Ibogaine and Brain Injury: The Evidence Continues to Build
In 2024, researchers at Stanford published the first findings from a study following 30 Special Operations veterans with a history of traumatic brain injury who underwent magnesium–ibogaine treatment in Mexico. The initial results reported substantial improvements in disability, PTSD, depression and anxiety, alongside measurable improvements across several areas of cognitive functioning.
Since then, this has developed into something of a series, with further papers exploring what may be happening beneath those clinical changes, including changes in brain structure, neural activity and functional connectivity. Now, the latest paper brings us back to perhaps the most obvious question raised by those original findings: do the improvements last?
Until now, the picture essentially stopped at 30 days.We had the initial clinical and cognitive findings, alongside emerging evidence of associated changes in the brain, but we didn't know what happened beyond that point. Did these improvements persist once participants returned to everyday life, or would they gradually fade? This latest study was designed to answer that question.
The researchers followed the original cohort out to 12 months, with 25 of the 30 participants completing the final assessment. The answer, at least for disability and psychiatric symptoms, appears remarkably encouraging. Significant improvements in disability, PTSD, depression and anxiety were still present one year after treatment, with large effect sizes across all four outcomes.
For me, though, there is something particularly exciting about watching this research develop. I became interested in the possibility that psychedelics might have a role to play in brain injury recovery, at a time when there was very little research directly exploring that question. We are now seeing clinical, cognitive and biological signals beginning to build around the same idea. What could this mean for brain injury recovery and the future of neurorehabilitation?
My Questions
The cognitive improvements identified at 30 days weren't followed up. The original study reported improvements across areas including processing speed, executive functioning, attention and memory, functions that can have a profound impact on everyday life after brain injury. If ibogaine has the potential to meaningfully improve these areas, understanding whether those changes persist beyond the first month is fascinating, and potentially hugely significant for brain injury rehabilitation.
I'd also love to see 12-month neuroimaging from this cohort. Are the structural brain changes observed at 30 days still present a year later?
There is also one significant caveat when interpreting the 12-month results: 23 of the 25 veterans had used at least one psychedelic between the one- and 12-month assessments. This obviously makes it impossible to cleanly attribute the longer-term outcomes to ibogaine alone. Although, perhaps somewhat ironically, the confound itself is interesting: either the benefits of ibogaine proved remarkably durable, or further psychedelic experiences helped sustain them. However, this only strengthens the evidence that psychedelics have a meaningful, and potentially groundbreaking, role to play in brain injury recovery.
Part of what makes ibogaine interesting in brain injury is its potential relationship with neuroplasticity. the brain's ability to change, reorganise and form new connections. Preclinical research has linked ibogaine with neurotrophic factors including BDNF and GDNF, which are involved in neuronal growth, survival and plasticity. More recently, the Stanford research has started to give us human evidence of what some of that change might look like: one month after treatment, researchers reported increased cortical thickness, reduced predicted brain age, altered neural complexity, and changes in cerebral blood flow and functional connectivity. For a brain that has been injured, that possibility is obviously fascinating, particularly when considered alongside the improvements already observed in processing speed, executive functioning, attention and memory.
What could this mean for brain injury?
This is where these findings become particularly exciting for me. TBI remains a leading cause of disability worldwide, yet for people living with its chronic effects, our ability to meaningfully alter the underlying picture remains incredibly limited. Neurorehabilitation can be hugely valuable, but much of what we do is ultimately about helping people adapt, develop strategies, compensating for difficulties and finding ways to function better.
This is what makes the emerging ibogaine research so interesting. Psychedelics are increasingly associated with neuroplasticity, and the research from this cohort has now reported changes spanning brain structure and function alongside improvements in cognition, disability and psychiatric symptoms. For someone living with brain injury, improvements in areas such as executive functioning, processing speed, memory, mood or trauma aren't small outcomes. They could fundamentally change someone's everyday life.
For myself who works directly with people living with brain injury, the need for something different is strikingly obvious. I see the limitations people continue to live with, often years after the original injury, and how few options exist that might meaningfully change those limitations. There is clearly much more research needed to explore the full potential of this medicine, particularly what it could mean for different brain injury populations, cognition, longer-term brain changes and ultimately recovery.
I have personally always believed in the potential of psychedelics for brain injury recovery, and the evidence is now moving the conversation beyond ifthey have a place in brain injury treatment and neurorehabilitation. The question now is becoming how and when we integrate them.
References
Faerman, A., Lissemore, J. I., Geoly, A. D., Cherian, K. N., Sridhar, M., Kim, B., ... & Williams, N. R. (2026). Is ibogaine treatment durable? 12-month follow-up of magnesium–ibogaine therapy (MISTIC) in special operations veterans with traumatic brain injuries. Translational Psychiatry. https://doi.org/10.1038/s41398-026-04327-5
Reed, O. (2026) Exploring the potential of psychedelics in brain injury recovery: A thematic analysis of participant narratives. https://www.researchgate.net/publication/403758971_Exploring_the_potential_of_Psychedelics_in_Brain_Injury_Recovery_A_Thematic_Analysis_of_Participant_Narratives