Kratom can affect certain forms of CYP enzymes that are crucial in the metabolization of other compounds such as pharmaceutical drugs. This can cause adverse drug reactions such as serotonin syndrome, various organ toxicity, and even death in some instances. Common examples: Elavil, Endep, Tofranil, Praminil, Anafranil, Celexa, Lexapro, Cipralex, Paxil, Seroxat, Prozac, Sarafem, Effexor, Effexor XR, Desyrel, Oleptro, Serzone, Buspar, Remeron, Zispin, Seroquel, Abilify, Geodon, Latuda, Clozaril, Erythromycin, Clarithromycin, Telithromycin, Rifampin (Rifampicin), and Rifabutin. “Clinical Assessment of the Drug Interaction Potential of the Psychotropic Natural Product Kratom.” Clinical Pharmacology and Therapeutics, March 2023.  https://doi.org/10.1002/cpt.2891.