Medical Issues

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Kava Kava (Piper methysticum) has been used as a
ceremonial beverage in the Pacific Islands for thousands of years. The roots are chewed or ground into a pulp and added to cold water. The resulting thick brew, which has been compared to the social equivalent of wine in France, is typically offered to guests and dignitaries visiting the Pacific Islands.

Kava Kava root (which is used in medicinal preparations) comes from a tall shrub that grows in the islands of the Pacific Ocean. This shrub produces large, green, heart-shaped leaves that grow thickly on the branches. Long, slender flowers grow where the branches meet the stems. The roots look like bundles of woody, hairy branches.Studies have indicated that Kava Kava roots contain fiber, proteins, potassium, and compounds known as Kava Kavalactones, and as yet unidentified compounds.

In March 2002, the FDA issued a consumer advisory concerning the potential for liver damage to those using Kava Kava. Kava Kava-containing products have been associated with liver-related injuries – including hepatitis, cirrhosis, and liver failure -- in over 25 reports of adverse events in other countries. Four patients required liver transplants. In the U.S., the FDA has received a report of a previously healthy young female who required liver transplantation, as well as several reports of liver-related injuries. Consumers who use a Kava Kava-containing dietary supplement and who experience signs of illness associated with liver disease should also consult their physician. Symptoms of serious liver disease include jaundice (yellowing of the skin or whites of the eyes) and brown urine. Non-specific symptoms of liver disease can include nausea, vomiting, light-colored stools, unusual tiredness, weakness, stomach or abdominal pain, and loss of appetite.

Potential Interactions
Anticonvulsants
Kava Kava may exaggerate the effects of medications used to treat seizures.*
Central Nervous System (CNS) depressants
Kava Kava may enhance the effects of CNS depressants such as benzodiazepines used for sleep disturbances or anxiety (particularly alprazolam) and barbiturates used for sleep disorders and seizures (such as pentobarbital). In fact, there has been one report of someone going into a coma from the combination of Kava Kava and alprazolam.*
Antipsychotic medications
Kava Kava may increase the risk of unpleasant side effects associated with phenothiazine medications (often used for the treatment of schizophrenia), such as chlorpromazine and promethazine.*
Levodopa
There has been at least one report that Kava Kava may reduce the effectiveness of levodopa, a medication used to treat Parkinson's disease.*
*Information from University of Maryland Medical Center