Kratom, a collective designation for species within the genus Mitragyna, comprises tropical evergreen trees indigenous to South and Southeast Asia. The plant holds considerable ethnobotanical relevance, particularly in the southern regions of Thailand and India, where it has been traditionally employed for its biphasic stimulant and sedative effects and in the management of conditions such as pain, fever, and diarrhoea. This review presents a comprehensive evaluation of kratom within the framework of Thai and Indian traditional medicine, with emphasis on its ethnopharmacological applications and its proposed relevance to neglected tropical diseases (NTDs). It examines the historical and cultural dimensions of kratom use across South and Southeast Asia, underscoring its integration into local medicinal systems and sociocultural practices. The phytochemical profile of kratom is analysed, focusing on its principal indole alkaloids, including mitragynine, speciogynine, speciociliatine, and 7-hydroxy-7H-mitragynine. In addition, the review outlines the prevailing regulatory landscape in both countries, highlighting ongoing policy discussions in Thailand aimed at balancing therapeutic potential against risks of misuse. Finally, it underscores the necessity for rigorous scientific investigation to clarify pharmacological mechanisms, establish safety parameters, and support the development of evidence-based therapeutic strategies derived from kratom's bioactive constituents, particularly in relation to NTDs. This review innovatively repositions M. speciosa beyond its conventional role in pain and addiction management by applying a 'genus-to-species' translational framework to predict its efficacy against NTDs, specifically highlighting novel applications in the green synthesis of antimalarial silver nanoparticles.
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Sommano et al. (2026) studied this question.
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