Some side effects may be occur with kratom usage as anorexia, weight loss, tremor, trouble sleeping, darkening in the cheeks, frequent urination, dry mouth, constipation, confusion, itching, hallucination and psychosis that may occur with long term addiction. Several recent reports describe some serious adverse effects from mitragynine: Addiction, withdrawal, hypothyroidism, hepatotoxicity and seizures.
Side effects of kratom are not clearly defined by clinical studies. There is lack of information about kratom interactions with medications, other herbs or other drug of abuse and this is a major obstacle in identifying the beneficial uses and safety of kratom.
The conjugated use of mitragynine alkaloid extract with other psychoactive drugs (as: alcohols, sedatives, opioids, stimulants, cannabinoids) increases the possibility for serious drug interactions.