Escitalopram
Lexapro
Also known as: Celexa
Both citalopram and ibogaine prolong QTc. Additive risk of torsades de pointes.
Severity
Contraindicated
Mechanism
QT-interval prolongation
Protocol Status
Onsite supervised taper at MindScape
Restart Delay
14 days
What "Contraindicated" Means
Absolute prohibition without an enforced washout. Treatment cannot proceed safely until the medication has been cleared from the body for the protocol's required interval.
Clinical Action
Onsite supervised taper at MindScape with continuous QTc telemetry; TA booster bridging during step-down. HCl flood dose deferred until plasma citalopram and QTc effect have cleared.
Where the Washout Happens
Onsite supervised taper at MindScape
Patient arrives on the current prescribed dose. The entire taper is conducted onsite under continuous physician supervision and telemetry, supported by twice-daily ibogaine TA (total alkaloid) booster doses where indicated. The HCl flood dose is administered only after titration to the protocol-defined safe threshold.
Post-Treatment Restart
Wait at least 14 days post-treatment before restarting.
The Pharmacology
Ibogaine and noribogaine block the cardiac hERG (IKr) potassium channel, which lengthens ventricular repolarisation and the QTc interval on a 12-lead EKG. Adding a second QT-prolonging drug compounds the effect and raises the risk of torsades de pointes — a polymorphic ventricular tachycardia that can be fatal. Every patient receives a baseline EKG, electrolyte panel, and continuous cardiac monitoring; medications in this class must be washed out long enough to return QTc into a safe range.
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Common Questions
Contraindicated. Both citalopram and ibogaine prolong QTc. Additive risk of torsades de pointes. Onsite supervised taper at MindScape with continuous QTc telemetry; TA booster bridging during step-down. HCl flood dose deferred until plasma citalopram and QTc effect have cleared.
Onsite supervised taper at MindScape. Patient arrives on the current prescribed dose. The entire taper is conducted onsite under continuous physician supervision and telemetry, supported by twice-daily ibogaine TA (total alkaloid) booster doses where indicated. The HCl flood dose is administered only after titration to the protocol-defined safe threshold. Wait at least 14 days post-treatment before restarting.
QT-interval prolongation. Ibogaine and noribogaine block the cardiac hERG (IKr) potassium channel, which lengthens ventricular repolarisation and the QTc interval on a 12-lead EKG. Adding a second QT-prolonging drug compounds the effect and raises the risk of torsades de pointes — a polymorphic ventricular tachycardia that can be fatal. Every patient receives a baseline EKG, electrolyte panel, and continuous cardiac monitoring; medications in this class must be washed out long enough to return QTc into a safe range.
In many cases yes. Our medical team works with your prescribing physician to taper or substitute medications safely before treatment. The right substitution depends on the underlying condition you are treating with Citalopram — contact us for an individual review.
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