Chronic khat use and psychotic disorders: A review of the literature and future prospects

Abstract

Aims: In recent decades, the traditional habit of chewing the khat leaves, which contain the amphetamine-like cathinone, has undergone profound changes in African and Arab countries, from a socially regulated use pattern to uncontrolled consumption. This is of special public mental-health concern. In this article, a review of the scientific literature on the relationship between khat use and psychosis is provided. Results: Several case studies, but only a few group and community-based studies, have addressed this topic. The studies show inconsistent results, have methodological problems, and fail to report quantitative results. Many important questions remain unaddressed. Conclusions: The frequently stated association between khat use and psychosis contrasts with the small number of sound studies. Currently, only a few conclusions can be drawn, that excessive khat use can cause brief psychotic disorders and that people with a preexisting vulnerability should be discouraged to use it. The direction of causality between general psychopathology and khat use remains unclear. This review confirms the need for quantitative, controlled, and longitudinal studies,

Evaluation of the effect of various drying techniques on the composition of the psychoactive phenylpropylamino alkaloids of khat (<i>Catha edulis</i> Forsk) chewing leaves

“…Few reports from Yemen and elsewhere have indicated that chronic khat consumption may be a leading cause of cancer, cellular toxicity and other metabolic disorders [10][11][12][13]. An extensive review by Al-Motarreb et al [8] and Odenwald [9] about khat chewing and cellular toxicity revealed that some of the literature reports contradicted each other and that the rest were inconclusive as a result of limited data quality and depth. The current understanding of many khat-related topics is still poor and thus further research is urgently needed [14].…”

“…The short term chewing effects have been well discussed [2,8,9] however, not so much information is available regarding the long-term health impact of chewing khat. Few reports from Yemen and elsewhere have indicated that chronic khat consumption may be a leading cause of cancer, cellular toxicity and other metabolic disorders [10][11][12][13].…”

The stimulant khat—Another door in the wall? A call for overcoming the barriers

“…In the mental health domain, studies show that khat is functionally used by people with Posttraumatic Stress Disorder (PTSD) and other mental disorders to achieve temporary relief from their symptoms (Bhui et al, 2003;Odenwald et al, 2009); and that excessive khat use is associated with the development of psychotic symptoms which may be brief or persistent (Odenwald et al, 2009;Odenwald, 2007;. Odenwald et al (2009) recently illustrated the causal mechanism for khat-induced paranoid symptoms among combatants.…”

“…In the present commentary, we call for a balanced and informed response to the growing concerns about this neglected psychoactive drug that possibly is a contributory factor in widespread social and psychological suffering in several countries where there are virtually no specialist mental health services and systems (Odenwald, 2007;Bhui and Warfa, 2007) and that more and more develops into the economic backbone for millions of farmers and traders. Three decades of futile discussions (International Narcotic Control Board, 2006) have not led to sustainable measures being taken while in a downward spiral, suffering related to abuse and economic dependency on the khat sector has become ever more severe and widespread.…”

La toxicité du khat impose-t-elle une modification de la réglementation de son usage en Europe?

“…Si chez beaucoup d'usagers les troubles psychiques restent mineurs, de nombreuses observations suggèrent un lien entre des troubles mentaux plus sévères et la consommation de khat [29,35,36]. Sont particulièrement discutés des épisodes psychotiques, accès maniaques, troubles schizophréniques et paranoïaques [12,37].…”