Kava, the anxiolytic herb: Back to basics to prevent liver injury?

British Journal of Clinical Pharmacology

Volumn 71, Issue 3, 2011, Pages 445-448

  Teschke, Rolf ^a   Sarris, Jerome ^b,c   Glass, Xaver ^d   Schulze, Johannes ^d  

^a UNIVERSITY HOSPITAL FRANKFURT   (Germany)

^b UNIVERSITY OF MELBOURNE   (Australia)

^c SWINBURNE UNIVERSITY OF TECHNOLOGY   (Australia)

^d GOETHE UNIVERSITY   (Germany)

Author keywords

Drug induced liver injury; Hepatotoxicity; Herbal hepatotoxicity; Herbs induced liver injury; Kava; Kava hepatotoxicity

Indexed keywords

KAVA EXTRACT;

ARTICLE; CULTIVAR; DRUG MANUFACTURE; DRUG SAFETY; DRUG USE; HUMAN; LIVER INJURY; LIVER TOXICITY; PLANT ROOT; PRIORITY JOURNAL; RHIZOME; WORLD HEALTH ORGANIZATION;

ANTI-ANXIETY AGENTS; DRUG-INDUCED LIVER INJURY; HUMANS; KAVA; LIVER; PACIFIC ISLANDS; PLANTS, MEDICINAL; RHIZOME;

EID: 79251649167     PISSN: 03065251     EISSN: 13652125     Source Type: Journal    
DOI: 10.1111/j.1365-2125.2010.03775.x     Document Type: Article

References (23)

1. Lebot V, Merlin M, Lindstrom L. Kava, the Pacific Elixir. New Haven: Yale University Press, 1997.
2. Singh YH. Kava: an overview. J Ethnopharmacol 1992; 37: 13-45.
3. Forster JG. A Voyage Round the World in His Britannic Majesty's Sloop, Resolution. London: J. White, 1777; Vol 2, pp 406-408.
4. Richardson WN, Henderson L. The safety of kava - a regulatory perspective. Br J Clin Pharmcol 2007; 64: 418-20.
5. World Health Organization. Assessments of the Risk of Hepatotoxicity with Kava Products. Geneva, Switzerland: WHO Document Production Services, 2007.
6. Lebot V. The quality of kava consumed in the South Pacific. HerbalGram 2006; 71: 34-7.
7. Sarris J, Kavanagh DJ, Byrne G, Bone KM, Adams J, Deed G. The Kava Anxiety Depression Spectrum Study (KADSS): a randomized, placebo-controlled crossover trial using an aqueous extract of Piper methysticum. Psychopharmacol 2009; 205: 399-407.
8. Pittler MH, Ernst E. Kava extract for treating anxiety (Cochrane Review). Cochrane Database Syst Rev 2003; Issue 1: CD003383. Wiley Interscience. DOI: 10.1002/14651858.
9. Schulze J, Raasch W, Siegers CP. Toxicity of kava pyrones, drug safety and precautions- a case study. Phytomedicine 2003; 10: (Suppl IV): 68-73.
10. Teschke R, Gaus W, Loew D. Kava extracts: safety and risks including rare hepatotoxicity. Phytomedicine 2003; 10: 440-6.
11. Schmidt M, Morgan M, Bone K, McMillan J. Kava: a risk-benefit assessment. In: The Essential Guide to Herbal Safety, eds Mills M, Bone K. St. Louis (Missouri): Elsevier Churchill Livingstone, 2005; 155-221.
12. Ernst E. A re-evaluation of kava (Piper methysticum). Br J Clin Pharmacol 2007; 64: 415-7.
13. Teschke R. Kava hepatotoxicity: a clinical review. Ann Hepatol 2010; 251-65.
14. Teschke R, Schwarzenboeck A, Akinci A. Kava hepatotoxicity: a European view. N Z Med J 2008; 121: 1283. Available at (Last accessed 25 June 2010).
15. Teschke R, Schwarzenboeck A, Hennermann KH. Kava hepatotoxicity: a clinical survey and critical analysis of 26 suspected cases. Eur J Gastroenterol Hepatol 2008; 20: 1182-93.
16. Lasme P, Davrieux F, Montet D, Lebot V. Quantification of kavalactones and determination of kava (Piper methysticum) chemotypes using near-infrared reflectance spectroscopy for quality control in Vanuatu. J Agric Food Chem 2008; 56: 4976-81.
17. Teschke R, Genthner A, Wolff A. Kava hepatotoxicity: Comparison of aqueous ethanolic, acetonic kava extracts and kava-herbs mixtures. J Ethnopharmacol 2009; 123: 378-84.
18. Schmidt M. Quality criteria for kava. HerbalGram 2007; 73: 45-9.
19. Food standards Australia New Zealand. Kava. A human health risk assessment. Technical report Series No.30. 2005. Available at (Last accessed 25 June 2010).
20. SPC Report. Pacific kava: a producer's guide. Secretariat of the Pacific Community, 2001. Suva, Fiji Islands. ISBN 982-203-810-0.
21. Teschke R. Kava hepatotoxicity: pathogenetic aspects and prospective considerations. Liver Int 2010; 30: 1270-9.in press. DOI: 10.1111/j.1478-3231.2010.02308.x.
22. Denham A, McIntyre M, Whitehouse J. Kava - the unfolding story: report on a work-in-progress. J Altern Complement Med 2002; 8: 237-63.
23. Zhou P, Gross S, Liu JH, Yu BY, Feng LL, Nolta J, Sharma V, Piwnica-Worms D, Qiu SX. Flavokawain B, the hepatotoxic constituent from kava root, induces GSH-sensitive oxidative stress trough modulation of IKK/NF-κB and MAPK signalling pathways. FASEB J 2010; 24. in press. DOI: 10.1096/fj.10-163311.