Abstract
Kava has a long history of traditional use for the treatment of symptoms related to anxiety, stress, and nervous restlessness and has demonstrated effectiveness for treatment of anxiety in double-blind, randomized, placebo-controlled trials. Lack of both dependence and documented adverse effects contributed to kava’s popularity up through the 1990s. Typical adverse effects have been limited to reversible yellowing of the skin after chronic use and a temporary condition known as kava dermopathy. Subsequent reports of hepatotoxicity in Europe and less frequently in the United States have resulted in a decrease in its popularity as well as regulatory action by various government regulatory bodies against specific formulations. Although subsequent analysis has concluded that “there is no clear evidence that the liver damage reported in the United States and Europe was caused by the consumption of kava” much of the US market for the herb has been diminished.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Anonymous. Kava-kava. In: The Review of Natural Products. St. Louis: Facts and Comparisons, 1996.
Singh YN. Kava: an overview. J Ethnopharmacol 1992;37:13–45.
Norton S, Ruze P. Kava dermopathy. J Am Acad Dermatol 1994;31:89–97.
Maisch U, Kieser M. Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines. Psychopharmacology 2001;157:277–283.
Heiligenstein E, Guenther G. Over-the counter psychotropics: a review of melatonin, St. John’s wort, valerian, and kava-kava. J Am Coll Health 1998;46:271–276.
Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353–356.
Schelosky L, Raffauf C, Jendroska K, Poewe W. Kava and dopamine antagonism. J Neurol Nerosurg Psychiatry 1995;58:639–640.
Keller F, Klohs MW. A review of the chemistry and pharmacology of the constituents of Piper methysticum. Lloydia 1963;26:1–15.
Jamieson DD, Duffield PH, Cheng D, Duffield AM. Comparison of the central nervous system activity of the aqueous and lipid extract of kava (Piper methysticum). Arch Int Pharmacodyn 1989;301:66–80.
Volz HP, Kieser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders — a randomized placebo-controlled 25-week outpatient trial. Pharmacopsychiatry 1997; 30:1–5.
Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol 2000;20(1):84–89.
Heinze HJ, Munthe TF, Steitz J, Matzke M. Pharmacopsychological effects of oxazepam and kava-extract in a visual search paradigm assessed with event-related potentials. Pharmacopsychiatry 1994;27:224–230.
Topic of the month, http://www.ownhealth.com/topic.html. Date accessed: Oct. 29, 1998.
Jussofie A, Schmiz A, Hiemke C. Kavapyrone enriched extract from Piper methysticum as modulator of the GAB A binding site in different regions of rat brain. Psychopharmacology 1994; 116:469–474.
Davies LP, Drew CA, Duffield P, Johnston GAR, Jamieson DD. Kava pyrones and resin: studies on GABAA, GAB AB, and benzodiazepine binding sites in rodent brain. Pharmacol Toxicol 1992;71:120–126.
Seitz U, Schule A, Gleitz J. [3H]-Monoamine uptake inhibition properties of kava pyrones. Planta Med 1997;63:548–549.
Baum SS, Hill R, Rommelspacher H. Effect of kava extract and individual kavapyrones on neurotransmitter levels in the nucleus accumbens of rats. Prog Neuropsychopharmacol Biol Psychiatry 1998;22:1105–1120.
Backhauss C, Krieglstein J. Extract of kava (Piper methysticum) and its methysticin constituents protect brain tissue against ischemic damage in rodents. Eur J Pharmacol 1992;215:265–269.
Tyler VE, Brady LR, Robbers JE, eds. Pharamcognosy, 8th ed. Philadelphia: Lea and Febiger, 1981.
Kretzschmar R, Meyer HJ, Teschendorf HJ. Strychnine antagonistic potency of pyrone compounds of the kavaroot (Piper methysticum Forst). Experientia 1970;26:283–284.
Gleitz J, Friese J, Belle A, Ameri A, Peters T. Anti-convulsive action of ±kavain estimated from its properties on stimulated synaptosomes and Na+ channel receptor sites. Eur J Pharmacol 1996;315:89–97.
Jamieson DD, Duffield PH. The antinociceptive actions of kava components in mice. Clin Exp Pharmacol Physiol 1990;17:495–508.
Garner LF, Klinger JD. Some visual effects caused by the beverage kava. J Ethnopharamacol 1985;13:307–311.
Duffield PH, Jamieson D. Development of tolerance to kava in mice. Clin Exp Pharmacol Physiol 1991;18:571–578.
Blumenthal M. Kava-kava rhizome. In: Popular Herbs in the U.S. Market. Austin: American Botanical Council, 1997.
Jappe U, Franke I, Reinhold D, Gollnick HPM. Sebotropic drug interaction resulting fromkava-kavaextracttherapy: anew entity? J Am AcadDermatol 1998;38:104–106.
Mathews JD, Riley MD, Fejo L, et al. Effects of the heavy usage of kava on physical health: summary of a pilot survey in an Aboriginal community. Med J Aust 1988;148:548–555.
Locher CP, Burch MT, Mower HF, et al. Anti-microbial activity and anti-complement activity of extracts obtained from selected Hawaiian medicinal plants. J Ethnopharmacol 1995;49:23–32.
Gleitz J, Beile A, Wilkens P, Ameri A, Peters T. Antithrombotic action of kava pyrone (+)-kavain prepared from Piper methysticum on human platelets. Planta Med 1997;63:27–30.
Steiner GG. The correlation between cancer incidence and kava consumption. Hawaii Med J. 2000;59:420–422.
Duffield AM, Jamieson DD, Lidgard RO, Duffield PH, Bourne DJ. Identification of some human urinary metabolites of the intoxicating beverage kava. J Chromatogr 1989;475:273–281.
Meseguer E, Sanchez V, Campos V. Life threatening parkinsonism induced by kava-kava. Mov Disord 2002;17(l): 195–196.
Escher M, Desmeules J. Hepatitis associated with kava, a herbal remedy for anxiety. Br Med J 2001;322:139.
Centers for Disease Control and Prevention. Hepatic toxicity possibly associated with kava-containing products-United States, Germany, and Switzerland, 1999–2002. MMWR Morb Mortal Wkly Rep 2002;51(47):1065–1067.
Russmann S, Helbling A. Kava hepatotoxicity. Ann Intern Med 2001;135(l):68–69.
Anonymous. Herbal kava: reports of liver toxicity. CanadianMed J 2002; 166(6):777.
Jamieson DD, Duffield PH. Positive interaction of ethanol and kava resin in mice. Clin Exp Pharmacol Physiol 1990; 17:509–514.
Thorndyke A, Rhyne H. Kava. http://www.unc.edu/∼cebradsh/kava.html. Date accessed: Oct. 29, 1998.
Almedia JC, Grimsley EW. Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med 1996; 125:940–941.
Mathews JM, Etheridge AS, Black SR. Inhibition of human cytochrome P450 activities by kava extract and kavalactones. Drug Metab Dispos 2002;30:1153–1157.
Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/ 5 phenotypes. Clin Pharmacol Ther 2005;77:415–426.
FDA Advisory on Kava potential for liver toxicity from FDA Center for Food Safety and Applied Nutrition, http://www.cfsan.fda.gov/R~dms/addskava.html. Date accessed: June 8, 2006.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Humana Press Inc.
About this chapter
Cite this chapter
Glover, D.D. (2007). Kava. In: Tracy, T.S., Kingston, R.L. (eds) Herbal Products. Forensic Science and Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-383-7_2
Download citation
DOI: https://doi.org/10.1007/978-1-59745-383-7_2
Publisher Name: Humana Press
Print ISBN: 978-1-58829-313-8
Online ISBN: 978-1-59745-383-7
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)