← The ApothecaryApocynaceaeseed, bark, leafFact-checked 24 October 2026

Significant riskHuman toxicity and safe doses are unknown. In rat liver microsomes akuammine and akuammiline were broken down quickly (half-lives 13.5 and 30.3 minutes). Because the alkaloids are opioid-active, akuamma should be treated as a drug with dependence potential.In an emergency, call your local emergency number or poison centre.

Akuamma

Picralima nitida

Also calledAkuamma seed

A West African tree whose seeds are a traditional remedy for pain and fever, and whose plant parts are also used for malaria and diabetes. The seed alkaloids, chiefly akuammine and akuammicine, act on opioid receptors; akuamma is sold in the US alongside other unscheduled psychoactive botanicals and has turned up in kava-style drinks. There are no clinical trials, and an opioid-like withdrawal has been reported.

What it is used for

Pain (general)
Limited
Seeds are used traditionally for pain. The isolated alkaloids bind mu and kappa opioid receptors, but in a 2021 study the mu-acting alkaloids showed limited pain relief in mice, contradicting earlier reports. In a 2024 US web survey, 28 of 369 respondents had tried akuamma, mostly for pain or opioid substitution, and 61% of them reported relief; there are no controlled trials.^1,2,3
Malaria
Limited
Used in folk medicine for malaria; several seed alkaloids, notably alstonine, showed antiplasmodial activity in vitro.^5,6
Addiction and withdrawal
Limited
Some US users take it as an opioid substitute. A 2026 case report described severe opioid-like withdrawal, relieved by buprenorphine, after heavy use of a 'kava' shot whose label listed akuamma; kratom derivatives were also found in the product.^3,7
Fever
Traditional
Seeds are traditionally used to treat fever.^1,2
Blood sugar and diabetes
Traditional
Listed among folk uses (with cancers); no clinical evidence.⁶

How it is prepared

powder

In the US the seeds are sold whole or powdered, and in capsules or drinks, as unregulated products; doses and contents are not standardised.

Amounts are as recorded by the named source, not a recommendation.

Safety

Pregnancy: Avoid
Breastfeeding: Avoid

Interactions with medicines

opioids, sedatives, alcohol and other CNS depressantsMajorThe alkaloids are opioid-receptor agonists, so additive effects are expected (theoretical; not studied).
kratom and other opioid-active botanicalsMajorOften co-formulated or co-used; a case of dependence and withdrawal involved a product containing both.

Interaction checker →

Do not use if

History of opioid use disorder

Side effects

Opioid-like dependence and withdrawal reported (one case)
Pruritus and gastrointestinal and autonomic symptoms in that case

In the healing traditions

African traditional medicine
Akuamma
West African use of the seeds for pain and fever, and of the plant for malaria, diabetes and cancers.
Modern pharmacology
Akuammine, akuammicine
Indole alkaloids whose main targets are opioid receptors; akuammicine is a potent kappa-opioid agonist and akuammine, pseudo-akuammigine and akuammiline act at mu-opioid receptors at micromolar potency. Studied as scaffolds for new opioid drugs.

Active compounds

akuammine: indole alkaloid; mu-opioid receptor agonist (micromolar)
akuammicine: potent kappa-opioid receptor agonist
pseudo-akuammigine, akuammiline, picraline: other major seed alkaloids
alstonine: seed alkaloid with antiplasmodial activity in vitro

History

Akuamma seeds have long been part of West African medicine for pain and fever. Their use in the United States, often alongside kratom and kava, has prompted pharmacological studies confirming opioid-receptor activity and semi-synthetic work on akuammine analogues as possible new pain drugs.

Sources

Reference, not prescription. Nothing here is medical advice. Herbs can interact with medicines and be dangerous in pregnancy; tell your doctor or pharmacist about anything you take.