Kratom is a tropical tree native to southern Asia. Kratom leaves or extract from its leaves have been used in alternative medicines for chronic pain and other conditions. Many people also use kratom to treat symptoms of depression or anxiety. Although some evidence suggests that some strains of kratom may help to relieve these symptoms, more research is needed.
The U.S. Food and Drug Administration (FDA) has not approved kratom for the treatment of depression or anxiety. Kratom is considered a dietary supplement, so it is not regulated by the FDA. If you are thinking about using kratom to treat symptoms of depression or anxiety, exercise caution.
Kratom is not technically an opioid, but its effects are similar to those of opioids such as morphine or codeine. The active ingredient in the kratom is called mitragynin. Mitragynine binds to opioid receptors in the brain to relieve pain. This action may be behind the antidepressant and anti-anxiety effects reported by some kratom users.
There is currently very little research on the effects of kratom on mood.
One 2017 review confirmed that, among some users, kratom improves mood and relieves anxiety. Researchers also pointed out that kratom may have sedative effects. Researchers have yet to examine whether side effects such as sedation may interfere with the expected benefits of sedation.
As reported in February 2018, the FDA confirmed from the analysis that kratom has opioid properties. More than 20 alkaloids in kratom have been identified in the laboratory, including those responsible for most of the pain-relieving action, indole alkaloid mitragynine, structurally related to yohimbine. Mitragynine is classified as a kappa-opioid receptor agonist and is approximately 13 times more potent than morphine. Mitragynine is believed to be responsible for opioid-like effects.
Kratom has been used for the treatment of pain and opioid withdrawal due to its opioid-like action. Animal studies suggest that the primary pharmacological action of mitragynine occurs in mu and delta-opioid receptors, as well as in serotonergic and noradrenergic pathways in the spinal cord. Post-synaptic alpha-2 adrenergic receptor stimulation and 5-hydroxytryptamine 2A receptor blocking may also occur. 7-hydroxymitragynine may have a higher affinity to opioid receptors. Partial agonistic activity may be involved.
Most of the kratom's psychoactive effects have evolved from anecdotal and case reports. Kratom has an unusual effect of producing both stimulant effects at lower doses and more CNS depressant side effects at higher doses. Stimulant effects manifest as increased alertness, increased physical energy, talkativeness, and more social behavior. Opioid and CNS depressant effects predominate at higher doses, but effects may be variable and unpredictable.
Consumers who use kratom anecdotal report reduced anxiety and stress, reduced fatigue, pain relief, sharpened focus, relief of withdrawal symptoms,
In addition to pain, other anecdotal uses include anti-inflammatory, antipyretic (lower fever), antitussive (cough suppressant), antihypertensive (lower blood pressure), local anesthetic, lower blood sugar, and antidiarrhoeal. It has also been promoted in order to enhance sexual function. None of the uses have been clinically studied or have been shown to be safe or effective.
Opioid-addicted individuals have been reported to use kratom to help prevent narcotic-like withdrawal side effects when other opioids are not available. Kratom withdrawal side effects may include irritability , anxiety, cravings, yawning, runny nose, stomach cramps, sweating and diarrhea; all similar to opioid withdrawal.
The February 2018 FDA analysis included 44 reported deaths associated with the use of kratom. Deaths reported by the FDA involved one person who did not have any historical or toxicological evidence of opioid use, except for kratom. In addition, reports suggest that kratom may be used in combination with other drugs that act in the brain, including illicit drugs, prescription opioids, benzodiazepines, and over-the-counter drugs such as anti-diarrheal drugs, loperamide (Imodium AD).
Mixing kratom, other opioids, and other types of medications can be dangerous. Kratom has been shown to have opioid receptor activity, and a combination of prescription opioids or even over-the-counter medications such as loperamide with kratom may lead to serious side effects.
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