What We Treat
Ibogaine for mental health
Depression, anxiety, PTSD, ADHD and OCD, burnout. The evidence for ibogaine runs from a striking veterans study to no study at all, and every page in this section tells you which, before it tells you anything else.
Ibogaine first, honestly
These pages lead with ibogaine because that is what you came to ask about. What has actually been measured: in open-label studies of people treated for opioid dependence and in veterans cohorts, depression, anxiety and PTSD symptoms fell after a single treatment, sometimes dramatically, and in the Stanford veterans study those changes came with measurable shifts in brain structure and brain rhythms.⁹ ⁴²
And what has not: no randomized controlled trial has tested ibogaine for any mental health condition. The strongest cohorts are small, all-male, uncontrolled, and confounded by co-administered compounds. For ADHD, OCD and burnout there is no study at all. Each page states where its condition sits on that spectrum, in body type, not in a footnote.
The measurements are also only half of what these pages are about. Ibogaine's treatment night is a long waking dream that walks a person through their own life, and in the research on the experience itself, people consistently report insights about their past, release from guilt, and something many rank alongside a spiritual transformation.¹¹³ ¹¹⁴ We take that seriously rather than apologizing for it, because a mental health condition is not only chemistry. It is a mind, and minds are healed by what they live through, not only by what they absorb.
The scale of the need is why we think the honesty matters. More than a billion people are living with a mental disorder,⁸⁶ and even in the wealthiest countries most of them are getting little or no help.⁹⁰ People failed by the standard system deserve new options; they also deserve not to be sold to. These pages try to be both things at once.
We do not treat mental health as a war against a broken brain. Most of what gets called mental illness is pain that never had a place to be processed: loss, pressure, disconnection, things that happened to you and things that did not happen for you.
That is why we work on the mind, not just the brain. The brain is chemistry, and the science on these pages matters. But the mind is the story you have been telling yourself for decades, and healing means retraining that story, not only rebalancing the molecules underneath it.
The medicine does not heal you. It opens a window. What happens in that window, and what you build in the months after it, is yours. Our job is to make the window safe, and to make sure you do not stand in it alone.
Charles D. Johnston & Tatiana Aya Tupinambá, Co-Founders, Nekawa
One honest sentence before the button
No mental health condition on these pages has a controlled ibogaine trial behind it, and we would rather tell you that in large type than have you find out later. What exists, open-label signals, mechanism, and our own operating experience, lives on each page next to the numbers. The consultation exists to work out whether any of it reasonably applies to you, and cardiac screening comes before everything, because it rules some people out.
Citations (10)
[9] Mash DC, Duque L, Page B, Allen-Ferdinand K (2018). Ibogaine Detoxification Transitions Opioid and Cocaine Abusers Between Dependence and Abstinence: Clinical Observations and Treatment Outcomes. Frontiers in Pharmacology, 9, 529. Read the source →
Open-label study reporting that ibogaine therapy in a safe dose range diminished opioid withdrawal symptoms and reduced drug cravings, transitioning opioid- and cocaine-dependent patients toward abstinence.
[42] Cherian K, Keynan J, Anker L, Faerman A, Brown R, Shamma A, Keynan O, Coetzee J, Batail JM, Phillips A, Bassano N, Sahlem G, Inzunza J, Millar T, Dickinson J, Rolle C, Keller J, Adamson M, Kratter I, Williams N (2024). Magnesium-ibogaine therapy in veterans with traumatic brain injuries. Nature Medicine, 30, 373–381. Read the source →
The MISTIC trial. 30 male US Special Operations Forces veterans with predominantly mild traumatic brain injury received intravenous magnesium plus oral ibogaine (mean 12.1 mg/kg); 23 met criteria for PTSD at baseline. One month after treatment the group had moved from mild-to-moderate disability to no disability on the WHODAS-2.0 (30.2 to 5.1, d = 2.20), the study primary outcome. PTSD symptoms fell 88% on average, with a 100% response rate and 86% remission (d = 2.54); depression fell 87% (83% remission) and anxiety 81% (83% remission). Suicidal ideation fell from 47% at baseline to 7% at one month. Participants also gained in processing speed, executive function, verbal fluency and verbal learning, with no cognitive decline on any measure, and there were no serious or unexpected treatment-emergent adverse events. Open-label and uncontrolled, in a highly selected cohort, with magnesium co-administered, so the effect cannot be attributed to ibogaine alone.
[86] World Health Organization (2025). Mental disorders (fact sheet, updated 30 September 2025). World Health Organization. Read the source →
An estimated 1.1 billion people worldwide, nearly 1 in 7, were living with a mental disorder in 2021, with anxiety and depressive disorders the most common. Also documents the treatment gap: even in high-income countries only about a third of people with depression receive formal care. Modelled Global Burden of Disease estimates, not diagnosed cases.
[87] World Health Organization (2022). Mental health and COVID-19: early evidence of the pandemic's impact (scientific brief). World Health Organization, 2 March 2022. Read the source →
Global prevalence of anxiety and depression rose an estimated 25% in the first year of the COVID-19 pandemic. A modelled estimate for the first pandemic year; prevalence has since receded toward baseline.
[88] World Health Organization (2025). Suicide (fact sheet, updated 25 March 2025). World Health Organization. Read the source →
More than 720,000 people die by suicide every year (727,000 in 2021), and suicide is the third leading cause of death among 15 to 29 year olds. Suicide is under-registered in many countries, so these are WHO-modelled estimates.
[90] National Institute of Mental Health, from the SAMHSA 2022 NSDUH (2024). Mental Illness (statistics page, data year 2022). National Institute of Mental Health. Read the source →
23.1% of US adults, 59.3 million people, lived with a mental illness in 2022, and only about half of them (50.6%) received mental health treatment that year. Household survey data based on self-report.
[91] Chisholm D, Sweeny K, Sheehan P, Rasmussen B, Smit F, Cuijpers P, Saxena S (2016). Scaling-up treatment of depression and anxiety: a global return on investment analysis. The Lancet Psychiatry, 3(5), 415–424. Read the source →
Depression and anxiety cost the global economy an estimated US$1 trillion each year in lost productivity, about 12 billion working days. The same model found every $1 invested in scaled-up treatment returns roughly $4 in better health and productivity. A 2016 economic model.
[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.
[114] Brown TK, Noller GE, Denenberg JO (2019). Ibogaine and subjective experience: transformative states and psychopharmacotherapy in the treatment of opioid use disorder. Journal of Psychoactive Drugs, 51(2), 155–165. Read the source →
In 44 opioid-dependent people undergoing ibogaine treatment, 43% met criteria for a complete mystical experience. Participants described cyclic visual content leading to confronting realisations involving remorse and regret toward others, subjective release from guilt and worthlessness, and many compared the significance of the experience to a spiritual transformation.
[86] Barsuglia JP and colleagues (2026). Indication-stratified mortality risk of ibogaine treatment under contemporary safety protocols: a multisite analysis of 19,071 patients and updated systematic review of fatalities. Research Square preprint rs-9966269 (not yet peer reviewed). Read the source →
The largest ibogaine safety dataset to date: 19,071 treatments across 11 international clinics operating under contemporary safety protocols. Six deaths occurred within 72 hours, all among patients treated for opioid use disorder (6 of 10,382); none occurred among the 8,689 patients treated for non-substance-use indications. In the accompanying review of documented fatalities, 41 of 44 with a known indication involved substance use disorder, predominantly opioid detoxification, clustering around preexisting cardiovascular disease, concurrent CNS depressants such as opioids and benzodiazepines, and absent or inadequate pretreatment cardiac screening. A preprint: it has not completed peer review.
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