Is ibogaine treatment durable? 12-month follow-up of magnesium–ibogaine therapy (MISTIC) in Special Operations Veterans with traumatic brain injuries

Traumatic brain injury (TBI) can result in chronic functional disability and is associated with persistent psychiatric symptoms, including posttraumatic stress disorder (PTSD), depression, and anxiety. Ibogaine, an oneirogenic alkaloid with unique pharmacological properties, has shown initial promise as a potential treatment for TBI-related sequelae. We previously observed large improvements in functional and psychiatric outcomes up to one month after a single treatment with magnesium-ibogaine in male U.S. Special Operations Veterans with a history of TBI. However, further evidence on the durability of these effects is needed. In this prospective long-term follow-up study, we evaluated the persistence of these clinical improvements over the subsequent year. Participants underwent comprehensive baseline and post-treatment assessments, with follow-up evaluations conducted at 3, 6, 9, and 12 months. Of 30 participants treated with magnesium-ibogaine, 25 completed the 12-month follow-up assessments. Outcome measures included a self-report measure of functional disability and clinician-administered assessments of psychiatric symptoms. Results demonstrated robust and sustained reductions in disability, PTSD, depression, and anxiety symptoms through 12 months post-treatment, with large effect sizes (Cohen’s d ≥ 2.18 at 12 months). Survival analyses estimated the probability of sustained remission at 12 months as 84% for PTSD, 66% for depression, and 61% for anxiety. These findings suggest that ibogaine treatment may lead to durable, clinically meaningful improvements in TBI-related symptoms. Further investigation through randomized controlled trials is warranted to validate these promising preliminary results.