Alcohol withdrawal can be a serious and life-threatening process that can occur in patients after weeks, months or years of regular drinking. Like benzodiazepine withdrawal, alcohol withdrawal has also been a factor in several fatalities temporally associated with ibogaine administration due to the adverse health effects of withdrawal such as cardiomyopathy, delirium tremens and seizures related to withdrawals (Alper 2012).
Acute alcohol withdrawals are usually between 24 to 120 hours after the last drink. The peak seizure risk is generally between 48 to 72 hours.
All patients should refrain from drinking alcohol for at least 3 days before ibogaine administration, and for at least a week afterwards.
Patients who are at risk for alcohol withdrawal syndrome need to be completely detoxed from alcohol dependency under medical supervision for 5 to 7 days prior to treatment.
If during the intake process or later it is suspected that a patient has been drinking, or is a regular drinking, detox and stabilization should be completed under medical supervision. Stabilization should continue for at least 5 to seven days prior to the administration of ibogaine, or until cleared of seizure risk by attending physician.
Care should be taken to ensure there are no residual alcohol-withdrawal related symptoms including QT prolongation, arrhythmia, hypertension, delirium tremens, abnormal psychological findings, confusion, etc.