We came across an interesting article the other day from an issue of Frontiers in Pharmacology that made us wonder about potentially using kratom as an antipsychotic. This is a peer-reviewed journal, and we try to use those as confirmation of pretty much anything printed on the internet or anywhere else really.

Having a team of other published researchers in the same field approve a piece before it is published makes the data more credible. This particular study piqued our interest because our government agencies have actually claimed that using kratom as an antipsychotic, or for any other purpose, causes psychosis.

This particular study attempted to compare mitragyna speciosa to typical antipsychotics (like haloperidol) and atypical antipsychotics (like risperidone) as a potential treatment option for subjects suffering from psychosis.

If effective, the big benefit would be that mainstream antipsychotic drugs are associated with lots of side effects; some of them serious and some potentially fatal. Keep in mind these drugs are approved by the FDA.

Side Effects of Traditional Antipsychotic Medications

Using kratom as an antipsychotic would be a natural way to go with relatively few side effects. Regarding traditional prescription drugs, we figure the best approach would probably be to start with a brief list of known adverse effects of mainstream antipsychotics:

  • Extrapyramidal effects: dystonia (neurological condition that can leave users’ limbs literally stuck in weird positions), akathisia (uncontrollable restlessness), Parkinson’s-like symptoms, and others
  • Metabolic Syndrome, a/k/a Syndrome X: this is a collection of symptoms including elevated lipid profiles (insoluble fat in the blood that can clog arteries), insulin resistance (precursor to type 2 diabetes), increased fat around the midsection, abnormally high LDL levels (the bad type of cholesterol), high blood pressure, and low HDL levels (the good kind).
  • Anti-cholinergic effects: dysfunction of the parasympathetic nervous system (involuntary muscle movements such as in digestion or bowel motility), confusion, blurred vision, and more
  • Hyperprolactinemia: effects include loss of libido, lactation in both males and females, and infertility

In The Real World

Let’s take a drug called Haloperidol for example. Haldol, which is the drug’s trade name, is known to cause tardive dyskinesia (a serious neurological condition involving uncontrollable movements all over the body) and neuroleptic malignant syndrome, which is a life threatening condition involving unstable blood pressure, stupor, and loss of autonomic function.

It’s not like this is top-secret knowledge, either. This delightful excerpt was taken right from the FDA’s own database:

“Cases of sudden death, QT-prolongation, and Torsades de Pointes have been reported in patients receiving HALDOL.”

Atypical antipsychotic drugs are associated with transient ischemic attacks (TIAs), metabolic syndrome, tardive dyskinesia, and an increased risk of dia

Details of the Study

In the study, which was first published in the December 2016 version of Frontiers in Pharmacology, the research team created a kratom solution using methanol as the base solvent and gave it to apomorphine-induced mice to see how well the solution performed in this standard test.

Apomorphine is a dopamine receptor agonist often used to treat Parkinson’s but in this case used to manufacture psychotic episodes.

The potential solution of using kratom as an antipsychotic appears to be interesting because the study mice not only showed decreased psychotic behavior, but kratom also improved catalepsy (muscle rigidity and limbs often being “stuck” in odd positions) in other mice that had been treated with haloperidol.

This conclusion was that mitragyna speciosa somehow regulates dopaminergic neurotransmission in the brain regions associated with psychosis. It was also shown to alleviate the symptoms of ketamine-induced social withdrawal. There was no mention of any adverse effects from the kratom concoction.

Kratom as an Antipsychotic

Kratom, contains the indole alkaloids, mitragynine, which interacts with serotonin, dopamine, and alpha-2 adrenergic receptors in the human body. D2 dopamine receptors are where traditional antipsychotic medications bind in the brain.

Mitragynine has been shown to bind to these receptors in the same way, acting as a dopamine antagonist. It may be through this action that we may successfully use kratom as an antipsychotic.

This suggests kratom’s main alkaloid may be a potential treatment for positive symptoms of psychosis such as auditory, tactile, and visual hallucinations. One study showed that mitragynine also proposed its own antagonism at certain serotonin receptors, also making it a potential treatment for the negative symptoms of psychosis such as lack of motivation and difficulty speaking.

Kratom and Depression

Regarding kratom for depression, there have been comparisons drawn between kratom and fluoxetine (Prozac) and amitriptyline (Elavil) due in part to the former’s performance on forced swimming and tail suspension tests carried out in rats.

These popular experiments place rats in a forced state of despair and monitor their perseverance, put simply. In both tests, rats dosed with mitragynine showed the same drive and persistence as those given the prescription medications.

There was also a decrease in blood levels of cortisol, a major stress hormone also present in humans. These findings were repeated in another animal study in 2006, which showed similar results on the forced swimming test.

The rats showed less time in a state of immobility when faced with the challenge – a typical anti-depressive indicator. There was also no effect on locomotive behavior, which is a key property of stimulants.

Dosage

Now that we know that people use kratom as an antipsychotic and antidepressant due largely to its mitragynine content, our next step should be to figure out what kratom products contain this chemical in sufficient quantity.

What is sufficient quantity? Inexperienced kratom users often begin with the equivalent of between 15-45 mg of mitragynine. We say equivalent because different forms of kratom contain different concentrations of this chemical.

Good kratom contains 1.5% mitragynine, so roughly 15 mg per 1 g of ground leaf powder. You would be looking at ingesting from 1-3 g of kratom powder if that’s your chosen form. Most capsules are made from our ground leaf powder. Each capsule contains around 500 mg of it on average, so you would need to consume 2-6 capsules to get enough mitragynine. The exact amount per capsule should be printed on the product packaging or at least on the manufacturer’s website.

Kratom extracts are the result of isolating the leaf’s alkaloids from the plant material, which means you consume a smaller volume of product. Extracts come in a wide range of strengths and a trustworthy kratom retailer will provide their mitragynine content on the product’s packaging and its website product page.

As an example, one company makes a product called Philosopher’s Blend containing 11%, which equates to 110 mg gram. A person would want to use a rough, rounded total of 150-450 mg of a product like this. To keep things easy to measure with common household tools, this would be about 1/8 to 1/4 of a teaspoon to start with this particular product. Again, vendors should provide these details readily.

There are also extract capsules available containing anywhere from 5% to 85% mitragynine, but the higher concentrations are rare. It is important to be careful with these products as overdose may be a potential threat in cases of severe misuse. If you try these products, remember to dose conservatively and wait at least an hour before deciding to take more.

One of these capsules would be more than enough in most situations, and probably too much for most. It is very important to note the exact concentration of your product and triple-check your math to ensure you are consuming an appropriate amount. As far as dosing frequency goes, most people get along fine with a morning dose and potentially another dosage in the afternoon. The effects of kratom last around four hours for most.

It is not recommended to take kratom daily without taking a break every now and then. This helps avoid dependence and tolerance. Many consumers use kratom during the work week and allow their body some time off on weekends.

Conclusion

Further studies would be great to further qualify the use of kratom as an antipsychotic. Research will go on as long as kratom remains decriminalized. Even if they do take away our right to use kratom, perhaps by turning its components into controlled, profitable, prescription medications, it’s safe to say that we will continue learning about it moving forward. The venue may just change a bit, that’s all.

So what’s the moral of the story? Your morning Green Malay your evening Red Maeng Da, or your Friday night Yellow Thai kratom is not going to make you go crazy, no matter how hard they try to convince you. In fact, it will probably help you if you’re already crazy!

Don’t stop following the science. Google Scholar is one source of information, though you need to pay attention to who funds studies and who is to benefit from the potential results as these things create an automatic bias. There’s also the Directory of Open Access Journals, which can give you a good starting point. Remember: think critically!