Cardiac Safety Is Non-Negotiable

Long half-life and cumulative cardiac burden make concurrent ibogaine administration unsafe. Requires a medically supervised transition to a short-acting opioid for 7–14 days prior to treatment. We manage this process with you.

Risk of serotonin syndrome. Requires physician-supervised taper and full washout (minimum 2 weeks; 4–6 weeks for fluoxetine). Patients are not treated until clearance is confirmed.

Low prescribed doses may be manageable with physician guidance. High-dose or long-term benzodiazepine use requires a supervised taper before treatment. Ibogaine does not treat benzodiazepine dependence.

Sympathomimetic stimulants increase cardiac strain and must be fully discontinued prior to treatment. Prescription stimulants require a physician-directed taper. Recreational use must be disclosed.

Most antipsychotic medications significantly prolong the QTc interval. This is an absolute contraindication with no current protocol for management. Patients on antipsychotics cannot receive ibogaine at this time.

Azithromycin, clarithromycin, fluoroquinolones (ciprofloxacin, levofloxacin), and similar antibiotics extend the QTc interval additively. Must be fully cleared (5+ half-lives) before treatment begins.

Class I and III antiarrhythmics (amiodarone, sotalol, flecainide, quinidine) carry additive QTc prolongation risk that makes ibogaine administration unsafe. Requires cardiologist consultation before any consideration.

Strict contraindication due to risk of hypertensive crisis and serotonin syndrome. Irreversible MAOIs must be cleared for a minimum of 14 days. Full disclosure is required on intake.

Medical-grade defibrillator immediately accessible throughout every treatment session.

First-line intervention for QTc prolongation and Torsades de Pointes. Ready for immediate IV administration.

Epinephrine, atropine, lidocaine, amiodarone, adenosine, and ACLS-grade resuscitation medications stocked on-site.

All treating physicians hold Advanced Cardiovascular Life Support certification. Not nurses — attending physicians.

Real-time cardiac rhythm and QTc tracking displayed at the patient bedside and nursing station throughout treatment.

Signed agreement with a cardiac-capable hospital in Cozumel. Transfer capability is within 20 minutes with a standing protocol.

Physician On-Site 24/7

MindScape treats one patient at a time per physician. Your physician is physically present throughout your entire treatment window — not on-call, not remotely available. Present. The registered nursing team maintains continuous bedside monitoring throughout the active experience and recovery period.

Ibogaine is safe for patients who pass a comprehensive cardiac screening. It is not safe for patients with undetected cardiac abnormalities. This is precisely why mandatory pre-treatment EKG and cardiac evaluation exists. MindScape Retreat has treated over 900 patients with zero cardiac events. Every one of them passed our full screening protocol before any treatment began.

The QT interval is a measurement on an electrocardiogram that represents the time your heart takes to electrically reset between beats. 'QTc' is the corrected value, adjusted for heart rate. When this interval becomes abnormally long (above 450ms for our purposes), the heart is vulnerable to a specific dangerous arrhythmia called Torsades de Pointes. Ibogaine prolongs QTc through its effect on hERG potassium channels. This is manageable when the baseline QTc is within safe limits and monitoring is continuous throughout treatment.

Not directly. Methadone requires a transition protocol — a medically supervised bridge to a short-acting opioid for 7 to 14 days before ibogaine treatment begins. This is due to methadone's long half-life and its own independent QTc-prolonging effect. MindScape's clinical team manages this transition process with patients who want to pursue ibogaine. It requires more planning, not more risk.

If your pre-screening EKG shows QTc prolongation above 450ms or any other significant cardiac finding, we will not proceed with treatment. We will communicate this clearly, explain the finding, and suggest you follow up with a cardiologist. In some cases, if the abnormality is addressable (electrolyte correction, medication adjustment), a repeat EKG after resolution may be appropriate. Patient safety always takes precedence over any other consideration.

Cardiac telemetry begins before the first dose is administered and continues for a minimum of 24 hours after the flood dose. In practice this means continuous monitoring throughout the active experience, through the resolution phase, and into early recovery. A follow-up EKG is performed before any patient is cleared for discharge.

SSRIs, SNRIs, MAO inhibitors, methadone, antipsychotics, stimulants, and QTc-prolonging antibiotics all require either a supervised taper or a sufficient washout period before ibogaine can be safely administered. Benzodiazepines at high doses also require careful management. This list is not exhaustive — every medication you take must be disclosed and reviewed by our medical team. Never stop any medication abruptly without physician guidance.