A case of a mixed overdose involving kratom (Mitragyna speciosa) leading to serotonin syndrome

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H. Reid Zweifel
Jonathan Browne
Jeffrey M Levine


Objective: Drug overdose deaths have risen precipitously over the past two years in the United States. Polysubstance overdose with opiates and amphetamines have been of particular concern. Kratom (Mitragyna speciosa) is an unregulated widely available herb with both stimulant and opiate μ-receptor activity. Studies suggest that its use is quickly increasing.

Case: We describe a patient who presented to a psychiatric hospital with a mixed toxic syndrome due to chronic kratom and prescribed SSRI use compounded by acute intake of methamphetamine. The patient displayed psychosis, tremulousness, myoclonus, and extreme anxiety. Her clinical picture was consistent with both serotonin syndrome and opiate withdrawal.

Conclusion: We call attention to this case because polysubstance overdoses are common, and kratom is widely available. Complex toxic presentations that involve kratom are likely to be increasingly encountered.


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How to Cite
Zweifel, H. R., Browne, J., & Levine, J. M. (2021). A case of a mixed overdose involving kratom (Mitragyna speciosa) leading to serotonin syndrome. Medical Science and Discovery, 8(12), 735–737. https://doi.org/10.36472/msd.v8i12.626
Case Reports
Received 2021-11-08
Accepted 2021-11-20
Published 2021-12-01


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