Ibogaine and 5-Meo-Dmt Treatment In Mexico: Adverse Events, Suicidal Ideation, Mental Health, and Psychological Flexibility Among United States Military Veterans

Background and Purpose

United States military Veterans are experiencing a significant mental health crisis marked by high rates of post‑traumatic stress disorder (PTSD), depression, anxiety, traumatic brain injury, and suicide. Existing psychotherapeutic and pharmacologic treatments often demonstrate limited effectiveness in this population, with high rates of nonresponse and treatment discontinuation. Retrospective and observational studies suggest that ibogaine and 5‑methoxy‑N,N‑dimethyltryptamine (5‑MeO‑DMT) may be associated with improvements in trauma‑related and comorbid psychiatric symptoms among Veterans; however, no large prospective study has evaluated safety, suicidal ideation, and longitudinal mental health outcomes in this population. This study prospectively examined real‑world ibogaine and 5‑MeO‑DMT treatment outcomes among U.S. military Veterans, with a focus on safety, mental health functioning, suicidal ideation, and psychological flexibility.

Methods

Veterans (n = 113) planning to attend an ibogaine and 5‑MeO‑DMT treatment program in Mexico were prospectively followed from baseline (pre‑treatment) to 1‑week, 3‑month, and 9‑month post‑treatment. Participants completed self‑report assessments of PTSD symptoms (PCL‑5), depression (PHQ‑2), anxiety (GAD‑2), suicidal ideation (DSI‑SS), and psychological flexibility (MPFI‑24). Adverse events and return of drug‑like effects were assessed at each follow‑up. Acute psychedelic effects, including mystical‑type experience, psychological insight, and emotional breakthrough, were measured one week post‑treatment. Linear mixed‑effects models evaluated changes in outcomes over time. Regression and mediation analyses examined whether acute psychedelic effects predicted symptom change and whether early changes in psychological flexibility mediated these relationships.

Results

Adverse events were infrequent, transient, and reported by 4–9% of participants at each follow‑up timepoint. Significant reductions were observed from baseline through 9 months in PTSD (ηp² = 0.74), depression (ηp² = 0.64), anxiety (ηp² = 0.64), and suicidal ideation (ηp² = 0.24; all ps < .001). Improvements emerged by one week post‑treatment and remained largely stable through follow‑up. Acute psychedelic experience intensity predicted greater reductions in PTSD and anxiety symptoms, and psychological insight predicted reductions in depression. Psychological flexibility increased significantly following treatment and mediated the relationship between acute psychedelic effects and long‑term PTSD symptom improvement.

Conclusions and Implications

Prospective findings suggest that ibogaine and 5‑MeO‑DMT treatment was associated with rapid and sustained improvements in symptoms of PTSD, depression, anxiety, a well as suicidal ideation among U.S. military Veterans, with low rates of adverse events. Psychological flexibility emerged as a key process associated with durable PTSD symptom improvement. These results address critical gaps in evidence related to Veteran mental health, suicide risk, and access to effective interventions, aligning with SSWR priorities focused on mental health equity, psychosocial mechanisms of change, and the evaluation of emerging interventions relevant to social work research and practice.