Prof. Dr. Paul Glue – online

Paul Glue, MD, FRCPsych, is Department Chair and Hazel Buckland Professor in Psychological Medicine at the Dunedin School of Medicine, University of Otago, New Zealand.

After graduating from Otago Medical School in 1980, he received psychiatry training in Auckland and in Oxford UK, and obtained MRCPsych in 1986. He was elected to FRCPsych in 2010.

In 1987 he moved to the US National Institutes of Health for preclinical neuroscience research and completed an MD in clinical psychopharmacology at the University of Bristol, UK in 1992. He was involved with translational clinical pharmacology research in the pharmaceutical industry for 18 years. He has published over 390 papers and abstracts, has 11 patents and several international research awards/prizes.

Since 2009 he has also been working as a consultant psychiatrist for the Southern District Health Board, in adult general psychiatry

He has broad research interests, in pharmacology, clinical trial design and statistics (e.g. trial simulation, adaptive trial designs). His research interests include development of novel therapeutics, and treatment of mood disorders.

He will present on

Can ibogaine be dosed more safely – impact of recent published human data:

Ibogaine is a root bark alkaloid from the rainforest shrub Tabernanthe iboga. Over the past 50 years, it has been reported to reduce opioid withdrawal symptoms (OWS) and craving in opioid-dependent patients, based on lay reports and case series. At this meeting I will summarize some of my recent research with single doses of ibogaine (IBO) and its active metabolite noribogaine (NIBO) with a focus on safer use/administration.

1: Inhibiting activity of CYP2D6, the enzyme that coverts ibogaine to noribogaine, leads to doubling of combined (IBO+NIBO) blood concentrations in healthy volunteers (J Clin Pharmacol 2015, 55:680).

2: Single doses of noribogaine 60-180mg prolonged QTc in a concentration-dependent manner (Clin Pharm Drug Devel 2016, 5:460-468). QTc prolongation is a risk factor for heart arrhythmias and death.

Impact of these data on screening patients: The profound effect of CYP2D6 inhibition on combined (IBO+NIBO) blood concentrations makes CYP2D6 geno-/phenotyping essential prior to ibogaine dosing. Patients should have careful pre-dose cardiology screening.

Impact on dosing: QTc prolongation is concentration-related. Dosing strategies giving repeated low doses every 2-3 hours over several days could minimize Cmax and thus limit QTc changes in future studies.

Impact on monitoring: Ibogaine clinics must have access to ECG telemetry during ibogaine treatment, and rapid access to medical support if arrhythmias occur.