Kava

Common names: Kava also is known as kawa, kava-kava, awa, yangona, kawain, and kavain.

Efficacy rating:

ÒÒÒ...Positive clinical trials

Safety rating:

What is Kava?

Kava is the dried rhizome and roots of P. methysticum. Kava is a large shrub widely cultivated in many Pacific islands from Hawaii and Tahiti to New Guinea. Many cultivars of kava are recognized.

What is Kava used for?

The kava beverage is prepared from the roots of the plant, which are chewed or pulverized and then steeped in water. The cloudy mixture is filtered and served at room temperature. Kava has been an important part of Pacific island ceremonial cultures for many centuries, with elaborate rituals attending its consumption. Traces of kava extract on archaeological artifacts from Fiji have been identified by mass spectrometry. Its main use has been to induce a relaxed state in the participants in a kava ceremony, facilitating discussion and interaction.

Kava has mild sedative effects and is used for nervous anxiety, stress, and restlessness. Clinical studies support these uses. However, concerns about liver toxicity have yet to be resolved (see toxicity).

What is the dosage of Kava?

Dosage of kava lactones in clinical studies has been in the range of 100 to 200 mg/day, corresponding to 1.5 to 3 g of ground root.

Is Kava safe?

Contraindications have not yet been identified.

Documented adverse effects. Avoid use.

Kava may increase the CNS side effects of alprazolam. Avoid concomitant use of kava and alprazolam.

Heavy kava use may cause visual disturbances and a scaly skin rash.

Rare cases of severe liver toxicity have been reported.

Kava has been implicated in a string of reports of fulminant hepatic failure made in Europe and the US. Despite the fact that the incidence of such adverse events appears to be very low, on the order of 1 per million doses consumed, authorities in Germany, Switzerland, France, Ireland, and the United Kingdom have removed kava products from the market. The German action has been protested by members of the Commission E as unwarranted. The FDA, as well as Australian and Canadian authorities, have issued warnings to consumers and health care workers on the potential for liver damage from kava products. A definite link has not been determined between kava and the observed severe cases of hepatotoxicity; interactions between kava and prescription or OTC drugs have not been ruled out. Caution would dictate that patients with any predisposition to liver problems should avoid use of kava. A systematic review of kava safety issues has been published. The incidence of hepatotoxicity is too low to have been detected in previous clinical trials.

References

Copyright © 2006 Wolters Kluwer Health

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