Citalopram
Celexa
Also known as: Seroquel
Moderate QTc prolongation + sedation. CYP3A4 substrate.
Severity
Major risk
Mechanism
QT-interval prolongation
Protocol Status
Pre-arrival washout (under your prescribing physician)
Restart Delay
Physician discretion
What "Major risk" Means
Serious clinical risk requiring physician-led tapering, washout, and monitoring. Treatment may proceed once the medication is appropriately cleared or transitioned.
Clinical Action
Discontinue minimum 5 days before treatment. Taper to avoid rebound insomnia.
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
5 days minimum before treatment.
Post-Treatment Restart
Restart at physician discretion once acute window closes.
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.
Same Mechanism
Same Severity Tier
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Opioid receptor potentiation
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Opioid receptor potentiation
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Opioid receptor potentiation
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Common Questions
Major risk. Moderate QTc prolongation + sedation. CYP3A4 substrate. Discontinue minimum 5 days before treatment. Taper to avoid rebound insomnia.
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. 5 days minimum before treatment.
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 Quetiapine — contact us for an individual review.
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