Martín Polanco was offering treatments with Ibogaine.

Ibogaine is a profoundly psychoactive medicine derived from the root of Iboga, a shrub indigenous to Equatorial West Africa that is sacred to the Bwiti lineages in Gabon¹. Despite being a federally illegal controlled substance in the US, Ibogaine’s medicinal properties are now under intense scrutiny in the West.

Watch this powerful message from Bwiti Master Moubeyi Bouale to Westerners interested in Iboga.

In Mexico, Barsuglia applied his background in neuropsychology research to document the experiences of veterans treating addiction, PTSD and traumatic brain injury with Ibogaine, alone and in combination with 5-MeO-DMT. He also traveled to Gabon to become initiated in a Bwiti lineage.

Because of Ibogaine’s unusual efficacy for overcoming opioid addiction, initiatives to expand access to the drug have attracted powerful bipartisan support. Former Texas governor Rick Perry has dedicated his life to this cause, and the state recently designated $50 Million to study Ibogaine treatment for mental health and traumatic brain injury, largely because of testimonies from veterans. That, and a recent Stanford study, have inspired neighboring states to consider similar measures. Recently, the State of Colorado Natural Medicine Board recommended state regulators should approach Gabon for Iboga through an ethical framework developed by the United Nations called the Nagoya Protocol.

So where’s the connection with older adults?

While researching Ibogaine for my book, I listened to a Psychedelic Therapy podcast episode where Barsuglia was interviewed, referring to Ibogaine as “miracle-grow for the brain, and a potential treatment for neurodegenerative diseases of aging. In a recent conversation, I asked him to share some insights about Iboga in its indigenous context as well as the promise of Ibogaine for supporting health and thriving of the older brain.

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I've studied psychedelics academically, clinically, and in retreat contexts, as well as in indigenous cultures, mainly in Africa. As a researcher, I originally worked in the neuropsychology of aging, especially in early onset dementias, Parkinson’s and frontal temporal dementia. My psychedelic work with Ibogaine was more on the mental health side with ibogaine-assisted psychotherapy for addiction and post-traumatic stress disorder, especially among veterans. And it's interesting to see how these fields are converging.

The main medicine I've worked with is Ibogaine, which comes from Iboga – a native plant used ritually in the Bwiti communities in Gabon. In Iboga initiation practices, some traditions highlight the significance of reconnecting to one’s truest essence, being seen and received in community, in order to be of service.

Tabernanthe Iboga - Photo credit ICEERS.org

Another thread in Bwiti tradition is that Iboga is a sacred tree that can connect you with your ancestors. When you take the medicine, the veil between the worlds can get very thin. Some people report having a dialogue with the ancestors on the other side. I was taught that one role of our ancestors is to help their living progeny from the other side. The Iboga rituals allow the initiate to ask for their help with protection, blessings, healing, strength or even light/illumination from higher realms…

Many Westerners who hear about Iboga want to have “the authentic experience” in Gabon. But the conditions they encounter there may be too intense. The Iboga experience itself is hard enough physically and psychologically. So I don't think it makes sense for large populations of Westerners to get initiated there.

In spreading traditional knowledge to the West, Gabon should be in charge of how Iboga might be translated or bridged. Certain Gabonese initiatory practices may or may not be recommended by indigenous elders. For example, some Westerners may need softer healing /therapeutic type work versus more intensive rites of passage, designed to push one to certain limits.

Artwork by Lauren Meyer/Painter Dancer

What is the science showing for ibogaine and the aging brain?

Many psychedelics boost growth factors in the brain. These are especially present during the “critical periods” of rapid growth of new brain cells experienced by babies and adolescents. Dr. Gül Dölen recently discovered that Ibogaine opens the critical period far longer than any other psychedelic.

It may be that bringing the brain back to this period of rapid neuronal growth is part of the anti-aging benefits of psychedelics. In some Bwiti practices, those emerging from their first initiation are referred to as a “Bandzi”, akin to a new hatchling or infant. Perhaps modern science is just catching up to this ancient knowledge?

One unique property of Ibogaine compared to other psychedelics is its capacity to reinforce a specific growth factor called glial-derived neurotrophic factor (GDNF) that is associated with regeneration of white matter deep in the interior core of the brain. Certain traumatic brain injuries such as repeated concussions or blast waves from explosives can cause microscopic tears in the brain’s white matter. Parkinson’s disease, ALS, MS and other neurodegenerative diseases are also associated with this region of the brain.

This is an early hypothesis, and there aren’t enough human brain studies to definitively say. However, in a recent case study of a patient with MS who had a large lesion in the white matter of the brain, after the Ibogaine treatment, there was a regrowth of 70% of the brain tissue. It was very dramatic.

I've worked with hundreds of veterans who had serious white matter disease – the kind you see in NFL players or boxers. They almost universally report that their cognitive functioning is much better after Ibogaine. This was substantiated in a recent Stanford study, which separately reported a reduction in estimated brain age by 1.6 years before and after ibogaine.

So there's a promising signal in the science, but it hasn't been well characterized.

Still a ways to go…

I now work with several investment groups looking at the medical applications of psychedelics. There are dozens of psychedelic biotech companies advancing psychedelic compounds for age-related issues, in what I see as three main streams: as a treatment for neurodegenerative diseases, for cognitive enhancement /longevity, and for psychological and spiritual healing and meaning making.

Many of these companies are creating new pharmaceutical derivatives of preexisting psychedelics. But some are doing truly novel drug development, including new psychedelic compounds that aren’t psychoactive but retain some cognitive enhancement benefits, and are gentle and safe enough to take at home.

In the meantime, it’s important for older adults to understand that commonly used clinical doses of Ibogaine can be physically very, very challenging. Iboga and ibogaine can cause dizziness, nausea, vomiting, and difficulty walking. On the mental side, it can cause brief periods of confusion and dark or challenging imagery and visions. We’ve had Navy Seals who described it as being the most horrible, challenging experience of their lives. It can also cause cardiac arrhythmias which can be lethal outside of a medical setting.

There's also an age cutoff in the medical guidelines around Ibogaine, and many clinics do not accept people over 65. Still, many older people have done Ibogaine. I know of one clinic that offers a neuro-recovery program where older populations are treated with low doses of Ibogaine which appear to offer a lot of benefits. The cardiac risks are less at lower doses, although this has not been well researched in large populations.

Ibogaine is still experimental, and very expensive… Also, because of the cardiac issues, any future use would need to happen through a medicalized framework. Ibogaine has the most drug interactions of any psychedelic, which can be an issue for older adults. SSRIs, and medications for Parkinson’s and dementia, for example, all interact with Ibogaine.

Academic and biotechnology researchers are innovating new ibogaine-inspired medicines to reduce cardiac risks and retain the beneficial aspects which hold such promise. However, these are still in the very early stages. For now, older adults may find that psychedelic-assisted therapy with psilocybin is a much safer, more accessible and more sustainable option*.

I also want to emphasize Master Moubeyi’s video message – that you can’t advance the pharmacy of Iboga without the spirituality. The Bwiti have a cosmology and theology that has emerged from centuries of working with the plant, as well as extensive medical and psychological knowledge which they feel needs to be considered in tandem with the medical use. They also have medical knowledge of Iboga and complimentary plants unknown in the West, including uses for skin conditions, infertility, and inflammatory issues.

Maybe, like the wise elders in Gabon, it’s incumbent upon our older generations to become some kind of positive force in these difficult times.

I think it’s really necessary, especially when the planet is so threatened and it feels like things politically are being run by a bunch of toddlers… In Bwiti culture, the elders are the ones who are referred to when there are difficult decisions to be made, spiritual guidance is needed, or when communities are sick or out of balance. According to some historians, you couldn’t be qualified as a leader in ancient Greece unless you’d gone through an initiation, achieved a higher spiritual IQ and purified your heart and intention.

1. The Iboga plant is an endangered species. The Ibogaine used clinically in Mexico and most research is derived from the Voacanga Africana plant which is more sustainably grown.