Clinical improvement following an integrative iboga microdosing protocol in post-concussive and hypoxic brain injury syndromes: a case series.

Background: Traumatic brain injury (TBI) can result in prolonged post-concussive syndrome and chronic hypoxic-ischemic brain injury (HIBI) sequelae remains therapeutically challenging with the persistence of significant neurological and cognitive impairments. While conventional treatments often provide limited relief, emerging research explores alternative therapeutic interventions, including psychedelic compounds combined with therapeutic interventions. Objectives: This naturalistic case series examines clinical observations following an integrative, participant-directed iboga-containing microdosing protocol paired with Accelerated Experiential Dynamic Psychotherapy (AEDP) in three individuals with persistent neurologic symptoms after traumatic brain injury (TBI) or hypoxic-ischemic brain injury. Methods: Three participants completed a 6 week protocol using Tabernanthe iboga root bark biomass (participant-directed titration 0.1-1.0 g/day, 4 days-on/3 days-off). Quantitative qNMR/HPLC analysis (University of Cape Town) demonstrated approximately 3.845% ibogaine content by mass, yielding estimated ibogaine-equivalent exposure of 3.8-38.5 mg/day. All administration utilized whole root bark biomass only. Weekly AEDP psychotherapy and supportive nutraceuticals were provided concurrently. Patient one: A 43 year-old man with TBI sustained in a motorcycle accident. Patient Two: A 40-year-old woman with chronic hypoxic brain injury sustained during an avalanche burial event. Patient Three: A 19 year old woman with TBI sustained in a motor vehicle accident. Results: All three patients demonstrated progressive neurological recovery over the 6-week microdosing iboga protocol with two of the patients declaring complete symptom remission at a long term follow up assessment. Initial reported symptoms included a constellation of daily headaches, episodic migraines, disequilibrium, irritability, mood swings, fatigue, brain fog, sleep disruptions, and loss of interest in typical life activities. At the conclusion of the protocol, and at long term follow-up visits, patients felt able to discontinue all prescription medications for symptomatic treatment, reporting absence of severe migraine headaches, resolution of brain fog, fatigue, irritability, and stabilized mood, with the ability to return all regular activities with a renewed enthusiasm for life. All patients provided consent to share their significant clinical and therapeutic improvement journey in this publication. Safety considerations: The microdosing protocol was carefully implemented with rigorous screening to mitigate potential cardiac and neurological risks associated with iboga administration, including medical background screening for potential drug interactions, and past medical history contraindications including heart conditions and/or the concomitant administration of selective serotonin reuptake inhibitors (SSRIs). Conclusion: This naturalistic case series provides hypothesis-generating observations regarding possible clinical improvement following an integrative iboga-containing intervention paired with psychotherapeutic and supportive care. The findings do not establish causality or iboga-specific efficacy and should be interpreted within the context of multimodal therapeutic exposure and substantial methodological limitations. These preliminary observations suggest that an integrative iboga microdosing protocol, in association with psychotherapeutic and supportive care, may be linked to meaningful improvements in prolonged post-concussive symptoms. As a hypothesis-generating case series, these findings warrant further investigation in controlled trials to establish causality and specificity.