Drug & supplement interaction

Iboga + Sertraline

Sertraline brand name: Zoloft.

Moderate Interaction
The bottom line Moderate

Sertraline falls into 3 drug categories that Iboga can interact with; the most serious is rated moderate. Theoretically, taking iboga with serotonergic drugs might increase levels of serotonin, resulting in additive effects with serotonergic drugs.

Read the full interaction report
SeverityModerate
LikelihoodPossible
Interactions3
EvidenceD
What do Severity, Likelihood & Evidence mean?
Know someone taking this? Share
Interaction report

Iboga and Sertraline

These two interact in 3 distinct ways. Each one is explained separately below.

Why Are There 3 Interactions?

Iboga interacts with whole categories of medication. Sertraline falls into 3 of those categories, so it can interact with Iboga in 3 different ways. We’ve listed each one below — your overall risk is driven by the most serious of them (Moderate).

Moderate

SEROTONERGIC DRUGS

1 of 3

Why this applies to Sertraline

Sertraline falls under SEROTONERGIC DRUGS — the group Iboga interacts with.

Theoretically, taking iboga with serotonergic drugs might increase levels of serotonin, resulting in additive effects with serotonergic drugs.
Ibogaine, a constituent in iboga, has serotonergic effects. Theoretically, combining serotonergic drugs with iboga might increase the risk of serotonergic side effects, including serotonin syndrome and cerebral vasoconstrictive disorders. Monitor patients for signs of serotonin syndrome and other serotonergic side effects if using iboga with serotonergic drugs.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with pairing Iboga with sertraline (Zoloft). Sertraline already raises serotonin levels in your brain, which is how it helps with depression and anxiety. Ibogaine, the active part of Iboga, also pushes serotonin activity. Stack the two together and you can get too much serotonin at once.

When serotonin climbs too high, the body can react with what we call serotonin syndrome: agitation, a racing heart, sweating, shivering, muscle twitching, and in serious cases confusion or fever. To be honest, this warning is mostly theoretical, based on how both substances work rather than solid studies. But Iboga also carries real heart rhythm dangers and is illegal in the U.S. Please don't combine them, and talk with your pharmacist or doctor first.

References
  1. Glick SD, Maisonneuve IS. Mechanisms of antiaddictive actions of ibogaine. Ann N Y Acad Sci 1998;844:214-26.
  2. Singhal AB, Caviness VS, Begleiter AF, et al. Cerebral vasoconstriction and stroke after use of serotonergic drugs. Neurology 2002;58:130-3. PubMed
  3. Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302. PubMed
Moderate

QT INTERVAL-PROLONGING DRUGS

2 of 3

Sertraline also falls under QT INTERVAL-PROLONGING DRUGS.

Theoretically, iboga may have an additive effect with drugs that prolong the QT interval.
Numerous case reports suggest that ibogaine, a constituent in iboga, can cause QT interval prolongation.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the concern with mixing Iboga and sertraline (Zoloft). Both can affect your heart's electrical timing, something called the QT interval. Sertraline carries a small QT risk on its own, and ibogaine (the active compound in Iboga) has been linked in several case reports to dangerous QT prolongation. Stacking the two together could add up and raise the chance of a serious, irregular heartbeat.

This is based mostly on anecdotal reports, not strong studies, so the evidence is fairly weak. But the potential outcome is serious, and ibogaine itself is illegal and risky. Sertraline also raises serotonin, so combining it with a serotonin-active substance adds another worry. Please don't change anything on your own. Talk with your doctor or pharmacist first.

References
  1. O'Connell CW, Gerona RR, Friesen MW, Ly BT. Internet-purchased ibogaine toxicity confirmed with serum, urine, and product content levels. Am J Emerg Med. 2015; 33(7):985.e5-6. PubMed
  2. Vlaanderen L, Martial LC, Franssen EJ, van der Voort PH, Oosterwerff E, Somsen GA. Cardiac arrest after ibogaine ingestion. Clin Toxicol (Phila). 2014;52(6):642-3. PubMed
  3. Asua. Growing menace of ibogaine toxicity. Br J Anaesth. 2013;111(6):1029-30. PubMed
  4. Hoelen DW, Spiering W, Valk GD. Long-QT syndrome induced by the antiaddiction drug ibogaine. N Engl J Med. 2009;360(3):308-9. PubMed
  5. Paling FP, Andrews LM, Valk GD, Blom HJ. Life-threatening complications of ibogaine: three case reports. Neth J Med. 2012;70(9):422-4.
  6. Pleskovic A, Gorjup V, Brvar M, Kozelj G. Ibogaine-associated ventricular tachyarrhythmias. Clin Toxicol (Phila). 2012;50(2):157. PubMed
  7. Litjens RP, Brunt TM. How toxic is ibogaine? Clin Toxicol (Phila). 2016;54(4):297-302. PubMed
  8. Grogan J, Gerona R, Snow JW, Kao L. Ibogaine consumption with seizure-like episodes, QTc-prolongation, and captured cardiac dysrhythmias. J Emerg Med 2019;57(4):e99-e104. PubMed
  9. 105383 Knuijver T, Schellekens A, Belgers M, et al. Safety of ibogaine administration in detoxification of opioid dependent individuals: a descriptive open-label observational study. Addiction 2021. PubMed
  10. Steinberg C, Deyell MW. Cardiac arrest after ibogaine intoxication. J Arrhythm 2018;34(4):455-457. PubMed
Moderate

CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS

3 of 3

Sertraline also falls under CYTOCHROME P450 2D6 (CYP2D6) INHIBITORS.

Theoretically, taking iboga with CYP2D6 inhibitors might increase the levels and clinical effects of ibogaine.
Ibogaine, the active constituent of iboga, is a substrate of CYP2D6. One pharmacokinetic study shows that taking the CYP2D6 inhibitor paroxetine prior to taking ibogaine 20 mg increases the exposure to ibogaine and its metabolite noribogaine by 2-fold when compared with ibogaine alone.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the key thing about this pairing: it's the Iboga that gets affected, not your Sertraline. Sertraline (Zoloft) gently blocks an enzyme in your liver called CYP2D6, and ibogaine, the active piece of Iboga, relies on that same enzyme to be broken down. So when the two are taken together, ibogaine and its byproduct can pile up. In one study, a similar medication roughly doubled ibogaine levels.

Why that worries me: Iboga already carries serious risks, including dangerous heart rhythm changes, and higher levels make that more likely. On top of that, both Sertraline and ibogaine push on serotonin, which raises the chance of serotonin syndrome (agitation, racing heart, sweating, shaking). Ibogaine is illegal in the U.S. and unsafe outside research. Please talk with your doctor or pharmacist before considering anything like this.

References
  1. Henstra M, Wong L, Chahbouni A, et al. Toxicokinetics of ibogaine and noribogaine in a patient with prolonged multiple cardiac arrhythmias after ingestion of internet purchased ibogaine. Clin Toxicol (Phila). 2017;55(6):600-602. PubMed
  2. Glue P, Winter H, Garbe K, et al. Influence of CYP2D6 activity on the pharmacokinetics and pharmacodynamics of a single 20?mg dose of ibogaine in healthy volunteers. J Clin Pharmacol. 2015;55(6):680-7. PubMed
  3. Rodriguez P, Urbanavicius J, Prieto JP, et al. A single administration of the atypical psychedelic ibogaine or its metabolite noribogaine induces an antidepressant-like effect in rats. ACS Chem Neurosci 2020;11(11):1661-1672. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Iboga Also Interacts With Other Medications

Iboga has 1 major, 500 moderate known drug interactions in our database — the Sertraline one above is among them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Iboga

Covers the 2,830 medications we’ve checked against Iboga. Pick one to open its full report.

From our Q&A

Questions About Iboga or Sertraline

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Iboga or Sertraline, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Sertraline

This page covers Iboga only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Sertraline page lists 188 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), American Hellebore (major), Arsenic (major), Cesium (major) and Ephedra (major).

By severity: 9 major · 139 moderate · 40 minor.

From our pharmacist’s overview on the Sertraline page

“If you take sertraline (Zoloft) for depression, anxiety, or panic, treat this page with real care. Nine of the 188 supplements here carry a major rating, and the biggest issue is how your body clears the drug.”

Reviewed by 2 · Jul 18, 2026

Open the Sertraline interaction page

How much people look this up

Where Iboga and Sertraline Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Iboga
Top half

#647 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Sertraline
Top 1%

#14 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Iboga

What is Iboga?

Iboga
  • Drug and alcohol addiction
  • Opioid withdrawal
  • Spiritual and ceremonial rituals
  • Fatigue and stimulant effects
  • Mood and emotional issues

Iboga is a Central African shrub whose root bark contains ibogaine, a powerful hallucinogenic compound studied mainly for addiction. It carries serious safety risks, including dangerous heart rhythm changes and deaths, and ibogaine is illegal in the United States and many other countries. We do not recommend its use outside of tightly controlled research settings.

Read the full Iboga monograph & all interactions
Medication

About Sertraline

What Is Sertraline Used For?

Brand name: Zoloft

Sertraline treats a range of mental health conditions. All formulations are approved for major depressive disorder (MDD) in adults and obsessive-compulsive disorder (OCD). The oral solution (including Zoloft oral solution) and several tablet formulations are also approved for panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD).

For OCD specifically, the capsule formulations and some tablet products are approved for use in adults and children aged 6 and older. Sertraline hydrochloride tablets (plain, not film-coated) are approved for OCD in pediatric patients as well. However, sertraline is not approved for major depressive disorder in children — only in adults.

See full Sertraline drug information
Keep checking

Other Drugs & Iboga

Browse every other medication we’ve checked against Iboga — both the ones with a known interaction and the ones without. Select any drug for the full detail.

1Major
500Moderate
0Minor
2,328No known interaction
Major

1 interaction

Moderate

500 interactions

Showing 60 of 500 moderate interactions — see all 500 on the Iboga page.

No interaction 2,328 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Pharmacist Counseling Corner

Taking Iboga and Sertraline Together: Common Questions

Can you take Iboga with Sertraline?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
Why are there 3 interactions listed for Iboga and Sertraline?
Sertraline belongs to more than one drug category, and Iboga interacts with each of those categories a little differently. We list every one so nothing is missed — your overall risk is driven by the most serious of them.
How serious is the Iboga and Sertraline interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Sertraline and Iboga?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.