Ibogaine and 5-MeO-DMT Treatment in Mexico: Adverse Events, Suicidal Ideation, Mental Health, and Psychological Flexibility Among United States Military Veterans

Background/Objectives Retrospective survey and clinical chart review studies have demonstrated the real-world effectiveness of ibogaine and 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) in addressing a range of mental health challenges among military Veterans in the United States (US), but no prospective research study has examined safety and effectiveness in this population. Design/Methods We prospectively followed Veterans (n=113; male=95%; Age=45.7 [SD=6.9]) planning to attend an ibogaine and 5-MeO-DMT treatment in Mexico to evaluate safety (i.e., adverse events and suicidal ideation), mental health outcomes (post-traumatic stress disorder [PTSD], depression, and anxiety symptoms; psychological flexibility) from baseline (i.e., pre-treatment) to 1-week, 3-months, and 9-months post-treatment, and to explore whether changes in psychological flexibility mediated relationships between acute drug effects and mental health outcomes. Results Adverse events were transient and infrequent (4–9% per timepoint). Significant reductions in PTSD (η p 2 = 0.74), depression (η p 2 = 0.64), anxiety (η p 2 = 0.64), and suicidal ideation (η p 2 = 0.24) were reported from baseline through 9-months (all p s < .001), with improvements emerging by 1-week and largely remaining stable through follow-up. Acute psychedelic experience intensity predicted greater PTSD and anxiety reductions, and psychological flexibility mediated the relationship between acute effects and PTSD improvement. Conclusion Despite the lack of objective reports, data suggest ibogaine and 5-MeO-DMT treatment is experienced as safe and has potential to provide prolonged improvements in self-reported mental health conditions among Veterans, with durable effects for up to 9-months. Future randomized controlled trials with larger, more diverse populations are urgently needed before this treatment is made available in the US.