Author: John Carter

KRATOM: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Given this background, we describe a case of respiratory complications induced by kratom. Third, autopsy and coroner reports of deaths related to kratom use recorded a few cardiac pathologies related to myocardial ischemia, such as coronary atherosclerosis, focal band necrosis in the myocardium, and hypertensive cardiovascular disease. However, a study of ECG findings by Leong Abdullah et al. (2021) proved that myocardial ischemia (T-wave inversion) did not occur differently among kratom users versus the control group.

Given the initial suspicion of sepsis due to multifocal pneumonia, the patient was empirically initiated on broad-spectrum antibiotics. Following intubation, he continued to be hypoxic and refractory to change in ventilator setting while under deep sedation with dyssynchrony and double triggering. Hence, he was paralyzed with a neuromuscular blocking agent cisatracurium for 24 hours. He was also placed in a prone position with a better respiratory response and started on intravenous methylprednisolone 40 mg four times daily which he was weaned off over 3 weeks.

Side Effects

This means the adverse effects of kratom or kratom side effects are also milder in comparison to those of opioids. In a study testing kratom as a treatment for symptoms of quitting opioids, called withdrawal, people who took kratom for more than six months reported withdrawal symptoms like those from opioid use. They may need treatments given for opioid addiction, such as buprenorphine (Brixadi, Sublocade, others) and buprenorphine-naloxone (Suboxone, Zubsolv). Researchers say most people who use kratom report using it for more than one reason.

Medications changed by the liver (Cytochrome P450 2C19 (CYP2C substrates) interacts with KRATOM

Kratom is an herbal product made from the leaves of the kratom tree (Mitragyna speciosa), said to have opioid-like effects. Kratom’s reported benefits include helping people cope with withdrawal symptoms and drug-related cravings, pain, fatigue, and mental health challenges. Fourth, concerning the risk of heart failure related to kratom use, autopsy and coroner reports of fatalities noted a few related cardiac pathologies, including left ventricular hypertrophy, cardiomegaly, and cardiomyopathy.

  1. He had consumed kratom multiple times daily to reduce his opioid withdrawal symptoms.
  2. Kratom is an unregulated herbal psychogenic substance which originated in southeast Asia1.
  3. Further in-depth review revealed that mitragynine causes apoptotic cell death by releasing oxygen free radicals and also enhances endothelial barrier permeability.
  4. The amount of kratom he had consumed was not described, however, and the patient’s serum mitragynine and 7-HMG levels were not assessed (ElJack et al., 2020).

Drugs & Supplements

Therefore, the question of whether kratom use can cause a cardiotoxicity risk merits further investigation. Despite a lack of human studies, a few case reports have pertained to kratom cardiotoxicity. Case 1 presented a 26-year-old man with no history of medical illness, who took no regular prescribed medication and who had visited an emergency department during cardiorespiratory arrest (primarily pulseless electrical activity). He had ingested an unknown quantity of kratom about 24 h prior to this incident.

Sedative medications (CNS depressants) interacts with KRATOM

Case 4 described a 44-year-old man with a history of hypertension and hyperlipidemia on pharmacotherapy. He was physically active, performing routine daily exercise, and had obtained unremarkable results from an annual cardiac examination. This patient visited an emergency department due to multiple episodes of ventricular fibrillation, which required defibrillation.

I know we ain’t doctors on here, but I’ve struggled to find consistent information on whether or not kratom can cause respiratory depression. Not life-threatening, but incredibly uncomfortable and an all-day thing. When a pregnant person uses kratom, the baby may be born with symptoms of withdrawal and need treatment.

Kratom is a supplement that is sold as an energy booster, mood lifter, pain reliever and remedy for the symptoms of quitting opioids, called withdrawal. Contamination in herbal supplements like kratom includes excess traces of heavy metals and bacteria. The FDA has issued numerous warnings about kratom contamination, including on the risk of developing heavy metal toxicity and exposure to contamination from salmonella.

Further in-depth review revealed that mitragynine causes apoptotic cell death by releasing oxygen free radicals and also enhances endothelial barrier permeability. These mechanisms are thought to play a major role in the pathogenesis of ARDS16. He subsequently showed improvement on chest radiography and his respiratory status improved on mechanical ventilation.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A substrates) interacts with KRATOM

Kratom is legal in the United States and is available for sale online and in some shops in some counties. Kratom is not listed under the U.S. schedule of controlled substances. However, kratom may seem to be in a legal gray area because several state regulations or prohibitions against the possession and use of kratom exist. Drug Enforcement Administration (DEA) say low doses of kratom have stimulating effects and higher doses of kratom have more sedating effects. Kratom products have been found to have heavy metals, such as lead, and harmful germs, such as salmonella, in them. The FDA has linked more than 35 deaths to salmonella-tainted kratom.

The quantity of kratom the patient had ingested prior to his death remained unknown (Aggarwal et al., 2018). Kratom is an unregulated herbal psychogenic substance which originated in southeast Asia1. It is an extract prepared from the leaves of Mitragyna speciosa, an evergreen tree belonging to the coffee family.

A urine drug screen was negative for opioids, cocaine, amphetamines, benzodiazepines, and tricyclic antidepressants. An investigation of the patient’s blood indicated hypokalemia (potassium of 2.9 mmol/L), while his other blood tests revealed circulatory arrest features. ECG findings reported an incomplete right bundle branch block while the patient’s echocardiogram was normal. After the patient recovered over 2 days, he described a history of continued polysubstance use, including kratom use. The amount of kratom he had consumed was not described, however, and the patient’s serum mitragynine and 7-HMG levels were not assessed (ElJack et al., 2020).