Kava Kava

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Information about Kava Kava

Kava kava is an herbal derived from roots of the plant Piper methysticum, which has been used for centuries as a recreational and ceremonial drink in Oceania and more recently in concentrated forms in herbal medications to treat anxiety and insomnia. 

Liver safety of Kava Kava

Products labeled as kava have been linked to the development of clinically apparent acute liver injury which can be severe and even fatal.  

History of Kava Kava

Kava kava is an herbal derived from roots of the plant Piper methysticum (“intoxicating Pepper” plant), a member of the pepper family found in the Western and South Pacific.  More commonly referred to simply as “kava” (bitter), it has been used for centuries as a recreational and ceremonial drink in Oceania (Polynesia, Micronesia and Macronesia).  It is prepared from the roots of the plant which are ground into a fine pulp to which water is added.  The active ingredients are kavapyrones (kavalactones), which have effects similar to alcohol, such as relaxation, talkativeness, and euphoria, while reportedly maintaining mental clarity.  For these reasons, kava has been proposed to be anxiolytic and used in patients with anxiety disorders and as treatment for insomnia, premenstrual syndrome and stress.  Kava appears to have an abuse potential, but it is rare with conventional doses.  Recently, concerns have arisen regarding the safety of kava products, in particular due to reports of liver injury.  For this reason, the use of kava has been banned or restricted in many countries of the world such as Germany, Switzerland, France, Canada, and Great Britain.  However, several groups have disputed the evidence for hepatotoxicity, suggesting that responsibility for liver injury lies with adulterants or concomitant drugs or herbals.  Furthermore, the literature on liver injury from kava has included several incomplete or overlapping reports, and causality was rarely well shown.  Nevertheless, there are a small number of cases of severe hepatic injury arising during therapy that are convincing.  Kava in many formulations remains available from nutrition stores and the Internet.

What is Kava Kava used for?

The kava pyrones are believed to have anxiolytic, analgesic, muscle relaxing, and anticonvulsant effects, mediated by effects on the limbic system, the part of the brain linked to emotions. 

Mechanism of action of Kava Kava

The mechanism of action of the pharmacological effects of kava has yet to be elucidated.  Research has demonstrated that several factors, including concentration, type of preparation, kava pyrone content, and kava variety used may affect pharmacologic activity.  Therapeutic uses of kava include the treatment of anxiety, insomnia, and stress.  Its abuse potential is low, but not absent. 

Dosage and administration for Kava Kava

Suggested dosage for treatment of nonpsychotic anxiety is 105 to 210 mg daily for three to four weeks. 

Side effects of Kava Kava

The most common side effects of kava are headache, dizziness, drowsiness, depression, diarrhea, and occasionally dermatologic manifestations.

Herbal and dietary supplements

Chinese and Other Asian Herbal Medicines

Multi-Ingredient Nutritional Supplements

See also Nutritional supplements

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