Is ibogaine treatment durable? 12-month follow-up of magnesium–ibogaine therapy (MISTIC) in special operations veterans with traumatic brain injuries

Special operations veterans with TBI still had meaningful symptom improvements 12 months after Ibogaine therapy

Faerman et al. (2026) conducted a prospective 12-month follow-up study examining whether improvements following magnesium–ibogaine therapy (MISTIC) were maintained over time in 30 male U.S. Special Operations veterans with a history of traumatic brain injury (TBI). The participants had previously received a single MISTIC treatment and had shown substantial improvements one month later.

Participants were assessed at 3, 6, 9 and 12 months after treatment. The researchers measured:

• Functional disability

• PTSD symptoms

• Depression

• Anxiety

Of the 30 participants who received treatment, 27 completed at least one long-term follow-up and 25 completed the 12-month assessment

The study found that improvements were maintained throughout the 12-month follow-up period.

At 12 months, participants had significantly lower levels of:

• Functional disability

• PTSD symptoms

• Depression symptoms

• Anxiety symptoms

compared with their pre-treatment baseline. All four outcomes remained statistically significant after correction for multiple comparisons (p < .001), with very large effect sizes (Cohen's d ≥ 2.18). Significant improvements were also observed at 3, 6 and 9 months.

The results cannot establish that ibogaine itself caused the improvements observed at 12 months. This is particularly important because 23 of the 25 participants who completed the 12-month assessment used at least one other psychedelic during the follow-up period. Nineteen reported using 5-MeO-DMT, and 18 of those used it in the context of a retreat. In addition, 12 participants received therapy or counselling.

The researchers did find that long-term outcomes were similar between participants who did and did not pursue additional interventions, and the findings remained significant in several sensitivity analyses. However, because this was an open-label, naturalistic study without a control group, these analyses cannot completely separate the effects of MISTIC from subsequent treatments or other factors

Abstract

Traumatic brain injury (TBI) can result in chronic functional disability and is associated with persistent psychiatric symptoms, including posttraumatic stress disorder (PTSD), depression, and anxiety. Ibogaine, an oneirogenic alkaloid with unique pharmacological properties, has shown initial promise as a potential treatment for TBI-related sequelae. We previously observed large improvements in functional and psychiatric outcomes up to one month after a single treatment with magnesium-ibogaine in male U.S. Special Operations Veterans with a history of TBI. However, further evidence on the durability of these effects is needed. In this prospective long-term follow-up study, we evaluated the persistence of these clinical improvements over the subsequent year.

Participants underwent comprehensive baseline and post-treatment assessments, with follow-up evaluations conducted at 3, 6, 9, and 12 months. Of 30 participants treated with magnesium-ibogaine, 25 completed the 12-month follow-up assessments. Outcome measures included a self-report measure of functional disability and clinician-administered assessments of psychiatric symptoms. Linear mixed-effects models demonstrated robust and sustained reductions in disability, PTSD, depression, and anxiety symptoms through 12 months post-treatment (all p < 0.001 after correction for multiple comparisons), with large effect sizes (Cohen’s d ≥ 2.18 at 12 months).

In participants who achieved remission immediately post-treatment, survival analyses estimated the probability of sustained remission at 12 months as 84% for PTSD, 66% for depression, and 61% for anxiety. Notably, most participants reported using other psychedelic substances or pursuing other interventions during the follow-up period, which should be considered when interpreting long-term symptom trajectories. In this naturalistic cohort, durable, clinically meaningful symptom improvements were observed in individuals with TBI up to 12 months after ibogaine treatment.

Further investigation through randomized controlled trials is warranted to validate these promising preliminary results and clarify the causal contributions of ibogaine treatment, subsequent interventions, and their combination.

Faerman, A., Lissemore, J.I., Geoly, A.D. et al. Is ibogaine treatment durable? 12-month follow-up of magnesium–ibogaine therapy (MISTIC) in special operations veterans with traumatic brain injuries. Transl Psychiatry (2026). Read Paper

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