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October 14, 2024A commonly cited reason for using kratom is the reduction of depression and anxiety symptoms. If you talk to average kratom users, you are likely to hear them describe kratom as providing anxiety relief.
Does kratom really help with depression and anxiety? Or is the improvement a placebo effect that could be accomplished with any other substance? Understanding the latest research on kratom and mood will help individuals decide whether or not taking kratom is a good idea for their mental health.
How kratom consumers use kratom for depression and anxiety
Whether or not kratom actually reduces depression symptoms, it is certainly being used as a mood enhancement substance.
Specifically, recent research found that 58-67% of kratom users state that they use it to manage both depression and other mental health issues. About 20% view depression management as the primary reason for their kratom use.
The same survey found that most people use kratom for depression are:
- Female
- Under the age of 41
- More likely to have a lower income
Kratom’s proven positive effects on mood
Even generic medical resources like WebMD report that kratom may have a positive effect on users’ moods. Interestingly, the effect on mood varies significantly based on your dosage size. A low dose (1-5 grams) is more likely to act as a stimulant, giving users an energy boost. On the other hand, a 5-15 gram dose, which is considered a high dose, has similar effects as both opioids and sedatives: relaxation, pain relief, and reduced anxiety.
A 2017 study from Swogger and Walsh acknowledged that kratom has mood-enhancing effects: “Kratom also enhances mood and relieves anxiety among many users. For many, kratom’s negative mental health effects – primarily withdrawal symptoms – appear to be mild relative to those of opioids.”
Kratom’s potential as an antidepressant
A promising study in 2020 from Johnson et. al. proposed that the opioid-like effects of kratom’s alkaloids (especially mitragynine and 7-hydroxymitragynine) have the potential to make the plant useful as an antidepressant.
In animals, mitragynine has been shown to have both antidepressant and antipsychotic properties. Specifically:
- It reduced immobility time in forced swimming and tail suspension tests in mice, similar to known antidepressants
- It decreased psychotic symptoms in mice induced by apomorphine
These effects are likely related to the way that kratom interacts with several different receptors in the brain:
- Opioid receptors (as partial agonists)
- Serotonin receptors
- Dopamine receptors
- Alpha-2 adrenergic receptors
The researchers emphasize that more studies are needed to confirm kratom’s potential as an antidepressant.
Health risks of using kratom
Responsible guidance on kratom must identify the pros and cons of its use. While some users may benefit from kratom’s potential antidepressant qualities, there are also mental health risks associated with kratom.
Even though kratom has a relatively low toxicity profile compared to traditional opioids, with no reported respiratory depression when used alone, potential drawbacks of kratom use include:
- Potential for addiction
- Possibility of developing withdrawal symptoms
- Lack of regulation and quality control, leading to inconsistent products and possible adulteration
- Unstudied interactions with other medications
- Physical side effects of use, including nausea, constipation, excessive sleepiness, sweating, dry mouth, tachycardia, and more
A study of kratom’s negative impact on mental health
A 2022 study from Nunez et. al documented the impact of kratom on the mental health of a patient whose manic episode appeared to be triggered by kratom use.
The patient had previously been diagnosed with Bipolar I which was well controlled. With a history of moderate Opioid Use Disorder (OUD), the patient had been in sustained remission for the past year and was living with his mother. However, he did not continue any maintenance therapy for his opioid use, and he ended up exhibiting bizarre behavior and verbal aggression.
His mother had to call the police when the patient became destructive. Police officers restrained the patient and transported him to the emergency room, where he explained that he had been using kratom right before the episode.
In the weeks leading up to the episode, the patient’s kratom use was determined to be significant. He was taking 30 mg of kratom daily in the form of two 15 mg capsules. He was taking 105 mg of kratom weekly, with some weeks adding up to 210 mg. He reported that his kratom use was to both target anxiety and prevent opioid cravings.
One week before his mother called the authorities, the patient had increased his kratom consumption by about five times. He was taking at least 10 capsules daily, adding up to about 1050 mg of weekly kratom consumption.
The patient’s symptoms included:
- Psychomotor agitation
- Restlessness
- Goal-oriented behavior
- Pressured, circumstantial, and perseverative speech pattern
- Flight of ideas
- Systemic paranoid ideation
- Persecutory delusions
- Decreased need for sleep (2-3 hours per night for the past week)
The patient required immediate medication for safety reasons and was then admitted to an acute inpatient psychiatric unit for treatment of his acute manic episode, which involved mood-congruent psychotic features. He spent six days in the hospital and was released upon stabilization.
The researchers came to the conclusion that there is strong evidence to suggest that it is plausible that high-dose kratom use may exacerbate certain psychiatric systems, including psychosis.
Implications for kratom users
The implications of kratom’s effects on depression and anxiety are complex. Some users report positive mood-enhancing effects, thanks to kratom’s alkaloids, but others may be susceptible to certain risks.
The emerging scientific evidence is somewhat mixed, but researchers agree on one thing: more research is needed to understand whether the benefits of using kratom for anxiety and depression outweigh the risks.
Given the wide range of findings, individuals who are considering kratom use for depression and anxiety should approach its use with caution. Consulting with a healthcare professional is the best course of action before making any decisions regarding substances for anxiety and depression.
As with any substance that affects mood and cognition, responsible use is essential. While kratom may offer benefits for some, it’s not a one-size-fits-all solution, and its use should be carefully considered in the context of one’s overall mental health and medical history.
Sources
- Gatta, Frances and Alexandra Benisek. “Health Benefits of Kratom.” WebMD. 13 May 2024.
- Johnson, Lindsay E et al. “The Potential for Kratom as an Antidepressant and Antipsychotic.” The Yale Journal of Biology and Medicine, vol. 93,2 283-289. 29 Jun. 2020.
- Maxsaya Baez Nunez, et al. “Kratom’s rising role in the potential exacerbation of mental health disorders: A case report and review of the literature,” Psychiatry Research Case Reports, Volume 1, Issue 2, 2022, 100069, https://doi.org/10.1016/j.psycr.2022.100069.
- Mayo Clinic. “Kratom: Unsafe and ineffective.” MayoClinic.org. 18 Jun. 2024. 6 Nov. 2022.
- Stanciu, Cornel N. “Is There Evidence to Support the Use of Kratom for the Self-Treatment of Depression?” Psychiatric Times.
- Swogger, Marc T, and Zach Walsh. “Kratom use and mental health: A systematic review.” Drug and Alcohol Dependence, vol. 183 (2018): 134-140. doi:10.1016/j.drugalcdep.2017.10.012
- Veal, Summer. “Kratom Withdrawal: Signs, Symptoms + Treatment.” SerenityGrove.com. 1 Jul. 2024.