Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-15T09:42:25.535Z Has data issue: false hasContentIssue false
  • English
  • Français

Adverse-Effect Profile of Kava

Published online by Cambridge University Press:  07 November 2014

Kathryn M. Connor ,
Jonathan R.T. Davidson  and
L. Erik Churchill
Get access Rights & Permissions [Opens in a new window]

Abstract

The use of alternative therapies has increased substantially over the last decade, particularly for more chronic conditions such as anxiety. Among the most widely used treatments are medicinal herbs, or phytomedicines, such as kava (Piper methysticum), which has demonstrated anxiolytic activity in both animal models and clinical samples. Kava has several advantages over conventional pharmacologic treatments for anxiety—in clinical settings it has been associated with better tolerability and lack of physiologic dependence and withdrawal. However, phytomedicines are not rigorously regulated in the United States and systematically collected safety data are very limited. These issues are a leading concern regarding the safety of medicinal herbs such as kava. In this report, the safety profile for kava is provided, including findings from a study of its use in generalized anxiety disorder. Safety parameters assessed include occurrence of adverse events, withdrawal symptoms, effect on heart rate, blood pressure, laboratory assessments, and sexual function. No differences were found between kava and placebo on any of the parameters evaluated. The data support the safety of kava in treating anxiety at 280 mg kava lactones/day for 4 weeks.

Type
Original Research
Information
CNS Spectrums , Volume 6 , Issue 10: Empirical Evaluations of Selected Herbal Remedies , October 2001 , pp. 848 - 853
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Greenberg, PE, Sisitsky, T, Kessler, RC, et al. The economic burden of anxiety disorders in the 1990s. J Clin Psychiatry. 1999;60:427–435.CrossRefGoogle ScholarPubMed
2. Lewin, L. Phantastica: A Classic Survey on the Use and Abuse of Mind-Altering Plants. Rochester, VT: Park Street Press; 1998.Google Scholar
3. Hansel, R. Therapie mit phythopharmaka. Deutsche Apothekon Zeitung. 1964;104:459.Google Scholar
4. Glietz, J, Friese, J, Beile, A, Ameri, A, Peters, T. Anticonvulsant action of (+)-kavain estimated from its properties on stimulated synaptosomes and Na+ channel receptor sites. Eur J Pharmacol. 1996;15:89–97.CrossRefGoogle Scholar
5. Walden, J, von Wagerer, J, Winter, U, Berger, M, Grunze, H. Effects of kavain and dihydromethysticum on field potential changes in the hippocampus. Prog Neuropsychopharmaco Biol Psychiatry. 1997;21:697–706.CrossRefGoogle ScholarPubMed
6. Seitz, U, Schule, A, Gleitz, J. [3H]-Monoamine uptake inhibition properties of kava pyrones. Planta Medica. 1997;63:548–549.CrossRefGoogle Scholar
7. 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.CrossRefGoogle ScholarPubMed
8. Jossofie, A, Schmiz, A, Hiemke, C. Kavapyrone enriched extract from Piper methysticum as modulator of the GABA binding site in different regions of rat brain. Psychopharmacology (Berl). 1994;116:469–474.CrossRefGoogle Scholar
9. Schelosky, L, Raffauf, C, Jendroska, K, Poewe, W. Kava and dopamine antagonism [letter]. J Neurol Neurosurg Psychiatry. 1995;58:639–640.CrossRefGoogle ScholarPubMed
10. Spillane, PK, Fisher, DA, Currie, BJ. Neurological manifestations of kava intoxication. Med J Australia. 1997;167:172–173.CrossRefGoogle ScholarPubMed
11. Norton, SA, Ruze, P. Kava dermopathy. J Am Acad Dermatol. 1994;31:89–97.CrossRefGoogle ScholarPubMed
12. Mathews, JD, Riley, MD, Fejo, L, et al. Effects of the heavy usage of kava on physical health: summary of a pilot study in an aboriginal community. Med J Australia. 1988;148:548–555.CrossRefGoogle Scholar
13. Strahl, S, Ehret, V, Dahm, HH, Maier, KP. Necrotizing hepatitis after taking herbal medication. [German]Dtsch Med Wshr. 1998;123:1410–1414.CrossRefGoogle Scholar
14. Escher, M, Desmeules, J, Giostra, E, Mentha, G. Hepatitis associated with kava, an herbal remedy for anxiety. Br Med J. 2001;322:139.CrossRefGoogle ScholarPubMed
15. Russmann, S, Lauterburg, BH, Helbling, A. Kava hepatotoxicity. Ann Int Med. 2001;135:68–69.CrossRefGoogle ScholarPubMed
16. Almeida, JC, Grimsley, EW. Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med. 1996;125:940–941.CrossRefGoogle ScholarPubMed
17. Brinker, F. Herb Contraindications and Drug Interactions, 2nd ed. Sandy, OR: Eclectic Medical Publications; 1998.Google Scholar
18. Herberg, KN. Effect of kava-special extract (WS 1490) combined with ethyl alcohol on safety-relevant performance parameters. Blutalkohol. 1993;30:96–105.Google ScholarPubMed
19. Foo, H, Lemon, J. Acute effects of kava, alone or in combination with alcohol, on subjective measures of impairment and intoxication and on cognitive performance. Drug and Alcohol Rev. 1997;16:147–155.CrossRefGoogle ScholarPubMed
20. Jamieson, DD, Duffield, PH. Positive interaction of ethanol and kava resin in mice. Clin Exp Pharmacol Physiol. 1990;17:509–514.CrossRefGoogle ScholarPubMed
21. Rasmussen, P. A role for phytotherapy in the treatment of benzodiazepine and opiate withdrawal. Eur J Herbal Med. 1997;3:11–21.Google Scholar
22. Duffield, PH, Jamieson, D. Development of tolerance to kava in mice. Clin Exp Pharmaco Physiol. 1991;18:518–571.Google ScholarPubMed
23. American Psychiatric Association. Diagnostic and Statistical Manual for Mental Disorders, 4th edition. Washington, DC: American Psychiatric Association. 1994.Google Scholar
24. Sheehan, DV, Lecrubier, Y, Sheehan, KH, et al. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psych. 1998;59(suppl 20):22–33.Google ScholarPubMed
25. Hamilton, M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32:50–55.CrossRefGoogle ScholarPubMed
26. Davidson, JRT, Potts, N, Richichi, E, et al. Treatment of social phobia with clonazepam and placebo. J Clin Psychopharmacol. 1993;13:423–428.CrossRefGoogle ScholarPubMed
27. Cutler, NR, Sramek, JJ, Keppel Hesselink, JM, et al. A double-blind, place-bo-controlled study comparing the efficacy and safety of ipsapirone versus lorazepam in patients with generalized anxiety disorder: a prospective multicenter trial. J Clin Psychopharmacol. 1993;13:429–437.CrossRefGoogle Scholar
28. McGahuey, CA, Gelenberg, AJ, Laukes, CA, Moreno, FA, Delgado, PL. The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Mar Ther. 2000;26:25–40.Google ScholarPubMed
29. Pittler, MH, Ernst, E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol. 2000;20:84–89.CrossRefGoogle ScholarPubMed
30. Volz, H-P, Kieser, M. Kava-kava extract WS1490 versus placebo in anxiety disorders: a randomized placebo-controlled 25-week out-patient trial. Pharmacopsychiatry. 1997;30:1–5.CrossRefGoogle Scholar
31. Blumenthal, M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin, TX: American Botanical Council; 1998.Google Scholar