Treatment of obsessive compulsive disorder and Kratom dependence with buprenorphine and supportive care

Filipa Teixeira; Oluwatobi Ajewole; Mihai Picior; Emmert Roberts

doi:10.1136/bcr-2025-265834

Treatment of obsessive compulsive disorder and Kratom dependence with buprenorphine and supportive care

Filipa Teixeira, Oluwatobi Ajewole, Mihai Picior, Emmert Roberts

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Abstract

Kratom is an herbal product derived from Mitragyna speciosa which, depending on the dose, has stimulant and opioid-like effects and is increasingly being used recreationally to self-medicate symptoms of anxiety and depression. This case describes a man in his 30 s who presented to a community drug and alcohol service seeking support for problematic Kratom use, which he started using to try and manage obsessive-compulsive disorder symptoms and low mood. Despite attempts to reduce his use, he was unable to discontinue Kratom use independently. Initiation of low-dose sublingual buprenorphine led to complete abstinence within 3 weeks. This case highlights not only the potential use of low-dose buprenorphine to manage Kratom withdrawal but also the complexity in managing co-existent mental health disorders in addiction services, emphasising the importance of psychiatry within a multidisciplinary approach.

Original language	English
Article number	e265834
Journal	BMJ case reports
Volume	18
Issue number	6
DOIs	https://doi.org/10.1136/bcr-2025-265834
Publication status	Published - 15 Jun 2025

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10.1136/bcr-2025-265834

Treatment of Obsessive-Compulsive_TEIXEIRA_PUblishedonline15June2025_GREEN_AAM (CC BY)Accepted author manuscript, 255 KBLicence: CC BY

https://casereports.bmj.com/lookup/doi/10.1136/bcr-2025-265834

Cite this

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abstract = "Kratom is an herbal product derived from Mitragyna speciosa which, depending on the dose, has stimulant and opioid-like effects and is increasingly being used recreationally to self-medicate symptoms of anxiety and depression. This case describes a man in his 30 s who presented to a community drug and alcohol service seeking support for problematic Kratom use, which he started using to try and manage obsessive-compulsive disorder symptoms and low mood. Despite attempts to reduce his use, he was unable to discontinue Kratom use independently. Initiation of low-dose sublingual buprenorphine led to complete abstinence within 3 weeks. This case highlights not only the potential use of low-dose buprenorphine to manage Kratom withdrawal but also the complexity in managing co-existent mental health disorders in addiction services, emphasising the importance of psychiatry within a multidisciplinary approach.",

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