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Toxicology – Kratom Toxicity
Source
Kratom is derived from the leaves of the Mitragyna speciosa tree native to Southeast Asia. It is commonly sold as a powdered product in shops and online, often used in teas or capsules.
Typical Presentation
Use may produce stimulant-like effects at lower doses and opioid-like effects at higher doses. Users may report increased energy initially, followed by more sedative effects with larger amounts.
Clinical Features
At low doses, kratom can cause mild stimulation and euphoria. At higher doses, effects resemble opioids and include pinpoint pupils (miosis), nausea, vomiting, decreased appetite, headache, and mild respiratory depression. Chronic use may lead to dependence, and withdrawal symptoms can occur after cessation.
Mechanism of Action
Kratom contains active alkaloids, primarily mitragynine and 7-hydroxymitragynine, which act on opioid receptors. Mitragynine also has some activity at alpha-adrenergic receptors, contributing to stimulant effects at lower doses. Compared to traditional opioids, its respiratory depressant effects are generally less pronounced.
Management
Treatment is supportive. In cases of significant opioid-like toxicity, naloxone may be considered, although its effectiveness may vary.
Key Points
Source
Kratom is derived from the leaves of the Mitragyna speciosa tree native to Southeast Asia. It is commonly sold as a powdered product in shops and online, often used in teas or capsules.
Typical Presentation
Use may produce stimulant-like effects at lower doses and opioid-like effects at higher doses. Users may report increased energy initially, followed by more sedative effects with larger amounts.
Clinical Features
At low doses, kratom can cause mild stimulation and euphoria. At higher doses, effects resemble opioids and include pinpoint pupils (miosis), nausea, vomiting, decreased appetite, headache, and mild respiratory depression. Chronic use may lead to dependence, and withdrawal symptoms can occur after cessation.
Mechanism of Action
Kratom contains active alkaloids, primarily mitragynine and 7-hydroxymitragynine, which act on opioid receptors. Mitragynine also has some activity at alpha-adrenergic receptors, contributing to stimulant effects at lower doses. Compared to traditional opioids, its respiratory depressant effects are generally less pronounced.
Management
Treatment is supportive. In cases of significant opioid-like toxicity, naloxone may be considered, although its effectiveness may vary.
Key Points
- Kratom has both stimulant and opioid-like properties depending on dose.
- It is sometimes used by individuals attempting to reduce opioid dependence.
- Severe toxicity and fatalities are uncommon and often involve coingestants or adulterants.
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