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Review Article

Kava: a comprehensive review of efficacy, safety, and psychopharmacology

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Pages 27-35 | Received 07 Jun 2010, Accepted 03 Sep 2010, Published online: 15 Nov 2010

References

  • Singh YN. Kava: an overview. J Ethnopharmacol 1992; 37:13–45.
  • Stevinson C, Huntley A, Ernst E. A systematic review of the safety of kava extract in the treatment of anxiety. Drug Saf 2002; 25: 251–261.
  • Norton SA, Ruze P. Kava dermopathy. J Am Acad Dermatol 1994; 31:89–97.
  • Bilia AR, Gallon S, Vincieri FF. Kava-kava and anxiety: growing knowledge about the efficacy and safety. Life Sci 2002; 70: 2581–2597.
  • Rickels K, Rynn M. Pharmacotherapy of generalized anxiety disorder. J Clin Psychiatry 2002; 63S14:9–16.
  • Degner D, Grohmann R, Kropp S . Severe adverse drug reactions of antidepressants: results of the German multicentre drug surveillance program AMSP. Pharmacopsychiatry 2004: Suppl 1: 39–45.
  • Chouinard G. Issues in the clinical use of benzodiazepines: potency, withdrawal, and rebound. J Clin Psychiatry 2004; 65S5:7–12.
  • Pittler MH, Ernst E. Kava extract for treating anxiety. Cochrane Database Syst Rev 2003:CD003383.
  • Clouatre DL. Kava kava: examining new reports of toxicity. Toxicol Lett 2004; 150:85–96.
  • Teschke R, Schwarzenboeck A, Akinci A. Kava hepatotoxicity: a European view. N Z Med J 2008; 121:90–98.
  • Cairney S, Maruff P, Clough AR. The neurobehavioural effects of kava. Aust N Z J Psychiatry 2002; 36:657–662.
  • Cohen J. Statistical power analyses for the behavioral sciences. Hillsdale, NJ: Erlbaum, 1988.
  • Raduege KM, Kleshinski JF, Ryckman JV, Tetzlaff JE. Anesthetic considerations of the herbal, kava. J Clin Anesth 2004; 16:305–311.
  • Singh YN, Singh NN. Therapeutic potential of kava in the treatment of anxiety disorders. CNS Drugs 2002; 16:731–743.
  • Nerurkar PV, Dragull K, Tang CS. In vitro toxicity of kava alkaloid, pipermethystine, in HepG2 cells compared to kavalactones. Toxicol Sci 2004; 79:106–111.
  • Amorim MFD, Diniz MFFM, Araújo MST . The controvertible role of kava (Piper methysticum G. Foster) an anxiolytic herb, on toxic hepatitis. Rev Bras Farmacogn 2007; 17:448–454.
  • Lebot V, Lévesque J. The origin and distribution of kava (Piper methysticum Forst. f. and Piper wichmannii C. DC., Piperaceae): a phytochemical approach. Allertonia 1989; 5:223–280.
  • Xian-guo H, Long-ze L, Li-zhi L. Electrospray high performance liquid chromatography mass spectrometry in phytochemical analysis of kava (Piper methysticum) extract. Planta Med 1997; 63:70–74.
  • Kinzler E, Kromer J, 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.
  • Gleitz J, Tosch C, Beile A, Peters T. The protective action of tetrodotoxin and (+/−)-kavain on anaerobic glycolysis, ATP content and intracellular Na+ and Ca2+ of anoxic brain vesicles. Neuropharmacology 1996; 35:1743–1752.
  • Jamieson DD, Duffield PH. The antinociceptive actions of kava components in mice. Clin Exp Pharmacol Physiol 1990; 17:495–507.
  • Singh YN. Effects of kava on neuromuscular transmission and muscle contractility. J Ethnopharmacol 1983; 7:267–276.
  • Gleitz J, Beile A, Wilkens P, Ameri A, Peters T. Antithrombotic action of the kava pyrone (+)-kavain prepared from Piper methysticum on human platelets. Planta Med 1997; 63:27–30.
  • Singh YN, Blumenthal M. Kava: an overview. HerbalGram 1997; 39:33–57.
  • Wheatley D. Stress-induced insomnia treated with kava and valerian: singly and in combination. Hum Psychopharmacol 2001; 16:353–356.
  • 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 (Berl) 1994; 116:469–474.
  • Davies LP, Drew CA, Duffield P, Johnston GA, Jamieson DD. Kava pyrones and resin: studies on GABAA, GABAB and benzodiazepine binding sites in rodent brain. Pharmacol Toxicol 1992; 71:120–126.
  • Boonen G, Häberlein H. Influence of genuine kavapyrone enantiomers on the GABAA binding site. Planta Med 1998; 64:504–506.
  • 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; 19:183–188.
  • Boerner RJ, Sommer H, Berger W, Kuhn U, Schmidt U, Mannel M. 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; 10S4:38–49.
  • Connor KM, Davidson JR. A placebo-controlled study of kava kava in generalized anxiety disorder. Int Clin Psychopharmacol 2002; 17:185–188.
  • 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; 10:631–639.
  • Geier FP, Konstantinowicz T. Kava treatment in patients with anxiety. Phytother Res 2004; 18:297–300.
  • 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.
  • Lehmann E, Kinzler E, Friedemann J. Efficacy of a special kava extract (Piper methysticum) in paitents 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.
  • Cagnacci A, Arangino S, Renzi A, Zanni AL, Malmusi S, Volpe A. Kava-kava administration reduces anxiety in perimenopausal women. Maturitas 2003; 44:103–109.
  • Coulter D. Assessment of the risk of hepatotoxicity with kava products. Geneva: World Health Organization, 2007.
  • Sarris J, Kavanagh D, Byrne G, Bone K, Adams J, Deed G. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled, cross-over trial using an aqueous extract of Piper methysticum. Psychopharmacology (Berl) 2009; 205:399–407.
  • Sarris J, Adams J, Kavanagh D. An explorative qualitative analysis of participants’ experience of using kava versus placebo in an RCT. Aust J Med Med Herbalism 2010; 22:12–16.
  • Poolsup N, Li Wan Po A, Knight TL. Pharmacogenetics and psychopharmacotherapy. J Clin Pharm Ther 2000; 25: 197–220.
  • Wanwimolruk S, Bhawan S, Coville PF, Chalcroft SC. Genetic polymorphism of debrisoquine (CYP2D6) and proguanil (CYP2C19) in South Pacific Polynesian populations. Eur J Clin Pharmacol 1998; 54:431–435.
  • Singh YN. Potential for interaction of kava and St John's wort with drugs. J Ethnopharmacol 2005; 100:108–113.
  • Whitton PA, Lau A, Salisbury A, Whitehouse J, Evans CS. Kava lactones and the kava-kava controversy. Phytochemistry 2003; 64:673–679.
  • Teschke R, Genthner A, Wolff A. Kava hepatotoxicity: comparison of aqueous, ethanolic, acetonic kava extracts and kava-herbs mixtures. J Ethnopharmacol 2009; 123:378–384.
  • Mathews JM, Etheridge AS, Black SR. Inhibition of human cytochrome P450 activities by kava extract and kavalactones. Drug Metab Dispos 2002; 30:1153–1157.
  • Zou L, Harkey MR, Henderson GL. Effects of herbal components on cDNA-expressed cytochrome P450 enzyme catalytic activity. Life Sciences 2002; 71:1579–1589.
  • Mathews JM, Etheridge AS, Valentine JL . Pharmacokinetics and disposition of the kavalactone kawain: interaction with kava extract and kavalactones in vivo and in vitro. Drug Metab Dispos 2005; 33:1555–1563.
  • Almeida JC, Grimsley EW. Coma from the health food store: interaction between kava and alprazolam. Ann Intern Med 1996; 125:940–941.
  • Clough AR, Jacups SP, Wang Z . Health effects of kava use in an eastern Arnhem Land Aboriginal community. Intern Med J 2003; 33:336–340.
  • Clough A. Enough! or too much. What is ‘excessive’ kava use in Arnhem Land? Drug Alcohol Rev 2003; 22:43–51.
  • Thompson R, Ruch W, Hasenohrl RU. Enhanced cognitive performance and cheerful mood by standardized extracts of Piper methysticum (Kava-kava). Hum Psychopharmacol 2004; 19:243–250.
  • Saletu B, Grunberger J, Linzmayer L, Anderer P. EEG-brain mapping, psychometric and psychophysiological studies on central effects of kavain: a kava plant derivative. Hum Psychopharmacol 1989; 4:169–190.
  • Heinze HJ, Münte TF, Steitz J, Matzke M. Pharmacopsychological effects of oxazepam and kava-extract in a visual search paradigm assessed with event-related potentials. Pharmacopsychiatry 1994; 27:224–230.
  • Münte 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.
  • 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 Alcohol Rev 1997; 16:147–155.
  • Prescott J, Jamieson D, Emdur N, Duffield P. Acute effects of kava on measures of cognitive performance, physiological function and mood. Drug Alcohol Rev 1993; 12:49–57.
  • Russell PN, Bakker D, Singh NN. The effects of kava on altering and speed of access of information from long-term memory. Bull Psychonomic Soc 1987; 25:236–237.
  • Mathews JD, Riley MD, Fejo L . Effects of the heavy usage of kava on physical health: summary of a pilot survey in an aboriginal community. Med J Aust 1988; 148:548–555.
  • Cairney S, Clough AR, Maruff P, Collie A, Currie BJ, Currie J. Saccade and cognitive function in chronic kava users. Neuropsychopharmacology 2003; 28:389–396.
  • Cairney S, Maruff P, Clough AR, Collie A, Currie J, Currie BJ. Saccade and cognitive impairment associated with kava intoxication. Hum Psychopharmacol 2003; 18:525–533.
  • Herberg KW. Fahrtüchtigkeit nach Einnahme von Kava-Spezial-Extrakt WS 1490, Doppelblinde, placebokontrollierte Studie [in German]. Z Allgemeinmed 1991; 13:842–846.
  • Baldwin DS, Polkinghorn C. Evidence-based pharmacotherapy of generalized anxiety disorder. Int J Neuropsychopharmacol 2005; 8:293–302.
  • Connor KM, Payne V, Davidson JR. Kava in generalized anxiety disorder: three placebo-controlled trials. Int Clin Psychopharmacol 2006; 21:249–253.
  • Schweitzer I, Maguire K, Ng C. Sexual side-effects of contemporary antidepressants: review. Aust N Z J Psychiatry 2009; 43:795–808.
  • Schosser A, Kasper S. The role of pharmacogenetics in the treatment of depression and anxiety disorders. Int Clin Psychopharmacol 2009; 24:277–288.
  • Hirunsatit R, Ilomaki R, Malison R . Sequence variation and linkage disequilibrium in the GABA transporter-1 gene (SLC6A1) in five populations: implications for pharmacogenetic research. BMC Genet 2007; 8:71.
  • Ulrich-Merzenich G, Panek D, Zeitler H, Wagner H, Vetter H. New perspectives for synergy research with the ‘omic’-technologies. Phytomedicine 2009; 16:495–508.
  • Gleitz J, Beile A, Peters T. (+/–)-Kavain inhibits veratridine-activated voltage-dependent Na(+)-channels in synaptosomes prepared from rat cerebral cortex. Neuropharmacology 1995; 34:1133–1138.
  • Magura EI, Kopanitsa MV, Gleitz J, Peters T, Krishtal OA. Kava extract ingredients, (+)-methysticin and (+/−)-kavain inhibit voltage-operated Na(+)-channels in rat CA1 hippocampal neurons. Neuroscience 1997; 81:345–351.
  • Martin HB, Stofer WD, Eichinger MR. Kavain inhibits murine airway smooth muscle contraction. Planta Med 2000; 66:601–606.
  • 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.
  • Seitz U, Schule A, Gleitz J. [3H]-monoamine uptake inhibition properties of kava pyrones. Planta Med 1997; 63:548–549.
  • Yuan CS, Dey L, Wang A . Kavalactones and dihydrokavain modulate GABAergic activity in a rat gastric-brainstem preparation. Planta Med 2002; 68:1092–1096.
  • Uebelhack R, Franke L, Schewe HJ. Inhibition of platelet MAO-B by kava pyrone-enriched extract from Piper methysticum Forster (kava-kava). Pharmacopsychiatry 1998; 31:187–192.

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