Psychoactive drug treats traumatic brain injury in veterans

A recently published study shows that the use of a psychoactive drug can lead to reducing military veterans' symptoms of PTSD and traumatic brain injuries.

For military veterans, many of the most painful wounds of war are invisible. Traumatic brain injuries (TBIs) resulting from head trauma or blast explosions are a leading cause of post-traumatic stress disorder (PTSD), depression, anxiety, and suicide among veterans. Few treatments have been effective at reducing the long-term effects of TBI, leaving many veterans feeling hopeless and helpless. 

Military veterans make up 20% of suicides in the US despite making up only 6.4% of the general population.

Dealing with an invisible problem

Now, researchers at Stanford University in California have found that ibogaine – a naturally occurring, plant-based psychoactive compound found in the roots of the African shrub iboga that has been used for centuries in spiritual and healing ceremonies – safely leads to improvements in depression, anxiety, and functioning among veterans with traumatic brain injuries.

Their new study, just published in the prestigious journal Nature Medicine under the title “Magnesium–ibogaine therapy in veterans with traumatic brain injuries,” included detailed data on 30 veterans of US special forces.

“This is [apparently] the first study to report evidence for a single treatment with a drug that can improve chronic disability related to repeated TBI from combat/blast exposures. Moreover, there is no currently available US Food and Drug Administration-approved treatment for chronic [effects] of combat-related TBI, “the researchers declared.

“No other drug has ever been able to alleviate the functional and neuropsychiatric symptoms of traumatic brain injury,” said psychiatrist and behavioral sciences Prof. Nolan Williams. “The results are dramatic, and we intend to study this compound further.”

TBI is a disruption in the normal functioning of the brain resulting from external forces such as explosions, vehicle collisions, or other bodily impacts. That trauma can lead to changes in the function and/or structure of the brain, which, in turn, contributes to neuropsychiatric symptoms.

A widespread issue abroad and at home

Hundreds of thousands of troops serving in Afghanistan and Iraq have sustained TBIs in recent decades, and these injuries are suspected of playing a role in the high rates of depression and suicide seen among military veterans – and surely in the IDF’s Gaza war as well.

With mainstream treatment options not fully effective for some veterans, researchers have sought therapeutic alternatives.

Ibogaine has gained interest from the medical and scientific communities for its potential to treat opioid and cocaine addiction, and research has suggested that it increases the signaling of several important molecules within the brain, some of which have been linked to drug addiction and depression. Since 1970, it has been designated as a Schedule I drug, preventing its use within the US, but clinics in both Canada and Mexico offer legal ibogaine treatments. 

“There were a handful of veterans who had gone to the clinic in Mexico and were reporting anecdotally that they had great improvements in all kinds of areas of their lives after taking ibogaine,” Williams said. “Our goal was to characterize those improvements with structured clinical and neurobiological assessments.”

Williams and his colleagues at Stanford teamed up with VETS, Inc., a foundation that helps facilitate psychedelic-assisted therapies for veterans. With support from VETS, 30 special operations veterans with a history of TBI and repeated blast exposures, almost all of whom were experiencing clinically severe psychiatric symptoms and functional disabilities, had independently scheduled themselves for treatment with magnesium and ibogaine at the clinic. 

Before the treatment, Stanford researchers gauged the participants’ levels of PTSD, anxiety, depression, and functioning based on a combination of self-reported questionnaires and clinician-administered assessments. Participants then traveled to a clinic in Mexico run by Ambio Life Sciences where, under medical monitoring, they received oral ibogaine along with magnesium to help prevent heart complications that have been associated with ibogaine.

The veterans then returned to Stanford for post-treatment assessments.

Promising results

“These men were incredibly intelligent, high-performing individuals who experienced life-altering functional disability from TBI during their time in combat,” Williams said. “They were all willing to try almost anything that they thought might help them get their lives back.”

At the beginning of the study, participants were experiencing clinically significant levels of disability as measured by the World Health Organization Disability Assessment Scale 2.0, which assesses disability in six functional domains, including cognition, mobility, self-care, getting along, life activities, and community participation. In addition, 23 met the criteria for PTSD, 14 for anxiety disorder, and 15 for alcohol use disorder. In their lifetimes, 19 participants had been suicidal, and seven had attempted suicide.

On average, treatment with ibogaine immediately led to significant improvements in functioning, PTSD, depression, and anxiety – and those effects persisted until at least one month after treatment. 

Before treatment, the veterans had an average disability rating of 30.2 on the disability assessment scale, equivalent to mild to moderate disability. One month after treatment, that rating improved to 5.1, indicating no disability. Similarly, one month after treatment, participants experienced average reductions of 88% in PTSD symptoms, 87% in depression symptoms, and 81% in anxiety symptoms relative to how they were before ibogaine treatment. Formal cognitive testing also revealed improvements in participants’ concentration, information processing, memory, and impulsivity.

“I wasn’t willing to admit I was dealing with any TBI challenges. I just thought I’d had my bell rung a few times — until the day I forgot my wife’s name,” said Craig, a 52-year-old study participant from Colorado who served 27 years in the US Navy.  “Since the ibogaine treatment, my cognitive function has been fully restored. This has resulted in advancement at work and vastly improved my ability to talk to my children and wife.”

“Before the treatment, I was living life in a blizzard with zero visibility and a cold, hopeless, listless feeling,” said Sean, a 51-year-old veteran from Arizona with six combat deployments who participated in the study and says ibogaine saved his life.  “After ibogaine, the storm lifted.”

Importantly, there were no serious side effects of ibogaine and no instances of heart problems that have occasionally been linked to ibogaine. During treatment, veterans reported only typical symptoms such as headaches and nausea.

Further implications

Williams and his team are planning further analysis of additional data collected on the veterans but not included in the current study, including brain scans that could help reveal how ibogaine led to improvements in cognition. They also hope to launch future studies to further understand how the drug might be used to treat TBI. They think ibogaine’s drastic effects on TBI also suggest that it holds broader therapeutic potential for other neuropsychiatric conditions.

“In addition to treating TBI, I think this may emerge as a broader neuro-rehab drug,” Williams concluded. “I think it targets a whole host of different brain areas and can help us better understand how to treat other forms of PTSD, anxiety and depression that aren’t necessarily linked to TBI.”