Management of a Kratom and Tianeptine Overdose

A middle-aged man with a history of polysubstance abuse presented with acute hypoxemic respiratory failure following self-reported ingestion of kratom and tianeptine. Initial evaluation showed significant respiratory depression, hypoxia, bilateral pulmonary infiltrates, and acute encephalopathy. Symptomatic management, naloxone administration, and ICU-level supportive care led to gradual clinical improvement. This case highlights the potential for severe respiratory and neurological compromise with combined kratom and tianeptine toxicity.