Ibogaine and Trazodone

Major risk. Dual liability that is easy to miss because it is prescribed as a sleep aid rather than an antidepressant: trazodone is a serotonin antagonist AND reuptake inhibitor (serotonin syndrome risk with noribogaine, a potent SERT inhibitor) and is independently associated with QTc prolongation. Physician-supervised discontinuation before treatment; expect rebound insomnia and plan a non-serotonergic sleep alternative. Do not restart for 14 days post-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. 7 days minimum before treatment. Wait at least 14 days post-treatment before restarting.

Serotonergic activity (serotonin syndrome). Noribogaine is a potent serotonin reuptake inhibitor. Combining it with another drug that raises synaptic serotonin (SSRIs, SNRIs, MAOIs, triptans, tramadol, MDMA, St John's Wort) can trigger serotonin syndrome — autonomic instability, hyperthermia, neuromuscular hyperactivity, and altered mental state. This is a leading cause of preventable harm in psychedelic medicine and the reason serotonergic medications carry the longest washout windows.

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 Trazodone — contact us for an individual review.