A Case of Malignant Catatonia in the Setting of Chronic Kratom Use

Researchers: Andrew Tsai, DO; Jingyi Gao, DO

Research focus: Malignant catatonia (MC) is a life-threatening subtype of catatonia that can progress rapidly. Prior to the current standardized benzodiazepine and electroconvulsive therapy approach, mortality was regarded as greater than 50%. Mortality risk persists with standard treatment at 9%. While there is a range of psychiatric and toxic metabolic etiologies associated with MC, autonomic dysregulation of dopamine and GABAnergic receptors is the presumed mechanism. Kratom, an herbal supplement with stimulant and opioid-like properties, has gained popularity in America for its purported wellness and pain-relieving effects. However, while it has been linked to exacerbation of underlying psychiatric conditions, to our knowledge, Kratom has never been reported to cause MC.