Kratom, a plant-based substance derived from the Mitragyna speciosa tree native to Southeast Asia, is used for various purposes. Concerns are emerging regarding its potential adverse effects, particularly whether kratom use can lead to psychosis. This article examines the existing research and the plant’s effects.
Understanding Kratom’s General Effects
Kratom contains active alkaloids, primarily mitragynine and 7-hydroxymitragynine, which interact with opioid receptors in the brain. Its effects are dose-dependent. Lower doses can produce stimulant-like effects, increasing alertness and energy, while higher doses tend to have opioid-like or sedative effects, offering pain relief and relaxation. Kratom’s compounds also influence other brain chemical systems, such as adrenergic, serotonergic, and dopaminergic pathways, contributing to its diverse effects on mood and perception.
Kratom and Psychosis: What the Research Says
Research on kratom and psychosis primarily relies on case reports and observational studies, making direct causation challenging, though several reports suggest a potential association between kratom use and psychotic symptoms like hallucinations, delusions, severe paranoia, and disorganized thinking. Some individuals develop these symptoms without a prior psychiatric history, and kratom use can worsen existing mental health disorders. Psychotic symptoms are often reported with high-dose or chronic kratom use. A systematic review identified ten cases of psychosis or mania linked to kratom use, and another study found approximately 4% of regular kratom users in Malaysia reported psychotic symptoms. More rigorous research is needed to fully understand this relationship.
Factors That May Increase Risk
Several factors can increase susceptibility to psychotic symptoms from kratom use. Pre-existing mental health conditions, such as schizophrenia, bipolar disorder, or anxiety disorders, significantly heighten the risk. Individuals with a genetic predisposition to psychotic disorders are also more vulnerable. Higher doses and prolonged or chronic use of kratom increase the likelihood of adverse psychiatric effects. Concurrent polysubstance use, combining kratom with other drugs, can lower the threshold for developing psychosis by creating complex brain interactions.
What to Do If Symptoms Appear
If an individual using kratom experiences symptoms of psychosis, such as hallucinations, delusions, severe paranoia, or disorganized thought patterns, immediate medical attention or a mental health evaluation is important. These symptoms require professional assessment, and being open and honest with healthcare providers about all substances used, including kratom, is crucial for accurate diagnosis and treatment. Professionals may recommend reducing or discontinuing kratom use, ideally under supervision, to manage symptoms. Early intervention is important for effectively managing psychotic episodes and preventing long-term complications. Healthcare provider support can help navigate the process safely and address underlying issues.