Akuamma
Also called Picralima nitida, akuamma seed
A 2026 case report describes a 36-year-old man, in remission from opioid use disorder, who drank a gas-station “kava” shot heavily and developed rapid tolerance, frequent redosing, night-time withdrawal, stomach and autonomic symptoms and itching all over. Benzodiazepines did not help; buprenorphine/naloxone improved the symptoms quickly. The product label listed akuamma (Picralima nitida), and lab testing of other samples of the same product found kratom (Mitragyna speciosa) derivatives and kavalactones. [6]
See Risks and toxicity, and the pages for Kava, Kratom and Buprenorphine.
Overview
Picralima nitida is a West African plant in the family Apocynaceae with many uses in African folk medicine, including for fever, high blood pressure, jaundice, period pain, stomach and gut problems and malaria. [9]
The seeds of the akuamma tree have been used as a traditional treatment for pain and fever, and these effects have been put down to a group of indole alkaloids in the seeds, known as the akuamma alkaloids. [1]
A 2023 paper says the plant has been used in West Africa as a traditional treatment for opioid withdrawal, fever and pain. [2]
A 2018 medical toxicology review of drugs people turn to when trying to wean themselves off opioids or treat opioid dependence on their own includes akuamma seeds among the agents it covers. [8]
Alkaloids and how they act
Pages for each alkaloid: Akuammine · Pseudo-akuammigine · Akuammidine · Akuammicine · Pericine
The seed contains at least five major alkaloids: akuammine, akuammicine, akuammiline, picraline and pseudo-akuammigine. [4]
Tested against a panel of more than 40 central nervous system receptors, five of the alkaloids had the opioid receptors as their main targets. Akuammicine was a potent kappa opioid receptor agonist, and three alkaloids (akuammine, akuammidine and pseudo-akuammigine) had micromolar activity at the mu opioid receptor. [1]
A 2023 paper describes akuammine, pseudo-akuammigine and akuammidine as weak mu opioid receptor agonists, with potencies of 2.6 to 5.2 μM. [2]
An earlier 1998 study found that akuammidine acted as an agonist at mu opioid receptors, while akuammine bound mu sites best but acted as an antagonist there. Akuammigine and pseudo-akuammigine showed little or no effect in its opioid tests. The authors concluded the alkaloids had neither high affinity nor selectivity for any of the opioid receptors tested. [3]
In mice, the mu-acting alkaloids showed limited pain-relieving effect in heat-pain tests, which the authors say contradicts earlier reports and the traditional use of the seeds as painkillers. [1]
A 2002 rat study reported that pseudo-akuammigine reduced paw swelling and had a pain-relieving effect that naloxone partly blocked. [10]
A 1982 paper reported pericine as a new CNS-active indole alkaloid, found in Picralima nitida cell suspension culture by opiate receptor binding studies. [11]
In rats given ground seed by mouth, only akuammine reached significant levels in the blood, with low oral bioavailability. In rat liver microsomes, akuammine and akuammiline had half-lives of 13.5 and 30.3 minutes. [4]
Who uses it, and why
In a US online survey run from December 2023 to July 2024, 28 of 369 adults (7.6%) said they had ever used akuamma seed. All of them had tried kratom, and they reported more kava and delta-8 THC use than the rest of the sample. [5]
Those who had tried akuamma seed reported worse pain, and said they used it for pain management and as an opioid substitute; 60.7% reported pain relief from it. None met the survey’s modified DSM-5 criteria for an akuamma seed use disorder. The authors say more research is needed on its safety, efficacy and health outcomes. [5]
A 2021 paper notes anecdotal reports that, unlike usual opioid painkillers, akuamma does not cause euphoria, tolerance or dependence. [1]
Risks and toxicity
See the case at the top of this page: severe opioid-like withdrawal after stopping a “kava” product whose label listed akuamma and which was found to contain kratom derivatives. [6]
Animal toxicity studies
These are rodent results. Animal doses are not human doses.
A 2019 rodent study of a water extract of the seeds reported an LD50 of 707.107 mg/kg. The extract was genotoxic at every dose tested. [7]
Given to pregnant rats, the extract lowered birth weight, and the authors conclude it has teratogenic effects and should not be used in pregnant women. They also say it may cause liver damage and oxidative stress with long-term use. [7]
Dosage
Mixing
References
- Journal / agency Creed SM, Gutridge AM, Argade MD, Hennessy MR, Friesen JB, Pauli GF, van Rijn RM, Riley AP. Isolation and Pharmacological Characterization of Six Opioidergic Picralima nitida Alkaloids. Journal of Natural Products. 2021. doi:10.1021/acs.jnatprod.0c01036 · PMID 33326237 Copyrighted, not open licence: restated in our words, not quoted. Lab and mouse studies.
- Journal / agency Hennessy MR, Gutridge AM, French AR, Rhoda ES, Meqbil YJ, Gill M, Kashyap Y, Appourchaux K, Paul B, Wang ZJ, van Rijn RM, Riley AP. Modified Akuamma Alkaloids with Increased Potency at the Mu-opioid Receptor. Journal of Medicinal Chemistry. 2023. doi:10.1021/acs.jmedchem.2c01707 · PMID 36827198 Copyrighted, not open licence: restated in our words, not quoted. Lab and mouse studies.
- Journal / agency Menzies JR, Paterson SJ, Duwiejua M, Corbett AD. Opioid activity of alkaloids extracted from Picralima nitida (fam. Apocynaceae). European Journal of Pharmacology. 1998. doi:10.1016/s0014-2999(98)00232-5 · PMID 9683021 Copyrighted, not open licence: restated in our words, not quoted. Lab (isolated tissue and binding) study.
- Journal / agency Gour A, Creed SM, Riley AP, Sharma A. Comprehensive pharmacokinetics and ADME evaluation of Akuamma alkaloids. Journal of Chromatography B. 2025. doi:10.1016/j.jchromb.2025.124713 · PMID 40582228 Copyrighted, not open licence: restated in our words, not quoted. Rat and cell studies.
- Journal / agency Timmons P, Hill K, Smith KE, Riley A, Mun CJ. Akuamma Seed (Picralima nitida) Use in the U.S.: Findings from a Web-Based Survey. Journal of Psychoactive Drugs. 2026. doi:10.1080/02791072.2026.2618033 · PMID 41563345 Copyrighted, not open licence: restated in our words, not quoted. Online survey.
- Journal / agency Malhotra A, McPherson GE, Scott KS, Li L. When “Kava” Isn’t Kava: Opioid-like Withdrawal Responsive to Buprenorphine: A Case Study. Journal of Addiction Medicine. 2026. doi:10.1097/ADM.0000000000001748 · PMID 42372078 Copyrighted, not open licence: restated in our words, not quoted. A single case.
- Journal / agency Awodele O, Coulidiaty AGV, Afolayan GO, Agagu S, Omoseyindemi B, Busia K. Toxicological evaluation of Picralima nitida in rodents. Journal of Ethnopharmacology. 2019. doi:10.1016/j.jep.2019.03.008 · PMID 30853649 Copyrighted, not open licence: restated in our words, not quoted. Animal (rat and mouse) study.
- Journal / agency Toce MS, Chai PR, Burns MM, Boyer EW. Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity. Journal of Medical Toxicology. 2018. doi:10.1007/s13181-018-0685-1 · PMID 30377951 Copyrighted, not open licence: restated in our words, not quoted. Review.
- Journal / agency Erharuyi O, Falodun A, Langer P. Medicinal uses, phytochemistry and pharmacology of Picralima nitida (Apocynaceae) in tropical diseases: a review. Asian Pacific Journal of Tropical Medicine. 2014. doi:10.1016/S1995-7645(13)60182-0 · PMID 24418074 Copyrighted, not open licence: restated in our words, not quoted. Review.
- Journal / agency Duwiejua M, Woode E, Obiri DD. Pseudo-akuammigine, an alkaloid from Picralima nitida seeds, has anti-inflammatory and analgesic actions in rats. Journal of Ethnopharmacology. 2002. doi:10.1016/s0378-8741(02)00058-2 · PMID 12020930 Copyrighted, not open licence: restated in our words, not quoted. Rat study.
- Journal / agency Arens H, Borbe HO, Ulbrich B, Stöckigt J. Detection of pericine, a new CNS-active indole alkaloid from Picralima nitida cell suspension culture by opiate receptor binding studies. Planta Medica. 1982. doi:10.1055/s-2007-971216 · PMID 6298847 No abstract online; only the title is used here.
Read 31 October 2026. TripSit had no akuamma entry, and PsychonautWiki only lists akuamma by name on its “Naturally occurring sources” page, so this page relies on journals.