Use of Qat in the UK

Abstract

Use ofQat in the UKDEARSIRS A recent newspaper article (The Independent, 1992) suggested that the plight of some Somalian refugees in this country is compounded by the adverse effects of heavy use of Qat, a mood-altering plant.Last year I encountered an acute psychotic episode associated with the use of Qat.My patient, a 28-year old Somalian male student, was brought to me by friends concerned by his agitated, restless, sleepless state.He described paranoid ideas and had felt suicidal.There was no previous psychiatric history.He was admitted infor mally to a local psychiatric unit where his symptoms settled rapidly, was discharged after a few days on no medication, and has remained well since.It emerged that his symptoms had followed a spell of heavy Qat consumption.Qat (Gat, Khat, or Mira) is the leaves and young shoots of Catha Edulis, a tree that grows at high altitude in East Africa (Ghodse, 1989; Kennedy, 1987).Originating in the Yemen, it is traditionally used in the Middle East and parts of North and East Africa by chewing or, formerly, by infusing the leaves (Arabian or Ethiopian tea).It has been described as a remedy for depression since the 13th century and is often a pleasurable group activity after a traditional meal, in rooms specially set aside and furnished, and is an important and traditional part of local social life.Official business and commerce are often con ducted while Qat is chewed during the afternoon siesta.It is also used by students and local lorry drivers to combat fatigue.Active ingredients include Cathine (D-pseudonorepinephrine) and Cathinone; effects are described as mildly stimulant and euphoric but may lead to restlessness, sleeplessness, anorexia, gastro-intestinal symptoms and (rarely) a psychotic