Kratom is scientifically known as Mitragyna Speciosa. A new indole alkaloid, 3-dehydromitragynine, was discovered in the fresh leaves (Houghton and Said 1986). Several of these alkaloids also occur in other species (e.g., Mitragyna parvifolia) (Jansen and Prast 1988, 115; Shellard 1974, 1983). Food and Drug Administration Statement from FDA Commissioner Scott Gottlieb, M.D., on the Agency's Scientific Evidence on the Presence of Opioid Compounds in Kratom, Underscoring Its Potential for Abuse.

Background: Mitragyna speciosa leaves have been abused by drug addicts as some of the alkaloids (mainly mitragynine) from the plant possess opiate and cocaine-like effects. Mitragyna speciosa grows naturally in Thailand, Malaysia, Indonesia, and Papua New Guinea and has been used for many years in Southeast Asia as an opium substitute.

Although mitragynine can act on the mu (μ)- and kappa (κ)-opioid receptors, it is structurally different from morphine and other opioid narcotic pain-killers. Mitragyna speciosa, also known as kratom, has the potential meet the need for pain medications that lack the addictiveness and overdose risk of classical opioid analgesics, such as morphine.

A 47-year-old man developed drug-induced liver injury following concomitant administration of escitalopram for major depressive disorder and Mitragyna speciosa for low back pain not all duration of treatments to reaction onset stated. Since the use of M. speciosa has been forbidden in Thailand, the leaves of M. diversifolia or others are frequently used as substitutes but are not considered as effective.

However, this kratom alternative is said to be generally milder and have fewer side effects than Mitragyna speciosa. Matsumoto, K., Horie, S., Ishikawa, H. et al. (2004), ‘Antinociceptive effect of 7-hydroxymitragynine in mice: Discovery of an orally active opioid analgesic from the Thai medicinal herb Mitragyna speciosa', Life Sciences, Volume 74, pp. 2143-2155.

Kratom induces stimulant and depressant effects according to the dose used: low doses (1-5 g) induce stimulant effects, reduce fatigue, alertness, and sociability and increase sexual desire, as well as produce mild adverse effects like anxiety and agitation; intermediate doses (5-15 g) induce pain and withdrawal relief; high doses (>15 g) cause stupor, sweating, dizziness, diarrhea, nausea, and dysphoria.

However, in some of the plants examined, the allo and normal indole alkaloids could not be detected. 7-Hydroxymitragynine is present only in very small amounts in kratom leaves and was identified in 1993. Jansen KL, Prast mitra science CJ. Ethnopharmacology of kratom and the Mitragyna alkaloids.
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