Ibogaine and Benzodiazepines: Why They Are Not Treated the Same Way

Ibogaine is not a treatment for benzodiazepine dependence. Unlike opioid withdrawal, which ibogaine can interrupt, withdrawal from benzodiazepines such as alprazolam (Xanax), clonazepam (Klonopin, Rivotril) or diazepam (Valium) can cause seizures and must be managed with a slow, medically supervised taper. People who use benzodiazepines, alone or with opioids, need to complete that taper before ibogaine can be considered.

Key takeaways

• There is no evidence that ibogaine relieves benzodiazepine withdrawal.
• Stopping benzodiazepines suddenly after regular use can cause seizures, delirium and, rarely, death.
• The safe approach is a gradual taper, often over weeks to months, supervised by a physician.
• Benzodiazepine withdrawal and ibogaine both affect the brain's excitability and heart safety, so they must not overlap.
• Many people who use opioids also use benzodiazepines; the benzodiazepine taper usually comes first.

Why benzodiazepines are different

Benzodiazepines calm the brain by enhancing GABA, its main "brake" system. With regular use, the brain adapts and reduces its own braking. If the drug is stopped suddenly, the brain becomes over-excited, which can cause anxiety, insomnia, tremors, hallucinations and seizures. Alcohol works in a similar way, which is why alcohol and benzodiazepine withdrawal are the two most medically dangerous.

Ibogaine does not act on GABA in the way benzodiazepines do. It can interrupt opioid withdrawal through other mechanisms, but there is no evidence that it prevents benzodiazepine withdrawal or its seizures.

The risks of combining withdrawal and ibogaine

• Seizures: benzodiazepine withdrawal lowers the seizure threshold. Adding a powerful psychoactive drug during that period adds unpredictable risk.
• Heart rhythm: withdrawal can cause vomiting, dehydration and electrolyte changes, which increase the danger of ibogaine's effect on the QT interval.
• Hidden use: street pills sold as Xanax are often counterfeit and may contain other benzodiazepines or fentanyl, so a full, honest substance history and testing are essential.

Read more in ibogaine side effects and heart safety.

The safe path: a gradual taper first

1. Medical evaluation of which benzodiazepines you take, the dose, for how long, and any history of seizures.
2. A supervised taper by your doctor. Commonly, short-acting benzodiazepines are switched to a longer-acting one, and the dose is reduced in small steps over weeks to months.
3. A stabilization period after the last dose, defined by the medical team.
4. Ibogaine, if appropriate, for the condition it is meant to treat, such as opioid dependence, with continuous cardiac monitoring.

Sleep medications such as zolpidem (Ambien) act on the same system and are reviewed the same way.

If you use opioids and benzodiazepines

This combination is common and is one of the main causes of overdose deaths, because both slow breathing. If you want ibogaine for opioid dependence, our medical team will usually plan the benzodiazepine taper first, then the opioid transition, then ibogaine. See ibogaine for opioid addiction and ibogaine for fentanyl.

Frequently asked questions

Can ibogaine help me quit Xanax or Klonopin?

There is no evidence that it can, and using it during benzodiazepine withdrawal can be dangerous. A slow medical taper is the safe way to stop.

How long does a benzodiazepine taper take?

It varies with the drug, the dose and how long you have used it, often weeks to months. Your doctor sets the pace.

Can I stop benzodiazepines on my own before coming?

No. Stopping suddenly can cause seizures. Always taper under medical supervision.

I only take a benzodiazepine occasionally to sleep. Does this apply to me?

Possibly not to the same degree, but every medication must be reviewed. Our medical team will tell you whether and how to stop before treatment.

Can I take my benzodiazepine during ibogaine treatment?

Your medications are reviewed individually during the evaluation. Do not take any medication during treatment that the medical team has not approved.

References

• Mosca, A. et al. "Ibogaine/Noribogaine in the treatment of substance use disorders: a systematic review of the current literature." Current Neuropharmacology, 2023.
• Ashton, H. Benzodiazepines: How They Work and How to Withdraw (the "Ashton Manual"), 2002. benzo.org.uk

Taking benzodiazepines and considering ibogaine? Our medical team will review your medications confidentially and plan a safe path. Request your evaluation.