

Episode 8: The Central Danger - Cardiotoxicity, hERG & QT Prolongation
Episode notes
Episode 8 is the series safety cornerstone. Cardiotoxicity is introduced as the single biggest barrier to ibogaine becoming an approved medicine. The mechanism is explained at the channel level: hERG (Kv11.1) potassium-channel blockade leads to delayed repolarization, QTc prolongation, and potentially fatal torsades de pointes. The hosts address why the risk window is extended (given the long half-lives of both parent and noribogaine), enumerate risk factors (baseline QT, hypokalemia/hypomagnesemia, bradycardia, drug interactions), and highlight the special vulnerabilities of the opioid-detox population. The real-world death record is reviewed honestly. Mitigation science — cardiac screening and monitoring, electrolyte optimization, and the magnesium co-administration hypothesis from the Stanford MISTIC study — is covered as the practical framewo ...