Kratom supplements have gained popularity among individuals searching to find herbal solutions to relieve pain, gain energy, or enhance mood. However, the use is similar to any type of drug that influences the brain, so it is necessary to learn about possible risks, especially concerning mental health.
Cases of severe psychiatric symptoms, such as bouts of psychosis, have been reported in kratom users. In this blog, we’ll have a closer look at what exactly kratom psychosis is, the signs and symptoms to be aware of, and the way to keep oneself safe if they decide to use kratom.
What Is Kratom Psychosis?
Kratom psychosis can be defined as a condition in which kratom causes psychotic symptoms, which include hallucinations, delusions, paranoia, disorganized thinking, and agitation.
The loss of contact with reality is a criterion of the appearance of a psychosis, and, though kratom is not a typical hallucinogen, its multidimensional relationship with brain chemistry may encourage a psychotic state, in exceptional circumstances.
Can Kratom Cause Psychosis?
The question of whether or not kratom can cause psychosis is a tricky one. Clinical case reports and scientific studies already indicate that in most users, kratom is not harmful, but under some circumstances, it can cause psychosis in a few individuals, particularly those with other underlying medical conditions or those who take higher doses or more frequent doses.
How Kratom Affects the Brain?
The key active substances of Kratom, mitragynine and 7-hydroxymitragynine, have their main effects via opioid receptors, although they interfere with adrenergic and serotonergic pathways.
They may modify mood, perception, and cognition and resulting in negative psychiatric outcomes in vulnerable people.
Another case report published in 2024 in Cureus discussed a patient with bipolar schizoaffective disorder who experienced acute paranoia and delusions as a result of the daily intake of kratom, which had been ramped up to higher doses during the previous weeks.
The patient had not experienced psychotic symptoms before, which were not resolved with an antipsychotic, even after treatment, and were indicative of kratom as a major cause of psychiatric decompensation.
Kratom Psychosis Symptoms
Psychotic symptoms linked to kratom use include:
- Hallucinations: Seeing, hearing, or sensing things that are not there.
- Paranoia: Irrational mistrust or suspicion of others.
- Delusions: Fixed false beliefs, such as feeling persecuted or believing in grandiose ideas.
- Disorganized Thinking: Difficulty concentrating or connecting thoughts logically.
- Agitation and Confusion: Restlessness and impaired orientation.
- Mood Disturbances: Anxiety, fear, or manic-like behaviors.
- Insomnia: Sleep disturbances that can worsen psychosis.
A survey of 150 frequent kratom users in Malaysia reported that approximately 4 percent showed minor psychotic illness, including olfactory hallucinations and delusions of persecution, but no causative relationship was identified.
Kratom Psychotic Symptoms vs. Schizophrenia
Schizophrenia is a long-term mental condition that has both positive (hallucinations, delusions) as well as negative symptoms (social withdrawal, lack of affect).
This type of psychosis stimulated by kratom usually resembles positive symptoms, yet it usually does not come with negative symptoms and permanent inabilities in functioning characteristic of schizophrenia.
Notably, kratom can worsen the effects on people with a preexisting condition of schizophrenia or schizoaffective disorder, predisposing the patient to relapse or admission.
Prevalence of Kratom-Related Psychosis
Kratom-related psychosis is known to be uncommon. Analysis of more than 2,300 cases of kratom introductions suggested agitation, confusion, hallucinations, and seizures as some of the severe side effects.
Nevertheless, on a larger scale of investigation, there is no solid evidence associating the use of kratom with heightened rates of psychosis amongst the general population.
Risk factors for kratom psychosis include:
- High or escalating doses
- Chronic heavy use
- Polysubstance abuse (e.g., cannabis, stimulants)
- Underlying psychiatric conditions
- Medication nonadherence
Other Psychiatric Effects of Kratom
Beyond psychosis, kratom can cause:
- Anxiety and agitation, especially at high doses
- Mood swings and irritability
- Insomnia and sleep disturbances
- Withdrawal symptoms mimicking depression and irritability
Case Reports Highlighting Kratom Psychosis
An interesting example was that of one patient who had PTSD and bipolar disorder and developed psychosis after taking excessive quantities of liquid kratom, and he stopped taking systemic medications.
The hallucinations, confusion, and insomnia that she was facing went away with the cessation of kratom and the use of antipsychotics.
In another scenario, a patient who had no previous psychotic experience thought of paranoid delusions and hearing voices following long-term kratom consumption, which reflects that the drug has a psychotic potential even in healthy people.
Mechanisms Behind Kratom-Induced Psychosis
Kratom’s alkaloids primarily target mu-opioid receptors, but also affect:
- Adrenergic receptors: Increasing stimulation and agitation
- Serotonergic receptors: Altering mood and perception
- Dopaminergic pathways: Dysregulation linked to psychosis
Such neurochemical interactions may interfere with normal brain functioning, especially in vulnerable personalities or when used excessively.
Kratom and Schizophrenia: What’s the Link?
Although psychosis due to kratom may be akin to schizophrenia, kratom psychosis tends to be regarded as substance-induced psychosis as opposed to untreated schizophrenia.
Nevertheless, the use of kratom can make the condition deteriorate or lead to relapses in persons with established schizophrenia or schizoaffective disorder.
Systematic review revealed that the use of kratom portends exacerbating psychotic and manic symptoms in individuals with pre-existing psychiatric diseases, necessitating care taken.
Precautions and Recommendations
1. Avoid Kratom if You Have a History of Psychosis
Individuals diagnosed with psychosis in the form of schizophrenia, psychotic bipolar disorder, or other mental disorders bearing psychotic manifestations are not advised to use kratom because it can have the effect of worsening the symptoms.
2. Use Moderately and Monitor Closely
Take small doses and do not start using it more. Be on the lookout for psychiatric distress, i.e., hallucinations or paranoia.
3. Avoid Mixing with Other Psychoactive Substances
Using kratom together with cannabis, stimulants, or other drugs enhances the possibility of negative psychiatric outcomes.
4. Seek Medical Help if Psychotic Symptoms Occur
When you hallucinate, have delusions, or go extremely confused on kratom an immediate professional help should be sought.
5. Maintain Medication Adherence
In case of a psychiatric diagnosis, you should take prescribed drugs and notify your provider in case you use kratom.
Treatment of Kratom-Induced Psychosis
Treatment typically involves:
- Stopping kratom use
- Supportive care and monitoring
- Antipsychotic medications to manage symptoms
- Psychiatric evaluation to assess underlying conditions
- Counseling and rehabilitation for kratom dependence
- Hospitalization may be necessary for severe cases to ensure safety and stabilization.
Final Thoughts
A severe side effect of kratom is psychosis, which can be the consequence of taking kratom. The psychiatric effects of most users are mild or none, but the risk of psychosis is elevated when the doses are high, the use is chronic, or when individuals have some pre-existing mental health condition.
It involves hallucinations, paranoid delusions, delusions, and disorganized thinking, returning to normal and being reversed upon treatment and abstinence, somewhat reflecting some of the symptoms of schizophrenia.
To reduce risks, it is important to use kratom responsibly, monitor its symptoms, and seek medical help as soon as possible. In case you or a person you know has experienced psychotic symptoms connected to kratom, you should turn to specialists.
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