What is it?
Kava is a plant native to the South Pacific. The root is used for medicine.
There are some BIG safety concerns about kava. Many cases of liver damage and even some deaths have been traced to kava use. As a result, kava has been banned from the market in Switzerland, Germany, and Canada, and several other countries are considering similar action. This ban has hurt the economies of Pacific Island countries that export kava.
Kava is used to calm anxiety, stress, and restlessness, and treat sleep problems (insomnia). It is also used for attention deficit-hyperactivity disorder (ADHD), epilepsy, psychosis, depression, migraines and other headaches, chronic fatigue syndrome (CFS), common cold and other respiratory tract infections, tuberculosis, muscle pain, and cancer prevention.
Some people use kava for urinary tract infections (UTIs), pain and swelling of the uterus, venereal disease, menstrual discomfort, and to arouse sexual desire.
Kava is applied to the skin for skin diseases including leprosy, to promote wound healing, and as a painkiller. It is also used as a mouthwash for canker sores and toothaches.
Kava was named by the explorer Captain Cook, who chose a name that meant "intoxicating pepper." While Captain Cook may have named kava, he didn’t discover it. Kava has been used for thousands of years by Pacific Islanders. Today in the South Pacific, kava is a popular social drink, similar to alcohol in Western societies. It also still has a role in rituals and ceremonies.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for KAVA are as follows:
Possibly effective for...
- Anxiety. The majority of evidence shows that certain kava extracts (extracts standardized to 70% kavalactones) can lower anxiety and might work as well as prescription anti-anxiety medications called low-dose benzodiazepines. But it might take up to 8 weeks of treatment to see improvement.
Insufficient evidence to rate effectiveness for...
- Benzodiazepine withdrawal symptoms. Some research suggests that slowly increasing the dose of kava while decreasing the dose of benzodiazepines over the course of a week can prevent withdrawal symptoms and reduce anxiety in people who have been taking benzodiazepines for a long period of time.
- Cancer prevention. There is some evidence that taking kava might help to prevent cancer.
- Insomnia. Research on the effectiveness of kava in people with sleeping problems is unclear. Evidence shows that taking 200 mg of a kava extract (WS1490) daily for 4 weeks reduces sleeping problems associated with anxiety. However, a study using a different kava product found that it did not reduce sleeping problems associated with anxiety.
- Anxiety related to menopause. Early research shows that taking 300 mg of a kava extract product (WS1490) daily for 8 weeks reduces anxiety and hot flashes in women with menopause.
- Stress. Early research suggests that taking a single dose of kava by mouth might reduce the physical changes associated with mentally stressful tasks.
- Attention deficit-hyperactivity disorder (ADHD).
- Chronic fatigue syndrome (CFS).
- Respiratory tract infections.
- Achy joints (rheumatism).
- Chronic bladder infections.
- Sexually transmitted diseases.
- Menstrual problems.
- Other conditions.
More evidence is needed to rate kava for these uses.
Kava affects the brain and other parts of the central nervous system. The kava-lactones in kava are believed to be responsible for its effects.
Kava is POSSIBLY UNSAFE when taken by mouth. Don’t use it. Serious illness, including liver damage, has occurred even with short-term use of normal doses. The use of kava for as little as one to three months has resulted in the need for liver transplants, and even death. Early symptoms of liver damage include yellowed eyes and skin (jaundice), fatigue, and dark urine. If you decide to take kava, despite warnings to the contrary, be sure to get frequent liver function tests.
Using kava can make you unable to drive or operate machinery safely. Do not take kava before you plan on driving. "Driving-under-the-influence" citations have been issued to people driving erratically after drinking large amounts of kava tea.
Special precautions & warnings:
Pregnancy and breast-feeding: Don’t use kava if you are pregnant or breast-feeding. Kava is POSSIBLY UNSAFE when taken by mouth. There is a concern that it might affect the uterus. Also, some of the dangerous chemicals in kava can pass into breast milk and might hurt a breast-fed infant.
Depression: Kava use might make depression worse.
Liver problems: Kava is hard on the liver, even healthy ones. Taking kava if you already have liver disease is taking a risk.
Surgery: Kava affects the central nervous system. It might increase the effects of anesthesia and other medications used during and after surgery. Stop using kava at least 2 weeks before a scheduled surgery.
Do not take this combination.
Sedative medications (CNS depressants)
Kava might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking kava along with sedative medications might cause too much sleepiness.
Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.
Be cautious with this combination.
Kava can cause drowsiness. Alprazolam (Xanax) can also cause drowsiness. Taking kava along with alprazolam (Xanax) may cause too much drowsiness. Avoid taking kava and alprazolam (Xanax) together.
Levodopa affects the brain by increasing a brain chemical called dopamine. Kava might decrease dopamine in the brain. Taking kava along with levodopa might decrease the effectiveness of levodopa.
Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)
Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are changed by the liver might increase the effects and side effects of some medications. Before taking kava, talk to your healthcare provider if you take any medications that are changed by the liver.
Some of these medications that are changed by the liver include clozapine (Clozaril), cyclobenzaprine (Flexeril), fluvoxamine (Luvox), haloperidol (Haldol), imipramine (Tofranil), mexiletine (Mexitil), olanzapine (Zyprexa), pentazocine (Talwin), propranolol (Inderal), tacrine (Cognex), theophylline, zileuton (Zyflo), zolmitriptan (Zomig), and others.
Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are broken down by the liver can increase the effects and side effects of your medication. Before taking kava, talk to your healthcare provider if you take any medications that are changed by the liver.
Some of these medications changed by the liver include amitriptyline (Elavil), clomipramine (Anafranil), cyclophosphamide (Cytoxan), diazepam (Valium), lansoprazole (Prevacid), omeprazole (Prilosec), lansoprazole (Protonix), phenytoin (Dilantin), phenobarbital (Luminal), progesterone, and others.
Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking kava, talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), diazepam (Valium), zileuton (Zyflo), celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), warfarin (Coumadin), and others.
Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates)
Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking kava, talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and drugs used for anesthesia during surgery such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), and methoxyflurane (Penthrane).
Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking kava, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.
Medications moved by pumps in cells (P-Glycoprotein Substrates)
Some medications are moved by pumps in cells. Kava might make these pumps less active and increase how much of some medications get absorbed by the body. This might increase the amount of some medications in the body, which could lead to more side effects. But there is not enough information to know if this is a big concern.
Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
Medications that can harm the liver (Hepatotoxic drugs)
Kava might harm the liver. Taking kava along with medication that might also harm the liver can increase the risk of liver damage. Do not take kava if you are taking a medication that can harm the liver.
Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.
Be watchful with this combination.
Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Some medications are changed and broken down by the liver. Kava might decrease how quickly the liver breaks down some medications. Taking kava along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking kava, talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.
Herbs and supplements that might harm the liver
There is some concern that kava might harm the liver. Using kava along with other products that might harm the liver could raise the risk of dangerous liver damage. Some of these products include androstenedione, chaparral, comfrey, DHEA, germander, niacin, pennyroyal oil, red yeast, and others.
Herbs and supplements with sedative properties
Kava can cause sleepiness or drowsiness. Using it along with other herbs and supplements that have the same effect might make you overly drowsy. Some of these herbs and supplements include 5-HTP, calamus, California poppy, catnip, hops, Jamaican dogwood, St. John's wort, skullcap, valerian, yerba mansa, and others.
Using kava along with alcohol might increase drowsiness and slow reflexes dangerously. There is also some concern that using kava along with alcohol could increase the risk of liver damage.
The appropriate dose of kava depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for kava. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
Ava Pepper, Ava Root, Awa, Gea, Gi, Intoxicating Long Pepper, Intoxicating Pepper, Kao, Kavain, Kavapipar, Kawa, Kawa Kawa, Kawa Pepper, Kawapfeffer, Kew, Lawena, Long Pepper, Malohu, Maluk, Maori Kava, Meruk, Milik, Piper methysticum, Poivre des Cannibales, Poivre des Papous, Rauschpfeffer, Rhizome Di Kava-Kava, Sakau, Tonga, Waka, Wurzelstock, Yagona, Yangona, Yaqona, Yaquon, Yongona.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).
To see all references for the Kava page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/872.html.
- Food and Drug Administration. Consumer advisory: kava-containing dietary supplements may be associated with severe liver injury. FDA Center for Food Safety and Nutrition. 2002;1.
- Russell P, Bakker D, and Singh N. The effects of kava on alerting and speed of access of information from long-term memory. Bull Psychonom Soc 1987;25:236-237.
- Malsch U and Kieser M. Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines. Psychopharm 2001;157:277-283.
- Lehmann E, Kinzler E, and Friedemann J. Efficacy of a special Kava extract (Piper methysticum) in patients with states of anxiety, tension and excitedness of non-mental origin - a double-blind placebo-controlled study of four weeks treatment. Phytomedicine 1996;3:113-119.
- Bhate H, Gerster G, and Gracza E. Orale Prämedikation mit Zubereitungen aus Piper methysticum bei operativen Eingriffen in Epiduralanästhesie. Erfahrungsheilkunde 1989;6:339-345.
- Assessment of the Risk of Hepatotoxicity with Kava Products. 2000;
- Furgiuele AR, Kinnard WJ, Aceto MD, and et al. Central activity of aqueous extracts of Piper methysticum (kava). J Pharm Sci 1965;54:247-252.
- Buckley, J. P., Furgiuele, A. R., and O'Hara, M. J. Pharmacology of kava. Ethnopharm Search Psych Drugs 1967;1:141-151.
- Emser W and Bartylla K. Improvement of sleep quality. Effect of kava extract WS 1490 on the sleep pattern in healthy subjects. Neurologie/Psychiatrie 1991;5:636-642.
- Gleitz J, Gottner N, Ameri A, and et al. Kavain inhibits non-stereospecifically veratridine-activated Na
Walden J, von Wegerer J, Winter U, and et al. Actions of kavain and dihydromethysticin on ipsapirone-induced field potential changes in the hippocampus. Human Psychopharm 1997;12:265-270.
- Kleiser B, Diepers M, Wagner N, and et al. Treatment of intracerebral hematomas with kava in rats. Neurology 1998;50:a398.
- Corrigan, D. A review of the safety and efficacy of kava-kava (Piper methysticumI). Unpublished 2005;
- Ma, Y., Sachdeva, K., Liu, J., Ford, M., Yang, D., Khan, I. A., Chichester, C. O., and Yan, B. Desmethoxyyangonin and dihydromethysticin are two major pharmacological kavalactones with marked activity on the induction of CYP3A23. Drug Metab Dispos 2004;32:1317-1324.
- Young RL, Hylin JW, Plucknett DL, Kawano Y, and Nakayama RT. Analysis for kawa pyrones in extracts of piper methysticum. Phytochemistry 1966;5:795-798.
- Smith RM, Thakrar H, Arowolo A, and et al. High-performance liquid chromatography of kava lactones from Piper methysticum. J Chromatography 1984;283:303-308.
- Smith RM. Kava lactones in Piper methysticum from Fiji. Phytochemistry 1983;22:1055-1056.
- Klohs MW, Keller F, Williams RE, and et al. A chemical and pharmacological investigation of Piper methysticum Forst. J Med Pharm Chem 1959;1:95-103.
- Duve RN. Gas-liquid chromatographic determination of major constituents of Piper methysticum. Analyst 1981;106:160-165.
- Duffield AM and Lidgard RO. Analysis of kava resin by gas chromatography and electron impact and methane negative ion chemical ionization mass spectrometry. New trace constituents of kava resin. Biomed Environ Mass Spectr 1986;13:621-626.
- Duffield AM, Lidgard RO, and Low GK. Analysis of the constituents of Piper methysticum by gas chromatography methane chemical ionization mass spectrometry. New constituents of kava resin. Biomed Environ Mass Spectr 1986;13:305-313.
- Singh Y and Blumenthal M. Kava: an overview. Distribution, mythology, botany, culture, chemistry and pharmacology of the South Pacific's most revered herb. HerbalGram 1997;39(Suppl 1):34-56.
- Meyer HJ and Meyer-Burg J. Hemmung des elektrokrampfes durch die kawa-pyrone dihydromethysticin und dihydrokawain. Arch Int Pharmacodyn 1964;148(1-2):97-110.
- Kretzschmar R, Teschendorf HJ, Ladous A, and et al. On the sedative action of the kava rhizome (piper methyst.). Acta Pharmacol Toxicol 1971;29:26.
- Hänsel R. Characterization and physiological activity of some Kawa constituents. Pacific Science 1968;22:293-313.
- Brüggemann F and Meyer HJ. Die analgetische wirkung der Kawa-inhaltsstoffe dihydrokawain und dihydromethysticin. Arzneimittelforschung. 1963;13:407-409.
- Leung, N. Acute urinary retention secondary to kava ingestion. Emerg Med Australas 2004;16:94.
- Saletu B, Grünberger J, Linzmayer L, and et al. EEG-brain mapping, psychometric and psychophysiological studies on central effects of kavain-a kava plant derivative. Hum Psychopharm 1989;4:169-190.
- Prescott J, Jamieson D, Emdur N, and et al. Acute effects of kava on measures of cognitive performance, physiological function and mood. Drug Alc Rev 1993;12:49-58.
- Chanwai, L. G. Kava toxicity. Emergency Medicine 2002;12:142-145.
- Foster, B. Recommendations from the Scientific Advisory Panel Subgroups on Hepatotoxicity. Hepatotoxicity of Health Products. Health Canada 2004;
- Rotblatt, M. and Ziment, I. Evidence-based herbal medicine. 2002;244-248.
- Siegers CP, Honold E, Krall B, and et al. Results of the drug monitoring L 1090 with Laitan capsules. Arztl Forsch 1992;39:7-11.
- Keller F and Klohs M. A review of the chemistry and pharmacology of the constituents of Piper methysticum. Lloydia 1963;26:1-15.
- Loew, D. and Gaus, W. Kava-Kava- Tragodie einer Fehlbeurteilung Zeitschrift. Phytotherapie 2002;23:267-281.
- Meyer HG. Pharmakologie der wirksamen prinzipien de kawarhizoms (Piper methysticum Forst.). Arch Int Pharmacodyn Ther 1962;138:505-536.
- Mittmann, U., Schmidt, M., and Vrastyakova, J. Akut-anxiolytische wirksamkeit von Kava-Spissum-Spezialextrakt studie. Journal Pharmakoogie und Therapie 2000;9:99-108.
- Center for Food Safety and Applied Nutrition (US Food and Drug Administration). Kava-containing dietary supplements may be associated with severe liver injury (document issued March 25, 2002).
- Stoller, R. Reports of hepatotoxicity with kava. Proceedings of the 24th Annual Meeting of Representatives of National Centres Participating in the WHO Drug Monitoring Programme, Dunedin, New Zealand 2008;
- Herberg KW. Driving ability after intake of kava special extract WS 1490, a double-blind, placebo-controlled study with volunteers. Zeitschrift für Allgemeinmedizin 1991;13:842-846.
- Izzo AA and Ernst E. Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs 2001;61:2163-2175.
- Center for Food Safety and Applied Nutrition (US Food and Drug Administration). Letter to health care professionals: FDA issues consumer advisory that kava products may be associated with severe liver injury (document issued March 25, 2002), contact information for FDA Medwatch program: 1-800-332-1088.
- Johnson D, Frauendorf A, Stecker K, and et al. Neurophysiological active profile and tolerance of kava extract WS 1490, A pilot study with randomized evaluation. TW Neurolgie Psychiatrie 1991;5:349-354.
- Gessner B and Cnota P. Extract of the kava-kava rhizome in comparison with diazepam and placebo. Z Phytother 1994;15:30-37.
- Stafford N. Germany may ban kava kava herbal supplement, Reuter's News Service Germany (November 19, 2001).
- Woelk H, Kapoula O, Lehrl S, and et al. [Treatment of patients suffering from anxiety- double-blind study: kava special extract versus benzodiazepines]. Z Allg Med 1993;69:271-277.
- Basch E, Ulbricht C, Hammerness P, and et al. Kava monograph. J Herbal Pharmacother 2002;2:65-91.
- Douglas W. The effects of heavy usage of kava on physical health. Med J Australia 1988;149:341-342.
- Langosch, J. M., Normann, C., Schirrmacher, K., Berger, M., and Walden, J. The influence of (+/-)-kavain on population spikes and long-term potentiation in guinea pig hippocampal slices. Comp Biochem.Physiol A Mol.Integr.Physiol 1998;120:545-549. View abstract.
- Boonen, G., Ferger, B., Kuschinsky, K., and Haberlein, H. In vivo effects of the kavapyrones (+)-dihydromethysticin and (+/-)- kavain on dopamine, 3,4-dihydroxyphenylacetic acid, serotonin and 5- hydroxyindoleacetic acid levels in striatal and cortical brain regions. Planta Med 1998;64:507-510. View abstract.
- Jappe, U., Franke, I., Reinhold, D., and Gollnick, H. P. Sebotropic drug reaction resulting from kava-kava extract therapy: a new entity? J Am Acad Dermatol. 1998;38:104-106. View abstract.
- Magura, E. I., Kopanitsa, M. V., Gleitz, J., Peters, T., and Krishtal, O. A. Kava extract ingredients, (+)-methysticin and (+/-)-kavain inhibit voltage-operated Na(+)-channels in rat CA1 hippocampal neurons. Neuroscience 1997;81:345-351. View abstract.
- Walden, J., von Wegerer, J., Winter, U., Berger, M., and Grunze, H. Effects of kawain and dihydromethysticin on field potential changes in the hippocampus. Prog.Neuropsychopharmacol.Biol Psychiatry 1997;21:697-706. View abstract.
- Gleitz, J., Friese, J., Beile, A., Ameri, A., and Peters, T. Anticonvulsive action of (+/-)-kavain estimated from its properties on stimulated synaptosomes and Na+ channel receptor sites. Eur.J Pharmacol 11-7-1996;315:89-97. View abstract.
- Suss, R. and Lehmann, P. [Hematogenous contact eczema caused by phytogenic drugs exemplified by kava root extract]. Hautarzt 1996;47:459-461. View abstract.
- Gleitz, J., Beile, A., and Peters, T. (+/-)-kavain inhibits the veratridine- and KCl-induced increase in intracellular Ca2+ and glutamate-release of rat cerebrocortical synaptosomes. Neuropharmacology 1996;35:179-186. View abstract.
- Herberg, K. W. [Effect of Kava-Special Extract WS 1490 combined with ethyl alcohol on safety-relevant performance parameters]. Blutalkohol 1993;30:96-105. View abstract.
- Rasmussen, A. K., Scheline, R. R., Solheim, E., and Hansel, R. Metabolism of some kava pyrones in the rat. Xenobiotica 1979;9:1-16. View abstract.
- Meyer, H. J. [Spasmolytic effect of dihydromethysticin, a constituent of Piper methysticum Forst]. Arch Int Pharmacodyn Ther. 1965;154:449-467. View abstract.
- Kretzschmar, R. and Meyer, H. J. [Comparative studies on the anticonvulsant activity of the pyrone compounds of Piper methysticum Forst]. Arch Int Pharmacodyn.Ther 1969;177:261-277. View abstract.
- Pfeiffer, C. C., Murphree, H. B., and Goldstein, L. Effect of kava in normal subjects and patients. Psychopharmacol Bull 1967;4:12. View abstract.
- Kretzschmar, R., Meyer, H. J., and Teschendorf, H. J. Strychnine antagonistic potency of pyrone compounds of the kavaroot (Piper methysticum Forst.). Experientia 3-15-1970;26:283-284. View abstract.
- Cawte, J. Parameters of kava used as a challenge to alcohol. Aust.N.Z.J Psychiatry 1986;20:70-76. View abstract.
- Duffield, A. M., Jamieson, D. D., Lidgard, R. O., Duffield, P. H., and Bourne, D. J. Identification of some human urinary metabolites of the intoxicating beverage kava. J Chromatogr. 7-28-1989;475:273-281. View abstract.
- Jamieson, D. D., Duffield, P. H., Cheng, D., and Duffield, A. M. Comparison of the central nervous system activity of the aqueous and lipid extract of kava (Piper methysticum). Arch Int Pharmacodyn Ther. 1989;301:66-80. View abstract.
- Lehmann, E., Klieser, E., Klimke, A., Krach, H., and Spatz, R. The efficacy of Cavain in patients suffering from anxiety. Pharmacopsychiatry 1989;22:258-262. View abstract.
- Jamieson, D. D. and Duffield, P. H. The antinociceptive actions of kava components in mice. Clin Exp Pharmacol.Physiol 1990;17:495-507. View abstract.
- Aporosa, S. A. Is kava alcohol?: The myths and the facts. Pac.Health Dialog. 2011;17:157-164. View abstract.
- Lindenberg, D. and Pitule-Schodel, H. [D,L-kavain in comparison with oxazepam in anxiety disorders. A double- blind study of clinical effectiveness]. Fortschr.Med. 1-20-1990;108:49-53. View abstract.
- Sarris, J., Panossian, A., Schweitzer, I., Stough, C., and Scholey, A. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence. Eur.Neuropsychopharmacol. 2011;21:841-860. View abstract.
- Laporte, E., Sarris, J., Stough, C., and Scholey, A. Neurocognitive effects of kava (Piper methysticum): a systematic review. Hum.Psychopharmacol. 2011;26:102-111. View abstract.
- Faustino, T. T., Almeida, R. B., and Andreatini, R. [Medicinal plants for the treatment of generalized anxiety disorder: a review of controlled clinical studies]. Rev Bras.Psiquiatr. 2010;32:429-436. View abstract.
- Sarris, J., Laporte, E., and Schweitzer, I. Kava: a comprehensive review of efficacy, safety, and psychopharmacology. Aust.N.Z.J.Psychiatry 2011;45:27-35. View abstract.
- Teschke, R., Fuchs, J., Bahre, R., Genthner, A., and Wolff, A. Kava hepatotoxicity: comparative study of two structured quantitative methods for causality assessment. J.Clin.Pharm.Ther. 2010;35:545-563. View abstract.
- Sarris, J. and Kavanagh, D. J. Kava and St. John's Wort: current evidence for use in mood and anxiety disorders. J.Altern.Complement Med. 2009;15:827-836. View abstract.
- Teschke, R., Genthner, A., and Wolff, A. Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixtures. J.Ethnopharmacol. 6-25-2009;123:378-384. View abstract.
- Sarris, J., Kavanagh, D. J., Adams, J., Bone, K., and Byrne, G. Kava Anxiety Depression Spectrum Study (KADSS): a mixed methods RCT using an aqueous extract of Piper methysticum. Complement Ther.Med. 2009;17:176-178. View abstract.
- Kinzler, E., Kromer, J., and Lehmann, E. [Effect of a special kava extract in patients with anxiety-, tension-, and excitation states of non-psychotic genesis. Double blind study with placebos over 4 weeks]. Arzneimittelforschung. 1991;41:584-588. View abstract.
- Christl, S. U., Seifert, A., and Seeler, D. Toxic hepatitis after consumption of traditional kava preparation. J.Travel.Med. 2009;16:55-56. View abstract.
- Duffield, P. H. and Jamieson, D. Development of tolerance to kava in mice. Clin Exp Pharmacol Physiol 1991;18:571-578. View abstract.
- Sarris, J., Kavanagh, D. J., Deed, G., and Bone, K. M. St. John's wort and Kava in treating major depressive disorder with comorbid anxiety: a randomised double-blind placebo-controlled pilot trial. Hum.Psychopharmacol. 2009;24:41-48. View abstract.
- van der Watt, G., Laugharne, J., and Janca, A. Complementary and alternative medicine in the treatment of anxiety and depression. Curr.Opin.Psychiatry 2008;21:37-42. View abstract.
- Holm, E., Staedt, U., Heep, J., Kortsik, C., Behne, F., Kaske, A., and Mennicke, I. [The action profile of D,L-kavain. Cerebral sites and sleep-wakefulness- rhythm in animals]. Arzneimittelforschung. 1991;41:673-683. View abstract.
- Zhou, S. F., Xue, C. C., Yu, X. Q., and Wang, G. Metabolic activation of herbal and dietary constituents and its clinical and toxicological implications: an update. Curr Drug Metab 2007;8:526-553. View abstract.
- Brown, A. C., Onopa, J., Holck, P., Kaufusi, P., Kabasawa, D., Craig, W. J., Dragull, K., Levine, A. M., and Baker, J. D. Traditional kava beverage consumption and liver function tests in a predominantly Tongan population in Hawaii. Clin Toxicol (Phila) 2007;45:549-556. View abstract.
- Matthias, A., Blanchfield, J. T., Penman, K. G., Bone, K. M., Toth, I., and Lehmann, R. P. Permeability studies of Kavalactones using a Caco-2 cell monolayer model. J Clin Pharm Ther 2007;32:233-239. View abstract.
- Geller, S. E. and Studee, L. Botanical and dietary supplements for mood and anxiety in menopausal women. Menopause. 2007;14(3 Pt 1):541-549. View abstract.
- Jeurissen, S. M., Claassen, F. W., Havlik, J., Bouwmans, E. E., Cnubben, N. H., Sudholter, E. J., Rietjens, I. M., and van Beek, T. A. Development of an on-line high performance liquid chromatography detection system for human cytochrome P450 1A2 inhibitors in extracts of natural products. J Chromatogr.A 2-2-2007;1141:81-89. View abstract.
- Smith, B. J., Phongsavan, P., Bauman, A. E., Havea, D., and Chey, T. Comparison of tobacco, alcohol and illegal drug usage among school students in three Pacific Island societies. Drug Alcohol Depend. 4-17-2007;88:9-18. View abstract.
- Droege, H. [Acute hepatitis due to kava-kava and St John's Wort: an immune-mediated mechanism?]. Dtsch Med Wochenschr. 8-25-2006;131(34-35):1882-1883. View abstract.
- Siegers, C. P. and Schmidt, M. [Acute hepatitis due to kava-kava and St John's Wort: an immune-mediated mechanism?]. Dtsch Med Wochenschr. 8-25-2006;131(34-35):1881-1882. View abstract.
- Loew, D. [Acute hepatitis due to kava-kava and St John's Wort: an immune-mediated mechanism?]. Dtsch Med Wochenschr. 8-25-2006;131(34-35):1880-1883. View abstract.
- Teschke, R. [Acute hepatitis due to kava-kava and St John's Wort: an immune-mediated mechanism?]. Dtsch Med Wochenschr. 8-25-2006;131(34-35):1880-1881. View abstract.
- Prescott, J., Jamieson, D., Emdur, N., and Duffield, P. Acute effects of kava on measures of cognitive performance, physiological function and mood. Drug Alcohol Rev. 1993;12:49-57. View abstract.
- Musch, E., Chrissafidou, A., and Malek, M. [Acute hepatitis due to kava-kava and St John's Wort: an immune-mediated mechanism?]. Dtsch Med Wochenschr. 5-26-2006;131:1214-1217. View abstract.
- Matsuda, H., Hirata, N., Kawaguchi, Y., Naruto, S., Takata, T., Oyama, M., Iinuma, M., and Kubo, M. Melanogenesis stimulation in murine B16 melanoma cells by Kava (Piper methysticum) rhizome extract and kavalactones. Biol.Pharm.Bull 2006;29:834-837. View abstract.
- Folmer, F., Blasius, R., Morceau, F., Tabudravu, J., Dicato, M., Jaspars, M., and Diederich, M. Inhibition of TNFalpha-induced activation of nuclear factor kappaB by kava (Piper methysticum) derivatives. Biochem Pharmacol 4-14-2006;71:1206-1218. View abstract.
- Ernst, E. Herbal remedies for anxiety - a systematic review of controlled clinical trials. Phytomedicine 2006;13:205-208. View abstract.
- Grace, R. Kava-induced urticaria. J Am Acad Dermatol 2005;53:906. View abstract.
- Foo, H. and Lemon, J. Acute effects of kava, alone or in combination with alcohol, on subjective measures of impairment and intoxication and on cognitive performance. Drug Alcohol Rev. 1997;16:147-155. View abstract.
- Boerner, R. J. and Klement, S. Attenuation of neuroleptic-induced extrapyramidal side effects by Kava special extract WS 1490. Wien.Med Wochenschr. 2004;154(21-22):508-510. View abstract.
- Jorm, A. F., Christensen, H., Griffiths, K. M., Parslow, R. A., Rodgers, B., and Blewitt, K. A. Effectiveness of complementary and self-help treatments for anxiety disorders. Med J Aust 10-4-2004;181(7 Suppl):S29-S46. View abstract.
- Patra, K. K. and Coffey, C. E. Implications of herbal alternative medicine for electroconvulsive therapy. J ECT. 2004;20:186-194. View abstract.
- Raduege, K. M., Kleshinski, J. F., Ryckman, J. V., and Tetzlaff, J. E. Anesthetic considerations of the herbal, kava. J Clin Anesth. 2004;16:305-311. View abstract.
- Sparreboom, A., Cox, M. C., Acharya, M. R., and Figg, W. D. Herbal remedies in the United States: potential adverse interactions with anticancer agents. J Clin Oncol. 6-15-2004;22:2489-2503. View abstract.
- Thompson, R., Ruch, W., and Hasenohrl, R. U. Enhanced cognitive performance and cheerful mood by standardized extracts of Piper methysticum (Kava-kava). Hum.Psychopharmacol. 2004;19:243-250. View abstract.
- Thomsen, M., Vitetta, L., Schmidt, M., and Sali, A. Fatal fulminant hepatic failure induced by a natural therapy containing kava. Med J Aust. 2-16-2004;180:198-199. View abstract.
- Relevant hepatotoxic effects of kava still need to be proven. A statement of the Society for Medicinal Plant Research. Planta Med 2003;69:971-972. View abstract.
- Clough, A. R., Wang, Z., Bailie, R. S., Burns, C. B., and Currie, B. J. Case-control study of the association between kava use and ischaemic heart disease in Aboriginal communities in eastern Arnhem Land (Northern Territory) Australia. J Epidemiol.Community Health 2004;58:140-141. View abstract.
- Clough, A. R., Bailie, R. S., and Currie, B. Liver function test abnormalities in users of aqueous kava extracts. J Toxicol.Clin Toxicol. 2003;41:821-829. View abstract.
- Boon, H. S. and Wong, A. H. Kava: a test case for Canada's new approach to natural health products. CMAJ. 11-25-2003;169:1163-1164. View abstract.
- Mills, E., Singh, R., Ross, C., Ernst, E., and Ray, J. G. Sale of kava extract in some health food stores. CMAJ. 11-25-2003;169:1158-1159. View abstract.
- Backhauss, C. and Krieglstein, J. Extract of kava (Piper methysticum) and its methysticin constituents protect brain tissue against ischemic damage in rodents. European Journal of Pharmacology 5-14-1992;215(2-3):265-269. View abstract.
- Whitton, P. A., Lau, A., Salisbury, A., Whitehouse, J., and Evans, C. S. Kava lactones and the kava-kava controversy. Phytochemistry 2003;64:673-679. View abstract.
- HAMILTON, M. The assessment of anxiety states by rating. Br.J.Med.Psychol. 1959;32:50-55. View abstract.
- Russmann, S., Barguil, Y., Cabalion, P., Kritsanida, M., Duhet, D., and Lauterburg, B. H. Hepatic injury due to traditional aqueous extracts of kava root in New Caledonia. Eur.J Gastroenterol.Hepatol. 2003;15:1033-1036. View abstract.
- Kava: first suspended, now prohibited. Prescrire.Int 2003;12:142. View abstract.
- Clough, A. R., Jacups, S. P., Wang, Z., Burns, C. B., Bailie, R. S., Cairney, S. J., Collie, A., Guyula, T., McDonald, S. P., and Currie, B. J. Health effects of kava use in an eastern Arnhem Land Aboriginal community. Intern Med J 2003;33:336-340. View abstract.
- Schiano, T. D. Hepatotoxicity and complementary and alternative medicines. Clin Liver Dis 2003;7:453-473. View abstract.
- Singh, Y. N. and Devkota, A. K. Aqueous kava extracts do not affect liver function tests in rats. Planta Med 2003;69:496-499. View abstract.
- Garrett, K. M., Basmadjian, G., Khan, I. A., Schaneberg, B. T., and Seale, T. W. Extracts of kava (Piper methysticum) induce acute anxiolytic-like behavioral changes in mice. Psychopharmacology (Berl) 2003;170:33-41. View abstract.
- Stickel, F., Baumuller, H. M., Seitz, K., Vasilakis, D., Seitz, G., Seitz, H. K., and Schuppan, D. Hepatitis induced by Kava (Piper methysticum rhizoma). J Hepatol. 2003;39:62-67. View abstract.
- Schmidt, M. Are kavalactones the hepatotoxic principle of kava extracts? The pitfalls of the glutathione theory. J Altern Complement Med 2003;9:183-187. View abstract.
- Humberston, C. L., Akhtar, J., and Krenzelok, E. P. Acute hepatitis induced by kava kava. J Toxicol.Clin Toxicol. 2003;41:109-113. View abstract.
- Currie, B. J. and Clough, A. R. Kava hepatotoxicity with Western herbal products: does it occur with traditional kava use? Med J Aust. 5-5-2003;178:421-422. View abstract.
- Feltenstein, M. W., Lambdin, L. C., Ganzera, M., Ranjith, H., Dharmaratne, W., Nanayakkara, N. P., Khan, I. A., and Sufka, K. J. Anxiolytic properties of Piper methysticum extract samples and fractions in the chick social-separation-stress procedure. Phytother Res 2003;17:210-216. View abstract.
- Cairney, S., Clough, A. R., Maruff, P., Collie, A., Currie, B. J., and Currie, J. Saccade and cognitive function in chronic kava users. Neuropsychopharmacology 2003;28:389-396. View abstract.
- Kava kava may cause irreversible liver damage. S.Afr.Med J 2002;92:961. View abstract.
- Centers for Disease Control and Prevention. Hepatic toxicity possibly associated with kava-containing products--United States, Germany, and Switzerland, 1999-2002. JAMA 1-1-2003;289:36-37. View abstract.
- Sibon, I., Rosier, E., and Orgogozo, J. M. [Meningismus after taking kava-kava]. Rev Neurol.(Paris) 2002;158:1205-1206. View abstract.
- Ernst, E. [Recall of the herbal anxiolytic kava. Underestimation of its value or overestimation of its risks?]. MMW.Fortschr.Med 10-10-2002;144:40. View abstract.
- De Smet, P. A. Safety concerns about kava not unique. Lancet 10-26-2002;360:1336. View abstract.
- Cairney, S., Maruff, P., and Clough, A. R. The neurobehavioural effects of kava. Aust.N.Z.J Psychiatry 2002;36:657-662. View abstract.
- Concerns over kava have the FDA's attention. Mayo Clin Health Lett 2002;20:4. View abstract.
- Parkman, C. A. Another FDA warning: Kava supplements. Case.Manager. 2002;13:26-28. View abstract.
- Pittler, M. H. and Ernst, E. Kava extract for treating anxiety. Cochrane Database.Syst Rev 2002;:CD003383. View abstract.
- Bujanda, L., Palacios, A., Silvarino, R., Sanchez, A., and Munoz, C. [Kava-induced acute icteric hepatitis]. Gastroenterol.Hepatol. 2002;25:434-435. View abstract.
- Ernst, E. Safety concerns about kava. Lancet 5-25-2002;359:1865. View abstract.
- Kava, R. The adverse effects of kava. Pac.Health Dialog. 2001;8:115-118. View abstract.
- Stevinson, C., Huntley, A., and Ernst, E. A systematic review of the safety of kava extract in the treatment of anxiety. Drug Saf 2002;25:251-261. View abstract.
- Kava concerns. FDA, Botanical Council raises safety concerns. AWHONN.Lifelines. 2002;6:13-15. View abstract.
- Watkins, L. L., Connor, K. M., and Davidson, J. R. Effect of kava extract on vagal cardiac control in generalized anxiety disorder: preliminary findings. J Psychopharmacol. 2001;15:283-286. View abstract.
- Boerner, R. J. Kava kava in the treatment of generalized anxiety disorder, simple phobia and specific social phobia. Phytother Res 2001;15:646-647. View abstract.
- Kraft, M., Spahn, T. W., Menzel, J., Senninger, N., Dietl, K. H., Herbst, H., Domschke, W., and Lerch, M. M. [Fulminant liver failure after administration of the herbal antidepressant Kava-Kava]. Dtsch Med Wochenschr 9-7-2001;126:970-972. View abstract.
- Wheatley D. Kava and valerian in the treatment of stress-induced insomnia. Phytother Res 2001;15:549-551. View abstract.
- Neuhaus, W., Ghaemi, Y., Schmidt, T., and Lehmann, E. [Treatment of perioperative anxiety in suspected breast carcinoma with a phytogenic tranquilizer]. Zentralbl.Gynakol. 2000;122:561-565. View abstract.
- De Leo, V, La Marca, A., Lanzetta, D., Palazzi, S., Torricelli, M., Facchini, C., and Morgante, G. [Assessment of the association of Kava-Kava extract and hormone replacement therapy in the treatment of postmenopause anxiety]. Minerva Ginecol. 2000;52:263-267. View abstract.
- Scherer, J. Kava-kava extract in anxiety disorders: an outpatient observational study. Adv.Ther. 1998;15:261-269. View abstract.
- Kelley, K. W. and Carroll, D. G. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. J.Am.Pharm.Assoc. 2010;50:e106-e115. View abstract.
- Buettner, C., Mukamal, K. J., Gardiner, P., Davis, R. B., Phillips, R. S., and Mittleman, M. A. Herbal supplement use and blood lead levels of United States adults. J.Gen.Intern.Med. 2009;24:1175-1182. View abstract.
- Lakhan, S. E. and Vieira, K. F. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J 2010;9:42. View abstract.
- Meolie, A. L., Rosen, C., Kristo, D., Kohrman, M., Gooneratne, N., Aguillard, R. N., Fayle, R., Troell, R., Townsend, D., Claman, D., Hoban, T., and Mahowald, M. Oral nonprescription treatment for insomnia: an evaluation of products with limited evidence. J Clin.Sleep Med 4-15-2005;1:173-187. View abstract.
- Lehrl S. Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders. Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial. J Affect Disord 2004;78:101-10. View abstract.
- Geier FP, Konstantinowicz T. Kava treatment in patients with anxiety. Phytother Res 2004;18:297-300. View abstract.
- Sarris J, Scholey A, Schweitzer I, et al. The acute effects of kava and oxazepam on anxiety, mood, neurocognition; and genetic correlates: a randomized, placebo-controlled, double-blind study. Hum Psychopharmacol 2012;27:262-9. View abstract.
- Cagnacci A, Arangino S, Renzi A, et al. Kava-Kava administration reduces anxiety in perimenopausal women. Maturitas 2003;44:103-9. View abstract.
- Gastpar M, Klimm HD. Treatment of anxiety, tension and restlessness states with Kava special extract WS 1490 in general practice: a randomized placebo-controlled double-blind multicenter trial. Phytomedicine 2003;10:631-9. View abstract.
- Sarris J, Kavanagh DJ, Byrne G, et al. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacology 2009;205:399-407. View abstract.
- Witte S, Loew D, Gaus W. Meta-analysis of the efficacy of the acetonic kava-kava extract WS1490 in patients with non-psychotic anxiety disorders. Phytother Res 2005;19:183-8. View abstract.
- Boerner RJ, Sommer H, Berger W, et al. Kava-Kava extract LI 150 is as effective as opipramol and buspirone in generalised anxiety disorder--an 8-week randomized, double-blind multi-centre clinical trial in 129 out-patients. Phytomedicine 2003;10 Suppl 4:38-49. View abstract.
- Connor KM, Davidson JR. A placebo-controlled study of Kava kava in generalized anxiety disorder. Int Clin.Psychopharmacol 2002;17:185-8. View abstract.
- Freshour JE, Odle B, Rikhye S, Stewart DW. Coltsfoot as a potential cause of deep vein thrombosis and pulmonary embolism in a patient also consuming kava and blue vervain. J Diet Suppl 2012;9:149-54. View abstract.
- Donadio V, Bonsi P, Zele I, et al. Myoglobinuria after ingestion of extracts of guarana, Ginkgo biloba and kava. Ginkgo biloba and kava. Neurol Sci 2000;21:124. View abstract.
- Bodkin R, Schneider S, Rekkerth D, et al. Rhabdomyolysis associated with kava ingestion. Am J Emerg Med 2012;30:635.el-3. View abstract.
- Li XZ, Ramzan I. Role of ethanol in kava hepatotoxicity. Phytother Res 2010;24:475-80. View abstract.
- Gurley BJ, Swain A, Hubbard MA, et al. Clinical assessement of CYP2D6-mediated herb-drug interactions in humans: Effects of milk-thistle, black cohosh, goldenseal, kava kava, St. John's wort, and Echinacea. Mol Nutr Food Res 2008;52:755-63. View abstract.
- Gurley BJ, Swain A, Barone GW, et al. Effect of goldenseal (Hydrastis canadensis) and kava kava (Piper methysticum) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos 2007;35:240-5. View abstract.
- Weiss J, Sauer A, Frank A, Unger M. Extracts and kavalactones of Piper methysticum G. Forst (kava-kava) inhibit P-glycoprotein in vitro. Drug Metab Dispos 2005;33:1580-3. View abstract.
- Connor KM, Payne V, Davidson JR. Kava in generalized anxiety disorder: three placebo-controlled trials. Int Clin Psychopharmacol 2006;21:249-53. View abstract.
- Jacobs BP, Bent S, Tice JA, et al. An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Medicine (Baltimore) 2005;84:197-207. View abstract.
- 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;77:415-26. View abstract.
- Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;18:2273-81. View abstract.
- Gow PJ, Connelly NJ, Hill RL, et al. Fatal fulminant hepatic failure induced by a natural therapy containing kava. Med J Aust 2003;178:442-3. View abstract.
- Moulds RF, Malani J. Kava: herbal panacea or liver poison? Med J Aust 2003;178:451-3. View abstract.
- Cairney S, Maruff P, Clough AR, et al. Saccade and cognitive impairment associated with kava intoxication. Hum Psychopharmacol 2003;18:525-33. View abstract.
- Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Database Syst Rev 2003;:CD003383. View abstract.
- Schulze J, Raasch W, Siegers CP. Toxicity of kava pyrones, drug safety and precautions--a case study. Phytomedicine 2003;10:68-73.. View abstract.
- Schmidt P, Boehncke WH. Delayed-type hypersensitivity reaction to kava-kava extract. Contact Dermatitis 2000;42:363-4. View abstract.
- Teschke R, Gaus W, Loew D. Kava extracts: safety and risks including rare hepatotoxicity. Phytomedicine 2003;10:440-6. View abstract.
- Logan JL, Ahmed J. Critical hypokalemic renal tubular acidosis due to Sjogren's syndrome: association with the purported immune stimulant echinacea. Clin Rheumatol 2003;22:158-9. View abstract.
- Singh YN. Effects of kava on neuromuscular transmission and muscle contractility. J Ethnopharmacol 1983;7:267-76.. View abstract.
- 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.. View abstract.
- Denham A, McIntyre M, Whitehouse J. Kava--the unfolding story: report on a work-in-progress. J Altern Complement Med 2002;8:237-263.. View abstract.
- Garner LF, Klinger JD. Some visual effects caused by the beverage kava. J Ethnopharmacol 1985;13:307-311.. View abstract.
- Cropley M, Cave Z, Ellis J, Middleton RW. Effect of kava and valerian on human physiological and psychological responses to mental stress assessed under laboratory conditions. Phytother Res 2002;16:23-7.. View abstract.
- Mathews JM, Etheridge AS, Black SR. Inhibition of human cytochrome P450 activities by kava extract and kavalactones. Drug Metab Dispos 2002;30:1153-7. View abstract.
- Anon. Hepatic toxicity possibly associated with kava-containing products-United States, Germany, Switzerland, 1999-2002. MMWR 2002;1:1065-1067.. View abstract.
- Seitz U, Schule A, Gleitz J. [3H]-monoamine uptake inhibititon properties of kava pyrones. Planta Med 1997;63:548-549.. View abstract.
- Boonen G, Pramanik A, Rigler R, Haberlein H. Evidence for specific interactions between kavain and human cortical neurons monitored by fluorescence correlation spectroscopy. Planta Med 2000;66:7-10. View abstract.
- Wooltorton E. Herbal kava: reports of liver toxicity. CMAJ 2002;166:777. View abstract.
- Bilia AR, Gallori S, Vincieri FF. Kava-kava and anxiety: growing knowledge about the efficacy and safety. Life Sci 2002;70:2581-97. View abstract.
- Singh YN. Kava: an overview. J Ethnopharmacol 1992;37:13-45. View abstract.
- Wu D, Yu L, Nair MG, et al. Cyclooxygenase enzyme inhibitory compounds with antioxidant activities from Piper methysticum (kava kava) roots. Phytomedicine 2002;9:41-7. View abstract.
- Steiner GG. The correlation between cancer incidence and kava consumption. Hawaii Med J 2000;59:420-2. View abstract.
- Ruze P. Kava-induced dermopathy: a niacin deficiency? Lancet 1990;335:1442-5. View abstract.
- Meseguer E, Taboada R, Sanchez V, et al. Life-threatening parkinsonism induced by kava-kava. Mov Disord 2002;17:195-6. View abstract.
- Malsch U, Kieser M. Efficacy of kava-kava in the treatment of non-psychotic anxiety, following pretreatment with benzodiazepines. Psychopharmacology (Berl) 2001;157:277-83. View abstract.
- Consultation letter MLX 286: Proposals to prohibit the herbal ingredient Kava-Kava (Piper methysticum) in unlicensed medicines. Medicines Control Agency, United Kingdom, July 19, 2002.
- Liver Toxicity with kava. Pharmacist's Letter/Prescriber's Letter 2001;18:180115.
- Russmann S, Lauterburg BH, Helbling A. Kava hepatotoxicity [letter]. Ann Intern Med 2001;135:68-9. View abstract.
- Escher M, Desmeules J, Giostra E, Mentha G. Hepatitis associated with Kava, a herbal remedy for anxiety. BMJ 2001;322:139. View abstract.
- Mathews JD, Riley MD, Fejo L, et al. Effects of heavy usage of kava on physical health: Summary of a pilot survey in an aboriginal community. Med J Aust 1988;148:548-55. View abstract.
- Pizzorno JE, Murray MT, eds. Textbook of Natural Medicine. 2nd ed. Edinburgh:Churchill Livingstone, 1999.
- Norton SA, Ruze P. Kava dermopathy. J Am Acad Dermatol 1994;31:89-97. View abstract.
- Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
- Schelosky L, Raffaup C, Jendroska K, Poewe W. Kava and dopamine antagonism. J Neurol Neurosurg Psychiatry 1995;58:639-40. View abstract.
- Davies LP, Drew CA, Duffield P, et al. Kava Pyrones and Resin: Studies on GABA-A, GABA-B, and Benzodiazepine Binding Sites in Rodent Brain. Pharmacol Toxicol 1992;71:120-6. View abstract.
- Jussofie 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 1994;116:469-74. View abstract.
- Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001;16:353-6. View abstract.
- Gleitz J, Beile A, Wilkens P, et al. Antithrombotic action of the kava pyrone (+)-kavain prepared from Piper methysticum on human platelets. Planta Med 1997;63:27-30. View abstract.
- Uebelhack R, Franke L, Schewe HJ. Inhibition of platelet MAO-B by kava pyrone-enriched extract from Piper methysticum Forster (kava-kava). Pharmacopsychiatry 1998;31:187-92. View abstract.
- Munte TF, Heinze HJ, Matzke M, Steitz J. Effects of oxazepam and an extract of kava roots (Piper methysticum) on event-related potentials in a word recognition task. Neuropsychobiology 1993;27:46-53. View abstract.
- 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;27:224-30. View abstract.
- Warnecke G. [Psychosomatic dysfunctions in the female climacteric. Clinical effectiveness and tolerance of Kava extract WS 1490]. Fortschr Med 1991;109:119-22. View abstract.
- Lehmann E, Kinzler E, Friedemann J. Efficacy of a special Kava extract (Piper methysticum) in patients with states of anxiety, tension and excitedness of non-mental origin- a double-blind placebo-controlled study of four weeks treatment. Phytomedicine 1996;3:113-9.
- 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. View abstract.
- Pittler MH, Ernst E. Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J Clin Psychopharmacol 2000;20:84-9. View abstract.
- Woelk H, Kapoula O, Lehrl S, et al. [Comparison of kava special extract WS 1490 and benzodiazepines in patients with anxiety]. Z Allg Med 1993;69:271-7.
- Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
- Singh YN, Blumenthal M. Kava an overview. HerbalGram 1997;39:33-44, 46-55.
- Almeida JC, Grimsley EW. Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med 1996;125:940-1. View abstract.
- Swensen JN. Man convicted of driving under the influence of kava. Salt Lake City, UT: Deseret News, 1996.
- Spillane PK, et al. Neurological manifestations of kava intoxication. Med J Aust 1997;167:172-3. View abstract.
- Strahl S, Ehret V, Dahm HH, Maier KP. [Necrotizing hepatitis after taking herbal medication]. Dtsch Med Wochenschr 1998;123:1410-4. View abstract.
- Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
- Show more references
- Show fewer references
Last reviewed - 05/30/2014
This copyrighted, evidence-based medicine resource is provided by Natural Medicines Comprehensive Database Consumer Version. Natural Medicines Comprehensive Database disclaims any responsibility related to consequences of using any product. This monograph should not replace advice from a healthcare professional and should not be used for the diagnosis or treatment of any medical condition.
Copyright © 1995 - 2014 Therapeutic Research Faculty
, publishers of Natural Medicines Comprehensive Database
, Prescriber’s Letter
, Pharmacist’s Letter
. All rights reserved. For scientific data on natural medicines, professionals may consult the Professional Version of Natural Medicines Comprehensive DatabaseNatural Medicines Comprehensive Database (http://www.naturaldatabase.com/)