Ibogaine and Clozapine

Contraindicated. QTc prolongation plus myocarditis/cardiomyopathy risk and agranulocytosis monitoring requirements. A structurally compromised myocardium is the worst possible substrate for ibogaine's QT effect. Treatment generally cannot proceed without specialist psychiatric and cardiology sign-off, including echocardiography and ANC monitoring. Never taper clozapine without the prescribing psychiatrist.

Generally not eligible until alternative management is established. Pharmacology (e.g., ultra-long half-life) makes safe washout impractical within any reasonable treatment window. Treatment generally cannot proceed until cardiology or the prescribing physician has established alternative management.

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 Clozapine — contact us for an individual review.