Abidali Mohammmad, St Victor Guitelle, Mashaly Shady, Dahal Pranab
Department of Internal Medicine, University of California, San Francisco-Fresno, CA, USA.
Department of Psychiatry, Nassau University Medical Center, East Meadow, NY, USA.
Int J Psychiatry Med. 2025 Mar;60(2):221-225. doi: 10.1177/00912174241281980. Epub 2024 Sep 6.
Kratom, derived from the , a plant native to Southeast Asia, is a substance that is gaining popularity in the United States as a tool for self-medicating in opiate withdrawal and pain management. Its active compounds, mitragynine and 7-hydroxymitragynine, interact with various receptors in the body, resulting in a spectrum of clinical effects.
A 56-year-old male with a history of depression and cannabis use disorder arrived at the emergency department in a state of severe agitation with erratic behavior and aggression. Further evaluation revealed a recent abrupt discontinuation of Kratom use. A psychiatric consultation was requested and performed by the consultation liaison team, diagnosing Kratom withdrawal as the most likely cause of his acute mania.
Neuropsychiatric symptoms arising from Kratom toxicity is a well-documented phenomenon. However, to our knowledge, this is the first documented case of acute mania induced by Kratom withdrawal.