Kava

Aka: Kava, Kava Kava

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II. Indications

  1. Anxiety Disorder

III. Mechanism

  1. Potentiates GABA Neurotransmitters

IV. Adverse Effects

  1. Serious Extrapyramidal Side Effects
  2. Excessive sedation when used with other CNS Depressants
  3. May exacerbate Parkinson's Disease
  4. Platelet Dysfunction
  5. Dermopathy or Photosensitivity
    1. Pruritic Red Papules and Plaques
    2. May be related to Sun Exposure after kava ingestion
  6. Hepatotoxicity
    1. Unclear mechanism and incomplete data
    2. Some cases progressed to liver failure
    3. Anke (2004) Planta Med 70(3):193-6 [PubMed]

V. Drug Interactions

  1. Multiple Cytochrome P450 interactions
    1. CYP2E1 inhibitor
    2. CYP2C9 Inhibitor
    3. CYP2C19 Inhibitor
  2. Additive effects with CNS Depressants
    1. Benzodiazepines
    2. Barbiturates
    3. Antipsychotics
    4. Alcohol

VI. Precautions

  1. Routine use not recommended due to hepatotoxicity risk (see below)
  2. Avoid use longer than 24 weeks
  3. Discontinue at least 5 days before surgery
    1. May potentiate perioperative general Anesthesia

VII. Efficacy

  1. Mildly effective in Anxiety Disorder
    1. Witte (2005) Phytother Res 19:183-8 [PubMed]

VIII. Resources

  1. FDA Warning regarding Kava Hepatotoxicity
    1. http://www.cfsan.fda.gov/~dms/addskava.html

IX. References

  1. Ang-Lee (2001) JAMA 286:208-16 [PubMed]
  2. Cupp (1999) Am Fam Physician 59(5):1239-44 [PubMed]

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