Piper methysticum (Kava-Kava)
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Introduction
A robust, well-branched perennial shrub with heart-shaped leaves.
Uses
Traditional use:
- used in Polynesia, Melanesia, Micronesia
- served as beverage during important meetings & ceremonies
- served at welcoming ceremonies
- religious ceremonies as a gift to the gods
- used to induce relaxation & sleep & calm nerves
- asthma
- weight loss
- gonorrhea
- urinary tract infections
Current uses:
Contraindications
No safety data in pregnancy
Dosage
- kava extract (WS 1490) 100 mg TID
- extract standardized to 70% kavapyrones
- fluid extract 1:1, 1-3 mL BID-TID
- discontinue 24 hours before surgery
Monitor
Adverse effects
- yellow scaly rash (> 9 gm/day)
- increased liver function tests, decreased albumin, increased cholesterol with heavy use
- acute hepatitis
- sedation
- avoid driving under the influence of high doses
Drug interactions
- reports of disorientation when used in conjunction with benzodiazepines
- conflicting data regarding potentiate of kava effect by alcohol & visa versa
- may increase effects of anticonvulsants[8]
Mechanism of action
- active ingredients:
- methystcin (a kavalactone)
- ynagonin
- kava resins & pyrone exert weak effects on benzodiazepine receptors in vitro
More general terms
References
- ↑ Victoria Rand, UCSF Fresno Lecture, 10/7/98
- ↑ Volz et al, Pharmacopsychotherapy, 1997
- ↑ Prescriber's Letter 8(3):16 2001
- ↑ Jump up to: 4.0 4.1 Prescriber's Letter 8(8):48, 2001
- ↑ Prescriber's Letter 9(1):6, 2002
- ↑ Kava Linked to Liver Damage http://www.nccam.nih.gov/health/alerts/kava/
- ↑ FDA Consumer Advisory KAVA-CONTAINING DIETARY SUPPLEMENTS MAY BE ASSOCIATED WITH SEVERE LIVER INJURY http://www.cfsan.fda.gov/~dms/addskava.html
- ↑ Jump up to: 8.0 8.1 Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
- ↑ Jump up to: 9.0 9.1 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018