14
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A Case of Kratom Overdose in a Pediatric Patient

      case-report
      ,
      Case Reports in Psychiatry
      Hindawi

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Kratom is a synthetic opioid that is federally unregulated and thus available for purchase through online retail and smoke shops in most states. Due to its availability, there is concern for misuse in the pediatric population. There is existing literature describing toxicity of kratom in adults; yet, to the best of our knowledge, there are no cases describing kratom toxicity in the pediatric population. Thus, we present the case of kratom overdose in a pediatric patient.

          Related collections

          Most cited references3

          • Record: found
          • Abstract: found
          • Article: not found

          A drug fatality involving Kratom.

          A 17-year-old white man who showed no obvious signs of trauma was found unresponsive in bed and was pronounced dead at the scene. The decedent had a documented history of heroin abuse and chronic back pain and reportedly self-medicated with Kratom (mitragynine). The autopsy was remarkable only for pulmonary congestion and edema and a distended bladder, both of which are consistent with, though not diagnostic of, opiate use. A laboratory work-up revealed therapeutic levels of over-the-counter cold medications and benzodiazepines. However, of interest was a level of mitragynine at 0.60 mg/L. Given the facts of the case, the Medical Examiner certified the cause of death as "possible Kratom toxicity" and the manner of death was classified as "accident." © 2012 American Academy of Forensic Sciences.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Biochemical Benefits, Diagnosis, and Clinical Risks Evaluation of Kratom

            Background Kratom (Mitragyna speciosa) is a tropical tree with a long history of traditional use in parts of Africa and Southeast Asia. Kratom is also known as Thom, Thang, and Biak. Its leaves and the teas brewed from them have long been used by people in that region to manage pain and opioid withdrawal and to stave off fatigue. Kratom is actually consumed throughout the world for its stimulant effects and as an opioid substitute (in form of tea, chewed, smoked, or ingested in capsules). Some case reports have associated kratom exposure with psychosis, seizures, intrahepatic cholestasis, other medical conditions, and deaths. The clinical manifestations of kratom effects are not well defined and the clinical studies are limited. Data research suggest that both stimulant and sedative dose-dependent effects do exist, in addition to antinociceptive, antidepressant activity, anxiolytic-like effects, and anorectic effects, but a growing concern for the drug’s effects and safety of use has resulted in national and international attention primarily due to an increase in hospital visits and deaths in several countries that are believed to have been caused by extracts of the plant. There is a dearth of double blind controlled studies. In this study, we aim to use existing literature to clarify both benefits and risks of kratom as well as its diagnosis evaluation as kratom misuse is an emerging trend in the Western world. Methods Literature review using databases such as Embase, Medline, PubMed, Cochrane Library, and Mendeley from 2007 to 2017 were evaluated by all authors to analyze current state on benefits, risks, and diagnosis evaluation of kratom (M. speciosa). Results Data analysis suggested that kratom possesses some benefits such as stimulant and sedative effects as wells as antinociceptive effects. It seems to inhibit pro-inflammatory mediator release and vascular permeability and can enhance immunity. In addition, it may be an antidepressant and anorectic. However, kratom can cause intrahepatic cholestasis, seizure, arrhythmia, impair memory function, coma, and death. Psychological manifestations described are euphoria and feeling relaxed to severe symptoms such as aggression, hostility, and psychosis. Medical manifestations described are polyuria, dry mouth, vomiting, and jerky movements. Currently, liquid chromatography/mass spectrometry and ion mobility spectrometry (IMS) are suggested as the most promising to rapidly screen kratom products providing a positive success rate. Conclusion Our data analysis has not determined if biochemical benefits of kratom may prove to outweigh its toxicity and risks. On the contrary, it seems that its potential side effects outweigh the benefits, and severe and real health hazards can, insidiously, lead to death. Kratom clinical, psychological, and medical manifestations can be disturbing. Kratom (M. speciosa) use, among multiple compounds of the leaf, appear to be increasing in the Western world. Promising methods to accurately identify kratom compounds are still ongoing.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found
              Is Open Access

              Kratom from Head to Toe—Case Reviews of Adverse Events and Toxicities

              Purpose of Review This review describes case reports for patients with kratom-associated adverse events in order to assist clinicians with patient management. A stepwise approach is proposed for assessing active kratom users as well as considerations for the management of toxicities or withdrawal. Recent Findings Multiple in vitro and in vivo studies illustrate the pharmacologic and toxicologic effects of kratom extract. No randomized controlled trials in humans exist that assess the safety and efficacy of the substance. Cross-sectional surveys from active users and reports from poison control centers have shown acute and chronic physiological and psychological adverse events. Summary Reports of adverse effects associated with kratom use have demonstrated hypothyroidism, hypogonadism, hepatitis, acute respiratory distress syndrome, posterior reversible encephalopathy syndrome, seizure, and coma. Overdose toxidrome leads to respiratory failure, cardiac arrest, and fatalities. Adult and neonatal withdrawal symptoms have also occurred. Clinicians should be aware of the risks and benefits of kratom use.
                Bookmark

                Author and article information

                Contributors
                Journal
                Case Rep Psychiatry
                Case Rep Psychiatry
                CRIPS
                Case Reports in Psychiatry
                Hindawi
                2090-682X
                2090-6838
                2020
                12 August 2020
                : 2020
                : 8818095
                Affiliations
                Henry Ford Health System, Department of Psychiatry, 1 Ford Place, 1C-09 Detroit, Michigan, USA 48202
                Author notes

                Academic Editor: Daisuke Matsuzawa

                Author information
                https://orcid.org/0000-0002-9630-8485
                https://orcid.org/0000-0002-6384-1793
                Article
                10.1155/2020/8818095
                7443027
                2af49b30-910d-4004-8962-bbf60c2f1dc4
                Copyright © 2020 Andrew Wong and Monique Mun.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 June 2020
                : 23 July 2020
                : 10 August 2020
                Categories
                Case Report

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

                Comments

                Comment on this article