Fatal intoxication after taking iboga: GC-MS/MS determination of ibogaine and ibogamine in iboga roots and post-mortem material

Objective: Tabernanthe iboga, or iboga, is a shrub native to equatorial Africa. Its root is commonly taken as a stimulant and hallucinogen. Ibogaine, the principal alcaloid in the plant, is the source of its psychotropic effects. We report the case of a 27-year-old man with a long history of drug addiction who was found dead in 2006, 12 hours after ingesting powdered iboga root as part of a detoxification programme. Ibogaine and ibogamine were identified and quantified in the powder ingested and in the body fluid samples taken at the scene of death and during the autopsy. Methods: Analysis was carried out using GC-MS/MS (electron impact - ion trap) after performing liquid-liquid extraction on the body fluids. Results: The concentrations measured in the post-mortem peripheral blood samples taken at the scene, and in the peripheral blood, urine and gastric juice samples taken during the autopsy were: 0.65, 1.27, 1.71 and 53.5 μg mL-1 for ibogaine; and 0.05, 0.10, 1.12 and 4.34 μg mL-1 for ibogamine. The powder was titrated at 7.2 per cent for ibogaine and 0.6 per cent for ibogamine. Conclusion: The presence of the two molecules in the biological samples was consistent with the recent ingestion of Tabernanthe iboga roots. The combined consumption of other central nervous system depressants (diazepam and methadone), revealed by further toxicological analysis, confirms the hypothesis of death caused by mixed overdose, of which the principal toxin was ibogaine. © 2012 Société Française de Toxicologie Analytique.