Ibogaine是一种植物衍生的生物碱和解离性迷幻剂,具有多种滥用物质的抗成瘾特性,包括酒精。5-甲氧基-N,N-二甲基色胺(5-MeO-DMT)是一种天然存在的迷幻剂,已知会出现有效的神秘类型体验,并且还显示出抗成瘾特性。两种化合物在治疗酒精使用障碍中的潜在治疗效果需要进一步研究,并且迄今为止还没有公开的人类神经影像学发现。我们介绍了一名31岁的男性退伍军人,患有中度酒精使用障碍,他在墨西哥的一家住院诊所寻求治疗,该诊所采用了盐酸伊波加因(1550mg,17.9mg/kg)在第1天,然后蒸发5-MeO-DMT(蟾蜍毒素源50mg,估计5-MeO-DMT含量,5-7mg)在第3天。患者接受了SPECT神经成像,其中包括之前的静息状态方案,和3天后完成的程序。在病人的伊博加因治疗期间,他经历了梦幻般的愿景,其中包括与他的酒精使用和解决过去的发展创伤有关的内容。他将5-MeO-DMT的治疗描述为一个高峰的转变和精神突破。关于治疗后SPECT神经影像学,双侧尾状核的脑灌注增加,左壳核,右岛,以及时间,枕骨,和小脑区域与患者的基线扫描相比。患者报告情绪有所改善,停止饮酒,治疗后5天的渴望减少,在1个月时持续的效果,在2个月时部分恢复轻度饮酒。在这种情况下,依波加因和5-MeO-DMT的连续给药导致与酒精使用障碍和已知的两种化合物的药理学广泛相关的多个脑区的灌注增加。这与短期治疗结果相吻合。在这些孤立的发现的背景下,我们提出了关于两种迷幻药在治疗酒精使用障碍方面的潜力的理论考虑。以及未来调查的领域。
Ibogaine is a plant-derived alkaloid and dissociative psychedelic that demonstrates anti-addictive properties with several substances of abuse, including alcohol. 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a naturally occurring psychedelic known to occasion potent mystical-type experiences and also demonstrates anti-addictive properties. The potential therapeutic effects of both compounds in treating alcohol use disorder require further investigation and there are no published human neuroimaging findings of either treatment to date. We present the
case of a 31-year-old male military veteran with moderate alcohol use disorder who sought treatment at an inpatient clinic in Mexico that utilized a sequential protocol with
ibogaine hydrochloride (1550mg, 17.9mg/kg) on day 1, followed by vaporized 5-MeO-DMT (bufotoxin source 50mg, estimated 5-MeO-DMT content, 5-7mg) on day 3. The patient received SPECT neuroimaging that included a resting-state protocol before, and 3 days after completion of the program. During the patient\'s
ibogaine treatment, he experienced dream-like visions that included content pertaining to his alcohol use and resolution of past developmental traumas. He described his treatment with 5-MeO-DMT as a peak transformational and spiritual breakthrough. On post-treatment SPECT neuroimaging, increases in brain perfusion were noted in bilateral caudate nuclei, left putamen, right insula, as well as temporal, occipital, and cerebellar regions compared to the patient\'s baseline scan. The patient reported improvement in mood, cessation of alcohol use, and reduced cravings at 5 days post-treatment, effects which were sustained at 1 month, with a partial return to mild alcohol use at 2 months. In this
case, serial administration of
ibogaine and 5-MeO-DMT resulted in increased perfusion in multiple brain regions broadly associated with alcohol use disorders and known pharmacology of both compounds, which coincided with a short-term therapeutic outcome. We present theoretical considerations regarding the potential of both psychedelic medicines in treating alcohol use disorders in the context of these isolated findings, and areas for future investigation.