Advanced search
Publication Cover
Expert Opinion on Drug Safety Volume 4, 2005 - Issue 4
Submit an article Journal homepage
350
Views
49
CrossRef citations to date
0
Altmetric
Review

Safety review of kava (Piper methysticum) by the Natural Standard Research Collaboration

Catherine Ulbricht Natural Standard Research Collaboration, 1 Broadway, 14th Floor, Cambridge, MA 02142, USA. [email protected]
,
Ethan Basch Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
,
Heather Boon University of Toronto, Toronto, Ontario, M5S 1A1, Canada
,
Edzard Ernst University of Exeter, The Queen’s Drive, Exeter, Devon, EX4 4QJ, UK
,
Paul Hammerness Harvard Medical School, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
,
David Sollars New England School of Acupuncture, 40 Belmont Street, Watertown, MA 02472, USA
,
Candy Tsourounis University of California, San Francisco, San Francisco, CA 94143, USA
,
Jen Woods Northeastern University, 360 Huntington Avenue, Boston, MA 02115, USA
&
Stephen Bent University of California, San Francisco, San Francisco, CA 94143, USA
 show all
Pages 779-794 | Published online: 12 Jul 2005

Bibliography

  • STAFFORD N: Germany may ban kava kava herbal supplement, Reuters News Service Germany (November 19, 2001).
  • MILLS E, SINGH R, ROSS C et al: Sale of kava extract in some health food stores. CMAJ(2003) 169(11):1158–1159.
  • MILLS SY, STEINHOFF B: Kava-kava: a lesson for the phytomedicine community. Phytomedicine (2003) 10(2-3):261–262.
  • SCHULZE J, RAASCH W, SIEGERS CP: Toxicity of kava pyrones, drug safety and precautions-a case study. Phytomedicine (2003) 10\(Suppl. 4):68–73.
  • ANONYMOUS: Kava: first suspended, now prohibited. Prescrire Int. (2003) 12(66):142.
  • PITTLER MH, Ernst E: Kava extract for treating anxiety. Cochrane Database Syst. Rev (2003) (1):CD003383.
  • •Systematic review.
  • BOON HS, Wong AH: Kava: a test case for Canada's new approach to natural health products. CMAJ (2003) 169(10:1163–1164.
  • •Policy.
  • SINGH YN: Kava: an overview. Ethnopharmacol (1992) 37(1):13–45.
  • DOUGLAS W: The effects of heavy usage of kava on physical health. Med. J. Aust. (1988) 149:341–342.
  • ERNST E: The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's Wort, Ginseng, Echinacea, Saw Palmetto, and Kava. Ann. Intern. Med. (2002) 136(1):42–53.
  • •Comparison of kava with other herbal therapies.
  • ERNST E: Second thoughts about kava. Arm J. Med. (2002) 113(4):347–348.
  • ERNST E: Recall of the herbal anxiolytic kava. Underestimation of its value or overestimation of its risks? MMW Fortschr. Med. (2002) 144(40:40.
  • ERNST E: Safety concerns about kava. Lancet (2002) 359(9320):1865.
  • PITTLER MH, ERNST E: Kava extract for treating anxiety. Cochrane Database Syst. Rev (2002) (2):CD003383.
  • •Systematic review.
  • BASCH E, ULBRICHT C, HAMMERNESS P et al: Kava monograph. J. Herbal Pharmacother. (2002) 2(4):65–91.
  • ••Full systematic review of efficacy and safety from which this article was adapted.
  • GEIER FP, KONSTANTINOWICZ T: Kava treatment in patients with anxiety. Phytother. Res. (2004) 18(4):297–300.
  • 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.
  • CAGNACCI A, ARANGINO S, RENZI A et al: Kava-Kava administration reduces anxiety in perimenopausal women. Maturitas (2003) 44(2):103–109.
  • RUSSMANN S, LAUTERBURG BH, HELBLING A: Kava hepatotoxicity. Ann. Intern. Med. (2001) 135(1):68–69.
  • ANONYMOUS: Kava kava may cause irreversible liver damage. SAIL Med. J. (2002) 92(12):961.
  • ANONYMOUS: Concerns over kava have the FDA's attention. Mayo Clin. Health Lett. (2002) 20(7):4.
  • DE SMET PA: Safety concerns about kava not unique. Lancet (2002) 360(9342):1336.
  • ANONYMOUS: From the Centers for Disease Control and Prevention. Hepatic toxicity possibly associated with kava-containing products-United States, Germany, and Switzerland, 1999–2002.JAMA (2003) 289(1):36–37.
  • CLOUGH AR, BAILIE RS, CURRIE B: Liver function test abnormalities in users of aqueous kava extracts. J. Toxicol Toxicol (2003) 41(6):821–829.
  • RUSSMANN S, BARGUIL Y, CABALION P et al: Hepatic injury due to traditional aqueous extracts of kava root in New Caledonia. Eur. Castroenterol Hepatol (2003) 15(9):1033–1036.
  • ANONYMOUS: Hepatic toxicity possibly associated with kava-containing products-United States, Germany, and Switzerland, 1999–2002.MMWR Morb. Mortal. Wkly Rep. (2002) 51(47):1065–1067.
  • BUJANDA L, PALACIOS A, SILVARINO R et al.: Kava-induced acute icteric hepatitis. Castroenterol Hepatol (2002) 25(6):434–435.
  • HUMBERSTON CL, AKHTAR J, KRENZELOK EP: Acute hepatitis induced by kava kava. Toxicol Clin. Toxicol (2003) 41(2):109–113.
  • STICKEL F, BAUMULLER HM, SEITZ K et al.: Hepatitis induced by Kava (Piper methysticum rhizoma). Hepatol (2003) 39(1):62–67.
  • ESCHER M, DESMEULES J, GIOSTRA E et al: Hepatitis associated with Kava, a herbal remedy for anxiety. BE Med. J. (2001) 322(7279):139.
  • KRAFT M, SPAHN TW, MENZEL J et al.: Fulminant liver failure after administration of the herbal antidepressant Kava-Kava. arch. Med. Wochenschr. (2001) 126(36):970–972.
  • THOMSEN M, VITETTA L, SCHMIDT M et al.: Fatal fulminant hepatic failure induced by a natural therapy containing kava. Med. Aust. (2004) 180(4):198–199.
  • GOW PJ, CONNELLY NJ, HILL RL et al.: Fatal fulminant hepatic failure induced by a natural therapy containing kava. Med. fAust. (2003) 178(9):442–443.
  • ANONYMOUS: Relevant hepatotoxic effects of kava still need to be proven. A statement of the Society for Medicinal Plant Research. Planta Med. (2003) 69(10:971–972.
  • DENHAM A, MCINTYRE M, WHITEHOUSE J: Kava-the unfolding story: report on a work-in-progress. f Ahern. Complement Med. (2002) 8(3):237–263.
  • SCHMIDT M: Are kavalactones the hepatotoxic principle of kava extracts? The pitfalls of the glutathione theory. f Ahern. Complement Med. (2003) 9(2):183–187.
  • PARKMAN CA: Another FDA warning: Kava supplements. Case Manager (2002) 13(4):26–28.
  • 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).
  • 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.
  • •Regulatory action.
  • DE LEO V, LA MARCA A, LANZETTA D et al: Assessment of the association of Kava-Kava extract and hormone replacement therapy in the treatment of postmenopause anxiety. Minerva Chum] (2000) 52(6):263–267.
  • CAWTE J: Parameters of kava used as a challenge to alcohol. Aust. NZ 1.Psychiatry (1986) 20(1):70–76.
  • GLEITZ J, FRIESE J, BEILE A et al: Anticonvulsive action of (4-)-kavain estimated from its properties on stimulated synaptosomes and Na-F channel receptor sites. Eur.I. Pharmacol (1996) 315(1):89–97.
  • SCHMITZ D, ZHANG CL, CHATTERJEE SS et al: Effects of methysticin on three different models of seizure like events studied in rat hippocampal and entorhinal cortex slices. Naunyn Schmiedebergs Arch. Pharmacol (1995) 351(4):348–355.
  • 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(7):1105–1120.
  • STEINER GG: The correlation between cancer incidence and kava consumption. Hawaii Med. J. (2000) 59(10:420–422.
  • GIRMAN A, LEE R, KLIGLER B: An integrative medicine approach to premenstrual syndrome. Am. I Obstet. Cynecol (2003) 188\(Suppl. 5):556–565.
  • SINGH YN: Effects of kava on neuromuscular transmission and muscle contractility. J. Ethnopharmacol (1983) 7(3):267–276.
  • 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(6):584–588.
  • WARNECKE G: Psychosomatic dysfunctions in the female climacteric. Clinical effectiveness and tolerance of Kava Extract WS 1490.Fortschr. Med. (1991) 109(0119–122.
  • 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):1–5.
  • VOLZ HP: Kava-kava und Kavain. Munch Med. Wschr. (1997) 139:42–46.
  • PITTLER MH, ERNST E: Efficacy of kava extract for treating anxiety: systematic review and meta-analysis. J. Psychopharmacol (2000) 20(0:84–89.
  • ••Systematic review and meta-analysis.
  • 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(2):101–110.
  • 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(8):631–639.
  • JAPPE U, FrAnke I, REINHOLD D et al.: Sebotropic drug reaction resulting from kava-kava extract therapy: a new entity? I. Am. Acad. Dermatol (1998) 38(1):104–106.
  • SCHMIDT P, BOEHNCKE WH: Delayed-type hypersensitivity reaction to kava-kava extract. Contact Dermatitis (2000) 42(6):363–364.
  • SUSS R, LEHMANN P: Hematogenous contact eczema caused by phytogenic drugs exemplified by kava root extract. Hautarzt (1996) 47(6):459–461.
  • SIEGERS CP, HON OLD E, KRALL B et al.: Results of the drug monitoring L 1090 with Laitan capsules. Arztl Forsch (1992) 39:7–11.
  • CAIRNEY S, MARUFF P, CLOUGH AR et al.: Saccade and cognitive impairment associated with kava intoxication. Hum. Psychopharmacol (2003) 18(7):525–533.
  • CAIRNEY S, CLOUGH AR, MARUFF P et al.: Saccade and cognitive function in chronic kava users. Neuropsychopharmacology (2003) 28(2):389–396.
  • CLOUGH AR, JACUPS SP, WANG Z et al.: Health effects of kava use in an eastern Arnhem Land Aboriginal community. Intern. Med. 1 (2003) 33(8):336–340.
  • MEYER HG: Pharmakologie der wirksamen prinzipien de kawarhizoms (Piper methysticum Forst.). Arch. Lit. Pharmacodym Ther. (1962) 138:505–536.
  • MATHEWS JD, RILEY MD, FEJO L et al.: Effects of the heavy usage of kava on physical health: summary of a pilot survey in an aboriginal community. Med. J. Aust. (1988) 148(10:548–555.
  • CLOUGH A, JONES P: Policy approaches to support local community control over the supply and distribution of kava in the Northern Territory (Australia). Drug Alcohol Rev (2004) 23(1):117–126.
  • CLOUGH AR, WANG Z, BAILIE RS et al: Case-control study of the association between kava use and ischaemic heart disease in Aboriginal communities in eastern Arnhem Land (Northern Territory) Australia. 1.Epidemiol Community Health (2004) 58(2):140–141.
  • SINGH YN, SINGH NN: Therapeutic potential of kava in the treatment of anxiety disorders. CNS Drugs (2002) 16(10:731–743.
  • RUZE P: Kava-induced dermopathy: a niacin deficiency? Lancet (1990) 335(8703):1442–1445.
  • KELLER F, KLOHS M: A review of the chemistry and pharmacology of the constituents of Piper methysticum. Lloydia (1963) 26:1–15.
  • STICKEL F, SEITZ HK, SCHUPPAN D: Review `Kava, kavapyrones and toxic liver injury' by R Teschke, Hanau Z Castroenterol 2003, 41:395-404.Z Castroenterol (2003) 41(8):888–889.
  • STRAHL S, EHRET V, DAHM HH et al: Necrotizing hepatitis after taking herbal remedies. Dtsch. Med. Wochenschr. (1998) 123(47):1410–1414.
  • NERURKAR PV, DRAGULL K, TANG CS: LI vitro Toxicity of Kava Alkaloid, Pipermethystine, in HepG2 Cells as Compared to Kavalactones. Toxicof Sci. (2004).
  • SCHERER J: Kava-kava extract in anxiety disorders: an outpatient observational study. Adv. Ther. (1998) 15(4):261–269.
  • 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(0:27–30.
  • DONADIO V, BONSI P, ZELE I et al: Myoglobinuria after ingestion of extracts of guarana, Ginkgo biloba and kava. Neurol Sci. (2000) 21(2):124.
  • HOLM E, STAEDT U, HEEP J et al: The action profile of D,L-kavain. Cerebral sites and sleep-wakefulness- rhythm in animals. Arzneimittelforschung (1991) 41(7):673–683.
  • MUNTE TF, HEINZE HJ, MATZKE M et al.: Effects of oxazepam and an extract of kava roots (Piper methysticum) on event-related potentials in a word recognition task. Neuropsychobiology (1993) 27(1):46–53.
  • GESSNER B, CNOTA P: Extract of the kava-kava rhizome in comparison with diazepam and placebo. Z Phytother. (1994) 15(1):30–37.
  • JOHNSON D, FRAUENDORF A, STECKER K et al: Neurophysiological active profile and tolerance of kava extract WS 1490, A pilot study with randomized evaluation. TW Neurolgie Psychiatric. (1991) 5(6):349–354.
  • HERBERG KW: Driving ability after intake of kava special extract WS 1490, a double-blind, placebo-controlled study with volunteers. Zeitschriff (dr Allgemeininedizin (1991) 13:842–846.
  • HERBERG KW: Effect of Kava-Special Extract WS 1490 combined with ethyl alcohol on safety-relevant performance parameters. Blutalkohol (1993) 30(2):96–105.
  • ALMEIDA JC, GRIMSLEY EW: Coma from the health food store: interaction between kava and alprazolam. Ann. Intern. Med. (1996) 125(11):940–941.
  • PRESCOTT J, JAMIESON D, EMDUR N et al.: Acute effects of kava on measures of cognitive performance, physiological function and mood. Drug Alc. Rev (1993) 12:49–58.
  • SALETU B, GRONBERGER J, LINZMAYER L et al.: EEG-brain mapping, psychometric and psychophysiological studies on central effects of kavain-a kava plant derivative. Hum. Psychopharm. (1989) 4:169–190.
  • RADUEGE KM, KLESHINSKI JF, RYCKMAN JV et al.: Anesthetic considerations of the herbal, kava. Clin. Anesth. (2004) 16(4):305–311.
  • PATRA KK, COFFEY CE: Implications of herbal alternative medicine for electroconvulsive therapy. J. ECT (2004) 20(3):186–194.
  • SCHELOSKY L, RAFFAUF C, JENDROSKA K et al: Kava and dopamine antagonism. I Neurol Neurosurg. Psychiatry (1995) 58(5):639–640.
  • MESEGUER E, TABOADA R, SANCHEZ V et al: Life-threatening parkinsonism induced by kava-kava. Mov. Disord. (2002) 17(1):195–196.
  • SPILLANE PK, FISHER DA, CURRIE BJ: Neurological manifestations of kava intoxication. Med. J. Aust. (1997) 167(3):172–173.
  • SIBON I, ROSIER E, ORGOGOZO JM: Meningismus after taking kava-kava. Rev Neurol (Paris) (2002) 158(12):1205–1206.
  • GARNER LF, KLINGER JD: Some visual effects caused by the beverage kava. Ethnopharmacol (1985) 13(3):307–311.
  • LEUNG N: Acute urinary retention secondary to kava ingestion. Emerg. Med. Australas. (2004) 16(1):94.
  • JAMIESON DD, DUFFIELD PH: Positive interaction of ethanol and kava resin in mice. Clin. Exp. Pharmacol Physic] (1990) 17(7):509–514.
  • JAMIESON DD, DUFFIELD PH: The antinociceptive actions of kava components in mice. Clin. Exp. Pharmacol Physic] (1990) 17(7):495–507.
  • MURPHY JM: Preoperative considerations with herbal medicines. ADEN,). (1999) 69(1):173–8, 180.
  • SPARREBOOM A, COX MC, ACHARYA MR et al.: Herbal remedies in the United States: potential adverse interactions with anticancer agents. Oncol (2004) 22(12):2489–2503.
  • 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(5):187–192.
  • MATHEWS JM, ETHERIDGE AS, BLACK SR: Inhibition of human cytochrome P450 activities by kava extract and kavalactones. Drug Metab. Dispos. (2002) 30(11):1153–1157.
  • UNGER M, HOLZGRABE U, JACOBSEN W et al: Inhibition of cytochrome P450 3A4 by extracts and kavalactones of Piper methysticum (Kava-Kava). Planta Med. (2002) 68(12):1055–1058.
  • ANKE J, RAMZAN I: Pharmacokinetic and pharmacodynamic drug interactions with Kava (Piper methysticum Forst. f.). j Ethnopharmacol (2004) 93(2-3):153–160.
  • ANKE J, RAMZAN I: Kava Hepatotoxicity: Are we any closer to the truth? Planta Med. (2004) 70(3):193–196.
  • ZOU L, HENDERSON GL, HARKEY MR et al.: Effects of kava (Kava-kava, Awa, Yaciona, Piper methysticum) on c-DNA-expressed cytochrome P450 enzymes and human cryopreserved hepatocytes. Phytomedicthe (2004) 11(4):285–294.
  • ZOU L, HARKEY MR, HENDERSON GL et al: Kava does not display metabolic toxicity in a homogeneous cellular assay. Planta Med. (2004) 70(4):289–292.
  • BOERNER RJ, KLEMENT S: Attenuation of neuroleptic-induced extrapyramidal side effects by Kava special extract WS 1490.Wien. Med. Wochenschr. (2004) 154(21–22):508–510.
  • DAVIES LP, DREW CA, DUFFIELD P et al.: Kava pyrones and resin: studies on GABAA, GABAB and benzodiazepine binding sites in rodent brain. Pharmacol Toxicol (1992) 71(2):120–126.
  • 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 (Ber) (1994) 116(4):469–474.
  • JAMIESON DD, DUFFIELD PH, CHENG D et al.: 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.
  • BECKMAN SE, SOMMI RW, SWITZER J: Consumer use of St. John's wort: a survey on effectiveness, safety, and tolerability. Pharmacotherapy (2000) 20(5):568–574.
  • DUFFIELD AM, LIDGARD RO, 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 Speen: (1986) 13:305–313.
  • DUFFIELD AM, 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 Speen: (1986) 13:621–626.
  • DUVE RN: Gas-liquid chromatographic determination of major constituents of Piper methysticum. Analyst (1981) 106:160–165.
  • KLOHS MW, KELLER F, WILLIAMS RE et al.: A chemical and pharmacological investigation of Piper methysticum Forst. J. Med. Pharm. Chem. (1959) 1(1):95–103.
  • SMITH RM: Kava lactones in Piper methysticum from Fiji. Phytochemistry (1983) 22:1055–1056.
  • SMITH RM, THAKRAR H, AROWOLO A et al.: High-performance liquid chromatography of kava lactones from Piper methysticum. I Chromatography (1984) 283:303–308.
  • YOUNG RL, HYLIN JW, PLUCKNETT DL et al.: Analysis for kawa pyrones in extracts of piper methysticum. Phytochemistry (1966) 5:795–798.
  • BROGGEMANN F, MEYER HJ: Die analgetische wirkung der Kawa-inhaltsstoffe dihydrokawain und dihydromethysticin. Arzneimittelforschung (1963) 13:407–409.
  • HANSEL R: Characterization and physiological activity of some Kawa constituents. Pacific Science (1968) 22:293–313.
  • KRETZSCHMAR R, Meyer HJ: Comparative studies on the anticonvulsant activity of the pyrone compounds of Piper methysticum Forst. Arch. Int. Pharmacodyn. Ther. (1969) 177(2):261–277.
  • KRETZSCHMAR R, MEYER HJ, TESCHENDORF HJ et al: Antagonistic action of natural 5,6-hydrogenated Kava pyrones against strychnine poisoning and experimental local tetanus. Arch. Int. Pharmacodyn. Ther. (1969) 182 (2) :251–268.
  • KRETZSCHMAR R, MEYER HJ, TESCHENDORF HJ: Strychnine antagonistic potency of pyrone compounds of the kavaroot (Piper methysticum Forst.). Experientia (1970) 26(3):283–284.
  • KRETZSCHMAR R, TESCHENDORF HJ, LADOUS A et al: On the sedative action of the kava rhizome (piper methyst.). Acta Pharmacol Toxicol (1971) 29(4):26.
  • MEYER HJ: Spasmolytic effect of dihydromethysticin, a constituent of Piper methysticum Forst. Arch. Int. Pharmacodyn. Ther. (1965) 154(2):449–467.
  • MEYER HJ, MEYER-BURG J: Hemmung des elektrokrampfes durch die kawa-pyrone dihydromethysticin und dihydrokawain. Arch. [nt. Pharmacodyn (1964) 148(1-2):97–110.
  • SINGH Y, 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.
  • BACKHAUSS C, KRIEGLSTEIN J: Extract of kava (Piper methysticum) and its methysticin constituents protect brain tissue against ischemic damage in rodents. Eur. Pharmacol (1992) 215(2-3):265–269.
  • KLEISER B, DIEPERS M, WAGNER N et al: Treatment of intracerebral hematomas with kava in rats. Neurology (1998) 50(4):a398.
  • WALDEN J, VON WEGERER J, WINTER U et al: Effects of kawain and dihydromethysticin on field potential changes in the hippocampus. Frog. Neuropsychopharmacol Biol. Psychiatry (1997) 21(4):697–706.
  • WALDEN J, VON WEGERER J, WINTER U et al: Actions of kavain and dihydromethysticin on ipsapirone-induced field potential changes in the hippocampus. Human Psychopharm. (1997) 12:265–270.
  • GLEITZ J, GOTTNER N, AMERI A et al.: Kavain inhibits non-stereospecifically veratridine-activated Na* channels. Planta Med. (1996) 62:580–581.
  • GLEITZ J, BEILE A, PETERS T: (4-)-kavain inhibits the veratridine- and KC1-induced increase in intracellular Ca2+ and glutamate-release of rat cerebrocortical synaptosomes. Neuropharmacology (1996) 35(2):179–186.
  • SEITZ U, SCHULE A, GLEITZ J: [3H]-monoamine uptake inhibition properties of kava pyrones. Planta Med. (1997) 63(6):548–549.
  • EMSER W, BARTYLLA K: Improvement of sleep quality. Effect of kava extract WS 1490 on the sleep pattern in healthy subjects. Neurologie/Psychiatrie (1991) 5(10:636–642.
  • BOONEN G, FERGER B, KUSCHINSKY K et al.: vivo effects of the kavapyrones (÷)-dihydromethysticin and (4-)- kavain on dopamine, 3,4-dihydroxyphenylacetic acid, serotonin and 5- hydroxyindoleacetic acid levels in striatal and cortical brain regions. Planta Med. (1998) 64(6):507–510.
  • BUCKLEY JP, FURGIUELE AR, O'HARA MJ: Pharmacology of kava. Ethnopharm. Search Psych. Drugs (1967) 1:141–151.
  • FURGIUELE AR, KINNARD WJ, ACETO MD et al.: Central activity of aqueous extracts of Piper methysticum (kava). Pharm. Sci. (1965) 54:247–252.
  • DUFFIELD PH, JAMIESON D: Development of tolerance to kava in mice. Clin. Exp. Pharmacol Physic] (1991) 18(8):571–578.
  • DUFFIELD AM, JAMIESON DD, LIDGARD RO et al.: Identification of some human urinary metabolites of the intoxicating beverage kava. .1 Chromatogr. (1989) 475:273–281.
  • DUFFIELD PH, JAMIESON DD, DUFFIELD AM: Effect of aqueous and lipid-soluble extracts of kava on the conditioned avoidance response in rats. Arch. Int. Pharmacodyn. Ther. (1989) 301:81–90.
  • BfArM notice to manufactures May 2005.

Websites

  • http://www.forumsec.org.fj/division/TID/ Kava_Rpt 192003/ExecutiveSummary.pdf Kava Report 2003.'In-Depth Investigation Into EU Member States Market Restriction on Kava Products.' (2003).
  • http://www.analyze-realize.com/ Publications/Kava.en.html. Analyze & realize: Kava, Too Good to be Disregarded (2005).
  • http://www.uni-muenstencle/Chemie.pb/ Kava/kavaframe.html Is Kava really hepatotoxic? An analysis of the known data on adverse effects of kava preparations on the liver. Institute of Pharmaceutical Biology and Phytochemistry (2005).
  • http://www.hc-sc.gc.ca/english/protection/ warnings/ 192002/2002_56e.htm Health Canada: Health Canada issues a stop-sale order for all products containing kava (2002).
  • hdp://www.nutraingredients-usa.com/ news/news-ng.asp?id=23246-germany-bans-kava Nutra ingredients USA: Germany bans kava kava after liver damage fears (2002).
  • http://www.tga.gov.au/import/kavainfo.htm Australian government department of health and ageing therapeutic goods administration (2004).
  • http://www.food.gov.uldfoodindustry/ regulation/ria/106032 Food Standards Agency: Kava-kava in food (England) Regulations (2002).
  • http://www.raps.org/s_raps/ sec_RANews_Detail.asp?TRACKID=&CI D=116&DID=17199 Regulatory Affairs Professionals Society (RAPS): Britain Voluntarily Suspends Kava-kava Sale.( 2005).
  • http://www.nzfsa.govt.nz/publications/ media-releases/ 192002/2002-08-16-dietary-supplements.htm New Zealand Food And Safety Authority: Kava as a dietary supplement — Privileged Statement issued under delegated authority from the Director-General of Agriculture and Forestry pursuant to Section 37 of the Food Act 1981 (2002).
  • http://foodhaccp.com/ msgboard.mv?parm_func=showmsg+parm_ msgnum=1010361 Nutra Ingredients: South Africa issues kava recall (2003).
  • http://www.wales-legislation.hmso.gov.uld legislation/wales/wsi 192002/20023157e.htm The National Assembly for Wales: The Kava-kava in Food (Wales) (Revocation) Regulations (2002).
  • http://www.wales-legislation.hmso.gov.uld legislation/wales/wsi 192003/20032755e.htm The National Assembly for Wales: The Kava-kava in Food (Wales) (Revocation) Regulations (2003).
  • •[201-212] are regulatory publications.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.