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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV1151

Suicide attempt following ibogaine and 5-MeO-DMT administration in treatment-resistant depression and polysubstance dependence: a case report

5-MEO AND 5-HO-DMT INDUCED SUICIDAL ATTEMPT FOLLOWING A PSYCHEDELIC RETREAT FOR POLYSUBSTANCE USE DISORDER

A patient with no previous history of suicide attempts developed new-onset (de novo) suicidal ideation followed by a serious suicide attempt after receiving ibogaine and 5-MeO-DMT at a psychedelic retreat.

Noting the limited safety data on the increasingly widespread use of psychedelics in complex psychiatric presentations such as polysubstance use and post-traumatic stress, this poster aims to present a case of new-onset (de novo) suicidality following ibogaine and 5-MeO-DMT administration. The patient was a 69-year-old man with chronic benzodiazepine and opioid dependence, treatment-resistant depression, and generalized anxiety, with no previous history of suicide attempts. One week before the suicide attempt, the patient attended a psychedelic retreat in Mexico to seek treatment for substance dependence and depression; he reported discontinuing opioids immediately before the program and received ibogaine derived from the Tabernanthe iboga plant on the first night. During the intense hallucinogenic effects, he experienced suicidal ideation for the first time, and these thoughts persisted in the days after the drug had been metabolized; five days later, following administration of vaporized, inhaled 5-MeO-DMT ("Bufo") derived from the toxin of the Incilius alvarius toad, his suicidal ideation, anxiety, and depressive symptoms worsened, and he left the program the next day. Upon returning to his home country, he did not report suicidal ideation during a psychiatric assessment in the emergency department, but attempted suicide three days later; he was brought to the emergency department with bilateral wrist lacerations, a penetrating injury to the left axilla, and hemodynamic instability, and confirmed after surgical stabilization that the event had been a suicide attempt. His hospital course was complicated by prolonged delirium and agitation; the delirium resolved 35 days after its onset, and transfer for physical and psychiatric rehabilitation was planned on day 40. The authors state that patients should undergo careful risk stratification before receiving psychedelics and that psychiatric risk assessment is also important in determining clinical trial inclusion criteria. To their knowledge, this is the first reported case of de novo suicidality following ibogaine or 5-MeO-DMT administration. Limitations include the possibility that substance intoxication or withdrawal influenced the clinical presentation, the inability to distinguish the underlying mechanism (the drug itself versus its psychotropic effects), the limited scope for causal inference, and the absence of confirmatory data on drug metabolism.

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