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Red kratom and red corvette: A case of mania induced by kratom withdrawal
Mohammmad Abidali1, Guitelle St Victor2, Shady Mashaly2
1Department of Internal Medicine, University of California, San Francisco-Fresno, CA, USA.
Background:
Kratom, derived from the Mitragyna speciose, 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.
Case:
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.
Conclusions:
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.
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