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Comment by panflute | Hacker News Reader

It seems strange to me to choose ibogaine when Salvia divinorum seems like it has a similar psychological experience without the physical heart risk.

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Saliva divinorum is inherently dysphoric due to its agonism of the kappa opiod receptor. For a different cheap legal drug that affects serotonin and the NMDA receptors like ibogaine does, there's always off label use of dextromethorphan (cough medicine)!

Again I'm a bit baffled as to what the unstated thought process is. Ibogain and Saliva divinorum share a short term dysphoric experience from kappa opioid receptor interference that might be an effective way to eliminate Trauma from earlier memories. Why use the more dangerous of the two and why avoid the experience if the experience is the intervention?

DXM is also the active ingredient in the antidepressant Auvelity (combined with bupropion)

Lot of interesting studies and anecdotes on its efficacy as an antidepressant

A small dose of DXM boosts the effectiveness of Wellbutrin by 10x or so. It's not an antidepressant itself. It's a dissociative and cough suppressant.

This is incorrect. DXM is the active ingredient in Auvelity. Bupropion is included because it inhibits the enzyme that breaks down DXM quickly. The bupropion boosts the effectiveness of DXM as the primary antidepressant, NOT the other way around like you're suggesting.

Really difficult to find a cough syrup with only high amounts of DXM and nothing else. All the brands changed their recipes in the late 90s.

They just sell DXM in softgels and tablets now

Edit: apparently that’s not true. There’s a brand of DXM-only syrup called Robocough now. What a ridiculous name for a Legitimate Cough Medicine

Isn't DXM terribly neurotoxic at those doses?

Or LSD, or magic mushrooms.

I've been assuming it was some sort of profit motive as TX has been pumping money into it. It seems like there might actually be science driven though. For tramatic brain injury combined with ptsd ibogaine causes a release of glial cell factors that help neuroplasticity wire around the damage. Its also horribly unsafe from a cardiac perspective so you would need a constant eeg during therapy driving up prices. So probably a little of the original motivation too.

Not really "horribly unsafe", it seems that with proper prescreening and magnesium supplementation cardiac risk can be safely managed. I was looking into this a few weeks ago.

However there is certainly a lack of data, and facilities doing treatment now are probably incentivized not to share adverse events.

Or DMT. I also question how they derive the consclusion of a "horrible heart risk". Imo there is not enough evidence for that.

I mean.. considering the alternatives of magic mushrooms which also have very promising results in early trials and have, afaik, no such scary side effects it seems like any risk big enough for doctors being needed close by seems bad.

What? These two substances aren't even in the same ballpark.

Maybe I have a liberal view of ballpark sizes but:

https://en.wikipedia.org/wiki/Ibogaine

"The action of ibogaine at the κ-opioid receptor may indeed contribute significantly to the psychoactive effects attributed to ibogaine ingestion; Salvia divinorum, another plant recognized for its strong hallucinogenic properties contains the chemical salvinorin A, which is a highly selective κ-opioid agonist"

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