Phenelzine
Nardil
Ibogaine and Isocarboxazid
Also known as: Marplan
LIFE-THREATENING: MAOI + ibogaine interaction.
Severity
Contraindicated
Mechanism
Monoamine oxidase inhibition
Protocol Status
Pre-arrival washout (under your prescribing physician)
Restart Delay
21 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
What our medical team does for patients on Isocarboxazid.
Discontinue minimum 14 days before treatment.
Where the Washout Happens
Pre-arrival washout (under your prescribing physician)
Discontinuation is completed before arrival, under the patient's own prescribing physician, with the medication-specific washout interval observed before the flood dose.
Pre-Treatment Washout Window
14 days minimum before treatment.
Post-Treatment Restart
Wait at least 21 days post-treatment before restarting.
The Pharmacology
How Isocarboxazid interacts with ibogaine: monoamine oxidase inhibition.
MAOIs (phenelzine, tranylcypromine, isocarboxazid, selegiline, rasagiline, moclobemide, ayahuasca) prevent breakdown of serotonin, dopamine, and norepinephrine. Combined with noribogaine's serotonergic activity, the result can be fatal serotonin syndrome and hypertensive crisis. This is an absolute contraindication with the longest enforced washout in the protocol.
Same Mechanism
Other medications that interact via monoamine oxidase inhibition.
Same Severity Tier
Other contraindicated medications (different mechanism).
Serotonergic activity (serotonin syndrome)
Fluoxetine
Prozac, Sarafem
Serotonergic activity (serotonin syndrome)
Sertraline
Zoloft
Serotonergic activity (serotonin syndrome)
Paroxetine
Paxil, Pexeva
QT-interval prolongation
Citalopram
Celexa
QT-interval prolongation
Escitalopram
Lexapro
Serotonergic activity (serotonin syndrome)
Fluvoxamine
Luvox
Common Questions
Isocarboxazid and ibogaine treatment.
Can I take ibogaine if I am on Isocarboxazid?
Contraindicated. LIFE-THREATENING: MAOI + ibogaine interaction. Discontinue minimum 14 days before treatment.
How long do I need to be off Isocarboxazid before ibogaine treatment?
Pre-arrival washout (under your prescribing physician). Discontinuation is completed before arrival, under the patient's own prescribing physician, with the medication-specific washout interval observed before the flood dose. 14 days minimum before treatment. Wait at least 21 days post-treatment before restarting.
What is the mechanism of the interaction?
Monoamine oxidase inhibition. MAOIs (phenelzine, tranylcypromine, isocarboxazid, selegiline, rasagiline, moclobemide, ayahuasca) prevent breakdown of serotonin, dopamine, and norepinephrine. Combined with noribogaine's serotonergic activity, the result can be fatal serotonin syndrome and hypertensive crisis. This is an absolute contraindication with the longest enforced washout in the protocol.
Can I switch to a different medication so I can have ibogaine treatment?
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 Isocarboxazid — contact us for an individual review.
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DA
Medically reviewed by Dr. Arellano, M.D.
Clinical Director, MindScape Retreat · Board-certified physician specializing in ibogaine-assisted detoxification with over 900 patients treated.
Last reviewed: May 2026 · See full medical team