Ibogaine, Brain Injury, and the Future of Neurorehabilitation
In recent months, ibogaine has moved from the fringes of psychedelic research into the centre of political and clinical attention in the United States. Momentum has been building through a combination of veteran advocacy, growing public pressure, and state-level initiatives, most notably in Texas, where funding has been pushed forward to accelerate research into ibogaine as a potential treatment for addiction and traumatic brain injury (TBI). This has been further reinforced at a federal level, with a new executive order signalling intent to fast-track research into psychedelic therapies more broadly. Taken together, there is a clear shift underway: what was once dismissed is now being actively explored at scale.
Alongside this momentum, a powerful narrative has taken hold, that ibogaine may offer something close to a reset for addiction. Reports often cite figures suggesting success rates of 80–90%, particularly in relation to opioid dependence.
A recent wave of interest in ibogaine has been driven in part by a Stanford-led study in Special Operations veterans with traumatic brain injury. Published in Nature Medicine, the initial findings showed substantial improvements in day-to-day functioning, alongside marked reductions in PTSD, depression and anxiety. These changes were not fleeting, they were still present at a one-month follow-up.
What makes this work particularly compelling is what followed. Rather than stopping at clinical outcomes, the same cohort was analysed further to explore what might be happening in the brain. A subsequent paper in Nature Mental Health linked cognitive improvements to changes in neural activity. In other words, the psychological changes were not just being reported, they were being reflected in measurable brain dynamics.
More recent analyses have taken this a step further by looking directly at what’s happening in the brain, using EEG and MRI data from the same group of veterans. These follow-ups, again at the one-month mark, looked at changes in brain activity and structure alongside cognitive performance. Improvements in executive function were linked to shifts in brainwave activity, particularly in theta rhythms, suggesting a change in how different parts of the brain are communicating. Alongside this, structural scans showed that predicted brain age decreased by around 1.3 years at one month, with increases in cortical thickness and expansion of subcortical volume, including areas of the cerebellum and forebrain.
TBI and Considerations for Neurorehabilitation
What makes these findings particularly relevant is how closely they map onto the broader challenges seen in traumatic brain injury. TBI is often defined by a combination of cognitive impairment, mood disturbance, and often unresolved psychological trauma. In many cases, substance use emerges downstream as a way of managing these ongoing symptoms. While still early, this raises the possibility that ibogaine may have relevance not just as a targeted addiction intervention, but within a wider neurorehabilitation context.
If findings like this were to be translated into a broader neurorehabilitation context, the question is no longer just whether it works, but how it would be delivered. Unlike conventional interventions, ibogaine is not simply something that produces isolated symptom change. It can also bring about intense psychological experiences, including the resurfacing of trauma and, in some cases, profound shifts in how individuals understand themselves and their reality. While this may be part of the therapeutic process, it also introduces a layer of complexity that standard neurorehabilitation pathways are not currently designed to handle.
In practical terms, this would likely require a level of structured integration support alongside any acute treatment. Individuals may leave the experience processing previously unresolved trauma or trying to make sense of insights that feel significant but destabilising. Without the right support, there is a risk that these experiences become difficult to navigate rather than therapeutic. This suggests that any future model would need to extend beyond the dosing session itself, incorporating short-term follow-up focused specifically on psychological integration.
This raises an interesting question around how existing neurorehabilitation services might adapt. One possibility is that neuropsychologists develop additional training in psychedelic-informed care, allowing them to support both cognitive recovery and post-experience integration. Alternatively, there may be space for a more distinct role, a psychedelic therapist working alongside traditional rehab teams, bridging the gap between neurological recovery and the psychological processing that can follow these experiences.
Durability, Dosing, and Alternatives
What this really opens is not just clinical possibilities, but practical questions around how such an intervention would work over time. All the published Stanford findings so far, from symptom change to EEG findings, to structural brain changes, are anchored to a one-month follow-up window. That means we still do not know whether the reported improvements in cognition, mood, trauma symptoms, or brain structure are transient, sustained, or whether some of them may fade without further intervention.
This then raises the question of dosing frequency. If one or two ibogaine sessions can produce meaningful short-term change, would additional sessions deepen those effects, help maintain them, or become unnecessary once a certain threshold has been reached? Equally, if an addiction response occurs early, does that mean the cognitive and emotional gains would continue the same trajectory, or might those require a different rhythm of follow-up care?
This also opens a broader question: whether ibogaine is the only psychedelic worth exploring in this space. The reason this matters is that some of the domains showing movement here, mood, trauma, cognition, and possibly neuroplasticity are not unique to ibogaine in psychedelic research. Reviews of psychedelics and brain injury have already pointed to possible relevance through neuroplasticity, neuroinflammation, hippocampal neurogenesis, and changes in brain complexity.
This aligns with emerging work in this area, including my own recent research, which identified themes of improved cognitive clarity, shifts in mood and trauma processing, and perceived improvements in cognitive functioning among individuals with brain injury following psychedelic use.
From that perspective, it becomes reasonable to ask whether less intense alternatives might also deserve investigation. Psilocybin, for example, has already attracted attention in brain-injury-adjacent contexts, and a 2025 Frontiers paper in veterans with TBI reported improved mental health outcomes alongside EEG changes after psilocybin retreat exposure, in addition to improvements in clarity of thought and reductions in cognitive fog, with small shifts observed in areas such as attention and executive function.
What Next?
Psychedelics are demonstrating their potential to drive meaningful improvements across cognition, mood, trauma, and addiction in individuals with TBI , within a field that still largely focuses on managing symptoms.
Important questions remain around durability, dosing, and how these approaches would be delivered in practice, but the scale of what is being suggested is difficult to ignore.
Research in the UK needs to seriously engage with these developments. What is becoming increasingly clear is that this has the potential to reshape the neurorehabilitation paradigm.
References
Blest-Hopley, G., Pasculli, G., Ruffell, S. G., Tsang, W., Emmanuel, O., Pate, K. M., ... & Carhart-Harris, R. (2025). Improved mental health outcomes and normalised spontaneous EEG activity in veterans reporting a history of traumatic brain injuries following participation in a psilocybin retreat. Frontiers in psychiatry, 16, 1594307. https://doi.org/10.3389/fpsyt.2025.1594307
Cherian, K. N., Keynan, J. N., Anker, L., Faerman, A., Brown, R. E., Shamma, A., ... & Williams, N. R. (2024). Magnesium–ibogaine therapy in veterans with traumatic brain injuries. Nature medicine, 30(2), 373-381. https://doi.org/10.1038/s41591-023-02705-w
Lissemore, J. I., Chaiken, A., Cherian, K. N., Buchanan, D., Espil, F., Keynan, J. N., ... & Williams, N. R. (2025). Magnesium–ibogaine therapy effects on cortical oscillations and neural complexity in veterans with traumatic brain injury. Nature Mental Health, 3(8), 918-931. https://doi.org/10.1038/s44220-025-00463-x
Reed, O. (2025) 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