Dottorato in NEUROSCIENZE CLINICO-SPERIMENTALI E PSICHIATRIA

Titolo della tesi: Mental Effects and Potential Therapeutic Use of Kratom/Mitragynine

Introduction. Kratom (Mitragyna speciosa), a traditional (sub)tropical plant from Southeast Asia, has become increasingly available in the West in recent decades. Despite the global spread of kratom for self-medicating pain, substance use disorder, and psychiatric symptoms outside clinical settings, data from controlled studies on human exposure to kratom and mitragynine, its main active alkaloid, are quite limited. Methods. Therefore, this thesis aims to improve knowledge on kratom/mitragynine use (e.g., safety and motivations), their behavioral effects, and the balance between therapeutic benefits and addictive potential through two literature reviews, a netnographic analysis, an online research on the darkweb, a placebo-controlled single blind experimental study and a survey. Results. Motivation for kratom use is often medically oriented in non-clinical settings. Low doses of mitragynine and kratom are safe for consumption and induce nootropic effects. Kratom might have value as an opioid substitute in the treatment of addiction and in managing (acute/chronic) pain. However, kratom’s side-effects and addictive potential require careful monitoring. Conclusions. Findings in this dissertation contributes to the intense debate on kratom use as therapeutic aid in some conditions and to the knowledge base of clinicians in the field of psychiatry and addiction medicine. Further tolerability and safety studies, including randomized-controlled trials, are necessary to evaluate kratom’s potential therapeutic benefits and safety issues, for which studies in this dissertation offer a potential basis.