Psychiatric Medications
Ibogaine and mood stabilizers
Lithium, valproate, lamotrigine, and the quetiapine handed out for everything. Mood stabilizer dependence is not an indication for ibogaine, the interaction risks are real, and the screening here is the strictest on this site. Read this page slowly.
How ibogaine can help, honestly told
Straight answer first, and this page needs two of them. One: no study has tested ibogaine for people on mood stabilizers, and nothing here claims otherwise. Two: this class of medication carries the sharpest interaction risks on this site. Lithium and quetiapine prolong the QT interval, and QT-prolonging drugs cannot be in your body when ibogaine is.¹²³ The 28-day washout is not our preference, it is the price of entry, and some people will be screened out entirely. We would rather lose your booking than gamble with your heart.
The spiritual work: meeting your moods instead of managing them
Here is the philosophical wager underneath this page: a mood is information before it is a malfunction. The treatment experience walks you through your own history, and people consistently report insights about their past and a changed relationship with what they find there.¹¹³ For people who have spent years being flattened into an acceptable middle, the striking discovery is often not that the highs and lows were right, but that they were saying something, and that nobody, including the person having them, had ever listened all the way through.
Who this is not for, said clearly
Active mania and active psychosis are screened out here, full stop: an intense psychedelic experience is the wrong tool for a mind in either state. And if lithium is genuinely holding your life together, we are not the ones to talk you off it. Much off-label prescribing, though, tells a different story: 40 to 75% of antipsychotic prescriptions are off-label, quetiapine most of all, mostly for insomnia and anxiety.¹⁴⁵ Many people carrying a "mood stabilizer" were never actually the patient it was designed for. Screening exists to tell these stories apart.
Ibogaine is the first step, never the whole answer
Nowhere is this truer. People who go through an ibogaine experience without structure afterwards often struggle to integrate it,¹²⁴ and a person re-learning to live with unmedicated moods needs more than a memorable night: they need a strong, healthy environment, a daily practice, and a spiritual, indigenous and philosophical approach to the mind that treats moods as weather to be worked with, not errors to be suppressed. That is the program. The treatment is its doorway.
Then, the neurochemistry, held at arm's length
The proposed biology, a sustained rise in the growth factor GDNF ⁸¹ and a broad recalibration of serotonin and reward signaling,¹¹¹ comes from addiction research. How it maps onto mood cycling is unknown, and we will not pretend otherwise. On this page more than any other, the honest sentence is: the science is not there yet, and the screening is where our confidence actually lives.
Why the four weeks are absolute
Lithium and quetiapine are QT-prolonging drugs, and ibogaine itself prolongs the QT interval in proportion to exposure.¹²³ Together they are a combination no responsible provider will touch, which is why the washout here is a hard requirement, not a guideline.
The taper itself is the opposite of abrupt: mood stabilizers are discontinued slowly, under your prescriber's supervision, with a relapse plan in place, before the 28 clean days even begin. For some people that process takes months, and we would rather wait months than rush it.
Screening then verifies everything: cardiac workup, full medication history, and an honest conversation about your diagnosis. Full disclosure is non-negotiable, because our safety record depends on knowing exactly what is in your system.
Stopping a mood stabilizer without medical supervision can be genuinely dangerous, including relapse into mania or depression. Nothing on this page is medical advice; every plan is made with your prescriber and the independent licensed Brazilian physicians who make the final screening decision.
Living with your weather
The medication model asks: how do we keep the line flat? We ask a different question: what does a life look like where the highs and lows are usable? The answer we have found is a daily architecture strong enough to hold both.
Exercise
A body worked hard every day is the most reliable mood regulator we know of, and the program administers it like the medicine it is.
Meditation
The skill this page turns on: watching a mood rise, crest and pass without being carried away by it or clamping it flat. Trained daily.
The jungle
The rainforest is the original lesson in weather: storms arrive, pour and pass, and the forest is fed by all of it. You live inside that lesson for a month.
Daily walking and hiking
Rhythm is regulation. The same trails, the same hours, tired legs and a steady cadence the nervous system can set its clock by.
Excellent food
Consistent, real meals at consistent hours. Blood sugar swings masquerade as mood swings more often than anyone admits.
Media detox
A feed engineered for outrage is amplitude you did not choose. It goes silent for the month, and the baseline settles noticeably.
And where the transition needs support, plants before prescriptions
Through the taper and after, support comes from the plant traditions rather than a new prescription: saffron and mulungu from South American practice, ashwagandha and brahmi from Ayurveda, chosen case by case with the medical team, and always disclosed to the physicians. Traditional, supportive, and never a stand-in for medical supervision.
Come see the place before you decide anything
This page asks more of you than any other: months of preparation and strict screening. The place should be worth it. Walk the campus, see the rooms, meet the routine.
Stabilized, by whose measure?
Thirty-seven million people worldwide live with bipolar disorder, and fewer than half of those affected will ever see the inside of any mental health care.¹⁴³ ¹⁴⁴ Meanwhile, in the rich world, the same drug class flows freely off-label: prescribed for sleep, for worry, for restlessness, for being difficult in a system that has fifteen minutes per appointment.¹⁴⁵
That is the strange arithmetic of this medication class: too scarce where it is desperately indicated, too casual where it never was. And everywhere it goes, it carries the same lifetime framing: maintenance, monitoring, every-three-month blood draws,¹⁴⁶ and almost no conversation about whether the person in front of the prescription pad might one day learn to hold their own weather.
For some people the medication is exactly right, and we say so without reservation. Our argument is narrower and more personal: the people who were flattened to fit an expectation deserve at least one serious, medically careful chance to find out who they are without it.
What if your mood did not need to be stabilized? What if you had to accept your highs and your lows, embrace them, and use them to your advantage?
You are not broken or imbalanced. You have simply not learned to engage with your moods, and you have been trying to fit everyone else's expectation of how you are supposed to feel. That ends now.
Charles D. Johnston & Tatiana Aya Tupinambá, Co-Founders, Nekawa
Beyond the flat line
The mood stabilizer era measured success as amplitude reduction: fewer highs, fewer lows, a narrower band. The traditions we draw from, indigenous and philosophical alike, measured something else: whether a person could inhabit the full range of their own experience and put it to use. We think medicine will eventually find its way back toward that second measure, and we are building one small proof of it in the rainforest.
Ibogaine, for the people who clear this page's strict screening, is the first step: one profound, supervised experience in place of an indefinite prescription, followed by the real work. The 28-Day UNprogram is that work: the practice, the rhythm, the forest, the philosophy, until your moods become an instrument you play rather than an alarm you silence.
No trial exists for any of this, the interactions are serious, and some readers of this page should stay exactly where they are. For the rest: come slowly, tell us everything, and let the physicians decide with you.
Citations (9)
[81] He DY, Ron D (2006). Autoregulation of glial cell line-derived neurotrophic factor expression: implications for the long-lasting actions of ibogaine. The FASEB Journal, 20(13), 2420–2422. Read the source →
Shows ibogaine triggers a sustained, self-sustaining upregulation of GDNF in reward-related brain regions — a mechanism for effects that outlast the drug itself.
[111] Mash DC (2023). IUPHAR invited review — Ibogaine: A legacy within the current renaissance of psychedelic therapy. Pharmacological Research, 190, 106620. Read the source →
Mechanism synthesis: ibogaine inhibits the serotonin transporter noncompetitively, its long-lived metabolite noribogaine slows serotonin reuptake and acts as a G-protein-biased kappa-opioid agonist, and rapid antidepressant-like effects are thought to involve ketamine-like NMDA receptor blockade. All framed as proposed mechanisms under investigation, not demonstrated clinical effects.
[113] Heink A, Katsikas S, Lange-Altman T (2017). Examination of the phenomenology of the ibogaine treatment experience: role of altered states of consciousness and psychedelic experiences. Journal of Psychoactive Drugs, 49(3), 201–208. Read the source →
Survey of 27 people who underwent ibogaine treatment: all reported insights about their personal past, 97% experienced visions, 77% saw content drawn from their own childhood, and 85% reported subjective relief from guilt. Large majorities reported insights about the meaning of life, death, and creation. A small, self-selected online survey, reported as phenomenology rather than outcome evidence.
[123] Knuijver T, Ter Heine R, Schellekens AFA, Heydari P, Lucas L, Westra S, Belgers M, Van Oosteren T, Verkes RJ, Kramers C (2024). The pharmacokinetics and pharmacodynamics of ibogaine in opioid use disorder patients. Journal of Psychopharmacology, 38(5), 481–488. Read the source →
PK/PD study in opioid use disorder patients: ibogaine clearance varies more than ten-fold with CYP2D6 enzyme activity, and QTc prolongation tracks drug exposure. The quantitative basis for strict cardiac screening and for clearing CYP2D6-inhibiting medications before treatment.
[124] Davis AK, Renn E, Windham-Herman AM, Polanco M, Barsuglia JP (2018). A mixed-method analysis of persisting effects associated with positive outcomes following ibogaine detoxification. Journal of Psychoactive Drugs, 50(4), 287–297. Read the source →
In a retrospective study of 73 people treated with ibogaine for opioid use disorder, roughly 23% reported difficulty integrating the experience into daily life afterwards. The evidence that ibogaine is a beginning that needs a structured program around it, not a standalone treatment.
[143] World Health Organization (2025). Bipolar disorder (fact sheet). World Health Organization, updated September 2025. Read the source →
An estimated 1 in 200 people, about 37 million worldwide, live with bipolar disorder (2021 modelled estimates), and WHO states that treatment coverage is low. Modelled Global Burden of Disease figures, not diagnosed cases.
[144] Merikangas KR, Jin R, He JP, Kessler RC, Lee S, Sampson NA, Viana MC, Andrade LH, Hu C, Karam EG, et al. (2011). Prevalence and correlates of bipolar spectrum disorder in the World Mental Health Survey Initiative. Archives of General Psychiatry, 68(3), 241–251. Read the source →
Across 11 countries, 2.4% of people met lifetime criteria for bipolar spectrum disorder, fewer than half of those affected ever received mental health treatment, and in low-income countries only 25.2% had any contact with the mental health system.
[145] Carton L, Cottencin O, Lapeyre-Mestre M, Geoffroy PA, Favre J, Simon N, Bordet R, Rolland B (2015). Off-label prescribing of antipsychotics in adults, children and elderly individuals: a systematic review of recent prescription trends. Current Pharmaceutical Design, 21(23), 3280–3297. Read the source →
Systematic review finding that 40–75% of adult antipsychotic prescriptions are off-label, with quetiapine the most frequently prescribed off-label antipsychotic, most often for insomnia and anxiety rather than psychosis or bipolar disorder.
[146] National Institute for Health and Care Excellence (2015). Bipolar disorder in adults: quality standard QS95 (lithium monitoring). NICE Quality Standard 95, statement 5. Read the source →
UK guidance requires people taking lithium to have blood levels checked every three months in the first year, with kidney, thyroid and calcium monitoring every six months, more often for older adults or anyone on interacting medications. The monitoring burden of a drug framed as lifelong maintenance.
Let’s connect.
No pressure. Tell us a little about what you’re going through.