Description of Ibogaine Description of Ibogaine Treatments made in BrazilTreatments made in Brazil

Dr. Bruno Rasmussen Chaves Dr. Bruno Rasmussen Chaves M.D. M.D.

Dr. Cleuza CananDr. Cleuza Canan PsychologistPsychologist

Ibogaine Treatment FacilityIbogaine Treatment FacilityM.P.P. Gonçalves HospitalM.P.P. Gonçalves HospitalSanta Cruz do Rio Pardo, Santa Cruz do Rio Pardo,

São Paulo, BrazilSão Paulo, Brazil

In Brazil we have been doing treatments with Ibogaine since 1997, in order to treat drug addiction, with excellent results.

Brazil has a huge public health Brazil has a huge public health problem with crack/cocaine users, problem with crack/cocaine users, which reaches the number of 2-4% which reaches the number of 2-4% of the population, (190 million), and of the population, (190 million), and a small (until nowadays) problem a small (until nowadays) problem with heroin (~ 50 cases)with heroin (~ 50 cases)

PROAD (Drug Addicts Orientation and Care Program, Federal University of PROAD (Drug Addicts Orientation and Care Program, Federal University of São Paulo, 2006)São Paulo, 2006)

We have treated until February We have treated until February 2009 2009

-54 patients (51 males, 3 females); -54 patients (51 males, 3 females);

-from 22 to 49 years old;-from 22 to 49 years old;

-53 of these from crack/cocaine -53 of these from crack/cocaine addiction;addiction;

-one from opiates addiction.-one from opiates addiction.

Here we will discuss the clinical Here we will discuss the clinical procedures related to the treatment procedures related to the treatment itself, it's safety, and not the itself, it's safety, and not the aftercare outcome, although we aftercare outcome, although we could not talk about Ibogaine and could not talk about Ibogaine and not say that it is very effective in not say that it is very effective in attenuating the dependence and in attenuating the dependence and in stabilizing the life of the majority of stabilizing the life of the majority of the persons who takes it.the persons who takes it.

All patients seeking to be treated All patients seeking to be treated are evaluated by the psychologist, are evaluated by the psychologist, then by the clinician, and asked to then by the clinician, and asked to perform some basic blood tests perform some basic blood tests (hemogram, liver enzymes, (hemogram, liver enzymes, creatinine, sodium, potassium, creatinine, sodium, potassium, magnesium, and sugar blood test) magnesium, and sugar blood test) and an EKG. and an EKG.

Exclusion CriteriaExclusion Criteria

Patients presenting with any of the Patients presenting with any of the following conditions are excluded:following conditions are excluded:

-pregnancy-pregnancy

-significant clinical issues, like non -significant clinical issues, like non controlled arterial hypertension, non-controlled arterial hypertension, non-controlled diabetes, previous myocardial controlled diabetes, previous myocardial infarction, cardiac arrhythmias, renal infarction, cardiac arrhythmias, renal failure, hepatic failure, Alzheimer and failure, hepatic failure, Alzheimer and Parkinson diseases.Parkinson diseases.

Exclusion CriteriaExclusion Criteria

Psychiatric diseases Psychiatric diseases -Schizofrenia-Schizofrenia -Anti-social personality-Anti-social personality

Social issuesSocial issues -Living alone subject-Living alone subject -subject who has not a proper social -subject who has not a proper social

and professional environment to and professional environment to come back tocome back to

After this evaluation, the treatment After this evaluation, the treatment is scheduled, and is asked for the is scheduled, and is asked for the patient that he/she stays abstinent patient that he/she stays abstinent from crack/cocaine for at least 20 from crack/cocaine for at least 20 days. The patient may be days. The patient may be hospitalized if he/she feels that hospitalized if he/she feels that he/she could not achieve this goal he/she could not achieve this goal alone, at home.alone, at home.

In the day before the treatment the In the day before the treatment the patient is asked to eat light food in patient is asked to eat light food in the evening, and to drink a lot of the evening, and to drink a lot of water until midnight. After that, he water until midnight. After that, he is asked not to eat or drink anymore.is asked not to eat or drink anymore.

M.P.P.Gonçalves Hospital

In the day of the procedure the patient In the day of the procedure the patient arrives at the hospital at 7 o’clock, he/she arrives at the hospital at 7 o’clock, he/she takes 20 mg of domperidone, and after 30 takes 20 mg of domperidone, and after 30 minutes he takes 12-20 mg/kg of Ibogaine minutes he takes 12-20 mg/kg of Ibogaine HCL. Although domperidone is described HCL. Although domperidone is described as a drug that has a possible risk of as a drug that has a possible risk of inducing a Torsades de Points arrhythmia, inducing a Torsades de Points arrhythmia, we have never seen it. All the time the we have never seen it. All the time the subject is monitorized, which includes subject is monitorized, which includes cardiac monitorization, blood pressure cardiac monitorization, blood pressure measures, and oxymetric monytorization.measures, and oxymetric monytorization.

The average patient throws up a few The average patient throws up a few times, some few a little more, he times, some few a little more, he shows ataxia, tremors and shows ataxia, tremors and visualizations, but there was no visualizations, but there was no significant clinical occurrences significant clinical occurrences during this number of procedures, during this number of procedures, except for:except for:

-one patient (male, 25 ) that had a -one patient (male, 25 ) that had a drop in the cardiac frequency to 45 drop in the cardiac frequency to 45 bpm, with the EKG showing sinusal bpm, with the EKG showing sinusal bradycardia, which lasted for 3 bradycardia, which lasted for 3 minutes, without hemodinamic minutes, without hemodinamic repercussions or symptoms.repercussions or symptoms.

-Another patient (male, 30) that had thrown -Another patient (male, 30) that had thrown up several times, and presented with an up several times, and presented with an upper gastrointestinal bleeding, probably a upper gastrointestinal bleeding, probably a Mallory-Weiss syndrome, (where the Mallory-Weiss syndrome, (where the repeated vomiting causes a rupture of the repeated vomiting causes a rupture of the mucosae of the terminal esophagus and mucosae of the terminal esophagus and bleeding). This patient had not any bleeding). This patient had not any hemodinamic repercussions, performed an hemodinamic repercussions, performed an upper gastrointestinal endoscopy which upper gastrointestinal endoscopy which confirmed the Mallory Weiss syndrome and confirmed the Mallory Weiss syndrome and was discharged 2 days later in a very good was discharged 2 days later in a very good condition. condition.

It´s interesting to say that one patient, It´s interesting to say that one patient, (male, 38), had a history of being shot by (male, 38), had a history of being shot by a firegun, years before the treatment, and a firegun, years before the treatment, and had 2 bullets still on his body, one near had 2 bullets still on his body, one near the heart, and another located at the T 10 the heart, and another located at the T 10 vertebrae, he was performed a parcial vertebrae, he was performed a parcial pancreatectomy, a left pneumectomy, a pancreatectomy, a left pneumectomy, a left nefrectomy and a splenectomy. left nefrectomy and a splenectomy. Although all this procedures, he was in a Although all this procedures, he was in a good health situation, and was treated, good health situation, and was treated, with absolutely no intercurrences.with absolutely no intercurrences.

In all of this 54 cases treated, In all of this 54 cases treated, absolutely no complications were absolutely no complications were seen, what makes us conclude that seen, what makes us conclude that the treatment with Ibogaine seems the treatment with Ibogaine seems to be a safe procedure.to be a safe procedure.

ConclusionConclusion

It is very important to follow a It is very important to follow a rigorous clinical protocol and to be rigorous clinical protocol and to be aware of pre-treatment clinical aware of pre-treatment clinical conditions, mainly cardiac problems. conditions, mainly cardiac problems.

It is important to the patient to be It is important to the patient to be rested, well hydrated, in good rested, well hydrated, in good clinical conditions.clinical conditions.

SedationSedation

We strongly recommend not to We strongly recommend not to sedate the patient, shortly after the sedate the patient, shortly after the treatment, in order to the subject treatment, in order to the subject fully feel ibogaine effects. But when fully feel ibogaine effects. But when it is necessary, we use diazepam.it is necessary, we use diazepam.

Howard LotsofHoward Lotsof

Thank youThank you