Preparation & Medical Screening

This is the page I want everyone to read before they reach out. Medical screening for iboga is non-negotiable. I will turn you away if there's a concern. That's not rejection — that's the bare minimum of responsible facilitation.

Most iboga-related deaths were preventable. They happened because screening was inadequate, medications weren't properly washed out, or cardiac monitoring wasn't in place.

Why screening is essential.

Ibogaine causes QT prolongation — a measurable change in the heart's electrical cycle. In a healthy heart, this is transient and manageable. In a heart with pre-existing QT prolongation or structural abnormalities, it can trigger fatal arrhythmias. Torsades de pointes — a specific type of arrhythmia — is the primary cause of ibogaine-related deaths.

This is not theoretical risk. People have died. The majority of those deaths were preventable with proper screening.

Required screening includes: comprehensive medical history, full medication review, ECG (electrocardiogram) to measure QT interval, blood work (electrolytes, liver function, kidney function), and potentially additional cardiac testing depending on what the initial screening reveals.

Absolute contraindications.

These are conditions where iboga is not safe under any circumstances:

Relative contraindications.

These require careful evaluation — they don't automatically disqualify you, but they require additional assessment:

Medication discontinuation.

This is where most of the practical complexity lives. Several classes of medication must be discontinued before iboga, and the timelines vary:

QT-prolonging medications — many common medications prolong QT. Antipsychotics, certain antibiotics, certain antiemetics, methadone. These must be cleared from your system before ceremony.

Serotonergic medications — SSRIs (Prozac, Zoloft, Lexapro), SNRIs (Effexor, Cymbalta), MAOIs. Combining these with ibogaine risks serotonin syndrome, which can be fatal. Tapering off SSRIs requires weeks to months.

Opioid transition protocols — if you're on opioids (including MAT medications like methadone or buprenorphine), there are specific transition protocols that must be followed. This is medically complex and requires professional guidance.

Benzodiazepine taper — benzodiazepines cannot be stopped abruptly. A gradual taper over weeks or months is required, supervised by a physician.

How to prepare.

Physical preparation begins 2–4 weeks before ceremony. Clean nutrition — whole foods, minimal processed food, adequate hydration. Prioritize sleep. Moderate exercise. Discontinue alcohol, cannabis, and recreational substances. Fast for 8–12 hours before ceremony.

Psychological preparation is equally important. Clarify your intentions — not a rigid script, but an honest assessment of what you're bringing to the work and what you hope to address. Expect difficulty — this is not a comfortable experience, and entering with realistic expectations reduces the likelihood of panic during the hard moments. Cultivate willingness to surrender — the experience asks you to let go of control.