Following “the Roots” of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries

Table 1

Report of adverse/toxicological effects of kratom.

Short time use effects	Nausea, constipation, sleep problems, temporary erectile dysfunction, itching, or sweating
Long time use effects	Anorexia, dry mouth, problems in diuresis, darker skin, and hair loss
Withdrawal symptoms	Hostility, aggression, aching of muscles and bones, jerky movements of the limbs, anorexia and weight loss, and insomnia
Infrequent effects	Seizures (individuals using high doses of kratom, either alone or combined with other drugs), intrahepatic cholestasis, psychotic symptoms, Adult Respiratory Distress Syndrome, and hypothyroidism
Fatalities	Kratom mixed with other substances: O-desmethyltramadol; propylhexedrine; over-the-counter cold medications and benzodiazepines; venlafaxine, diphenhydramine, and mirtazapine; zopiclone, citalopram, and lamotrigine