#66 - Dr. Rod Paulsen: How We Screen for Ibogaine#66 - Dr. Rod Paulsen: How We Screen for Ibogaine
Root Medicine
Talia Eisenberg and Dr Rod Paulsen talk through how candidates are assessed for ibogaine treatment, including psychiatric risks, SSRI tapers and support needs. They also discuss ibogaine’s brain effects, limits, and why it acts as a reset that still requires committed aftercare.
54:34•9 Oct 2026
How Dr Rod Paulsen Decides Who Is Ready for Ibogaine
Episode Overview
- Around 15% of prospective ibogaine clients are screened out due to conditions like schizophrenia spectrum disorders, bipolar I, or high genetic risk.
- Safe ibogaine work requires careful SSRI tapering, especially with fluoxetine, and collaboration with the prescriber using a slow, hyperbolic strategy.
- Ibogaine acts on multiple receptors and noribogaine lingers, creating a temporary period of easier change, but it functions as a reset rather than a permanent cure.
- Having solid support in place—psychiatry, psychotherapy, community or peer circles—is essential, as ibogaine cannot replace ongoing mental health care.
- Visions are not required for benefit; people without visionary experiences can show similar improvements in depression and quality of life scores.
“It’s not a cure. It’s a reset. It’s a window of opportunity. It’s putting oil in the engine, but you still need to maintain the engine.”
What drives someone to seek a life without addiction, and how do clinicians decide who is ready for such a big step? This conversation between Talia Eisenberg and psychiatrist Dr Rod Paulsen digs into exactly that, focusing on how candidates are screened for ibogaine treatment at Beond. Dr Paulsen shares his own route into psychedelic medicine, from early SSRI use as a teenager to neuroscience at NYU, opioid withdrawal research, and sitting on MDMA trials for PTSD.
That mix of lived experience and lab work shapes how he now assesses people for ibogaine: “I don’t want to make anyone psychotic or manic. I don’t want to induce that.” You’ll hear a clear breakdown of who is usually excluded (schizophrenia spectrum, bipolar I, high‑risk family histories, untreated borderline personality disorder) and why around 15% of applicants are turned away.
He talks through the delicate reality of saying no to deeply distressed people, and how he instead points them towards options like TMS, ketamine, DBT, or better psychiatric support. The pair also unpack what needs to be in place before anyone flies out: slow “hyperbolic” tapers off SSRIs, especially fluoxetine; strong aftercare plans; and honest conversations about ibogaine as “a reset… a window of opportunity”, not a magic cure.
Dr Paulsen explains ibogaine’s “promiscuous” receptor profile in plain language, why noribogaine may bring that post-treatment quiet mind, and why visions are not essential for improvements in depression and quality of life. Throughout, the tone stays practical, candid and occasionally funny, while staying rooted in safety and evidence.
If you’re sober-curious about ibogaine, working in mental health, or just weighing up another tool for your healing toolbox, this episode might help you ask better questions about whether ibogaine is truly right for you.
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