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Herb library · Herb · Picralima nitida

Akuamma

The intensely bitter seeds of a West and Central African forest tree, taken there for fever, malaria and pain. Its alkaloids act on the body's opioid receptors in the laboratory, and the seeds are now sold online in the US as a pain remedy. It has not been properly studied in people.

Traditional use

Holland recorded in 1915 that on the Gold Coast (today's Ghana) it was used extensively in place of quinine. PROTA, the handbook of Plant Resources of Tropical Africa, records that across its range the seeds, bark and roots are taken for fever and malaria and widely for pain and for chest and stomach complaints, usually by chewing or crushing the seeds or drinking a decoction; that in Ghana a seed decoction is used as an enema and for pain; and that the seeds are chewed as a tonic and stimulant.

What studies show

  • Insufficient

    Pain, fever and malaria: no controlled study of akuamma in people was found. In a 2026 US web survey, 28 of 369 respondents had used the seeds, mostly for pain or as an opioid substitute, and about 6 in 10 of them said it relieved pain; a survey like this cannot show whether it works or is safe. Its alkaloids act on opioid receptors and the seeds block malaria parasites in laboratory studies.

Be careful of

Cautions

  • NoteIts alkaloids act on the opioid receptors that morphine and kratom act on. A man who drank a gas-station "kava" product listing akuamma on the label developed severe opioid-like withdrawal; testing found kratom in the product as well. Do not combine it with opioids, sedatives or alcohol, and do not use it in place of prescribed opioids or addiction care.
  • InteractionIn a laboratory study, akuamma extract strongly blocked the liver enzyme CYP2D6 and moderately blocked CYP3A4 and CYP2C19, which clear many common drugs. The authors called the CYP2D6 effect a particular concern. Tell your clinician before taking it with any prescription medicine.
  • NoteMalaria is a medical emergency. Akuamma is not a substitute for tested malaria medicine.
  • PregnancyNo safety information for pregnancy or breastfeeding exists; do not use it then.
  • Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines, are pregnant or breastfeeding, or are giving it to a child.

From the old books

What herbals and dispensaries of the past printed. History, in their words.

“Extensively used by the natives, Gold Coast, in place of quinine (Oppenheimer, Son & Co. Herb. and Mus. Kew).”
J. H. Holland, The Useful Plants of Nigeria, Part III (Kew Bulletin, Additional Series IX) (1915), Part III, p. 439. See the page of The Useful Plants of Nigeria, Part III (Kew Bulletin, Additional Series IX), Part III, p. 439 (opens in a new tab) · Read the full passage from The Useful Plants of Nigeria, Part III (Kew Bulletin, Additional Series IX), Part III, p. 439

Sources

  1. Akuamma seed (Picralima nitida) use in the U.S.: findings from a web-based survey (J Psychoactive Drugs, 2026) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
  2. When "kava" isn't kava: opioid-like withdrawal responsive to buprenorphine: a case study (J Addict Med, 2026) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
  3. Potential inhibition of major human cytochrome P450 isoenzymes by selected tropical medicinal herbs — implication for herb-drug interactions (Food Sci Nutr, 2019) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
  4. Constituents of Picralima nitida display pronounced inhibitory activities against asexual erythrocytic forms of Plasmodium falciparum in vitro (J Ethnopharmacol, 1996) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
  5. Modified akuamma alkaloids with increased potency at the mu-opioid receptor (J Med Chem, 2023) — PubMed record (opens in a new tab) · NIH · read September 25, 2026
  6. Picralima nitida — PROTA4U record (uses) (opens in a new tab) · PROTA · read September 25, 2026

Reviewed September 25, 2026.