Kava-Kava

The kava is a plant species of the pepper genus (probably originally from New Guinea) from the pepper family (Piperaceae), which is an evergreen, shrub-like plant that grows to a height of around 3 meters. The kava has heart-shaped leaves up to 20 cm in size. It is native to the South Sea islands, especially New Guinea.

Kava kava was used in religious ceremonies on the Pacific islands as long as 3000 years ago. The relaxing, performance-enhancing and anxiety-relieving effects, including euphoria, were known to the natives of Australia and Hawaii as far away as the USA.

Kava kava extracts contain 5-12% 6-substituted beta-methoxy-lactones, the so-called kavapyrones (or kavalactones). These include: kavaine, methysticine. Kavain and dihydrokavain have sedative and analgesic effects. Flavokawain A. has an antiproliferative, anticarcinogenic and angiogenesis-inhibiting effect.

The peeled and chopped, dried rhizome(kava-kava rhizoma ) is used phytotherapeutically.
The drug mostly originates from cultures in Polynesia and Melanesia.

HMPC: Risk exceeds benefit, due to liver damage, additional carcinogenic potential.

ESCOP monograph: states of anxiety, tension and restlessness of non-psychotic origin. Cave: Hepatotoxic effect.

Commission E monograph: Nervous states of anxiety, tension and restlessness, liver toxicity not yet known in 1990

No longer recommended.

Limitation to 120 mg Kavalaktone, maximum duration of use of two months, control of liver values, prescription only. see also under Notes!

Comatose states have been described following the combination of kava with alprazolam, a diazepine derivative.

The approval of kava kava extracts was initially revoked by the Federal Ministry for Drugs and Medical Devices (BfArM ) in 2002 due to hepatotoxic side effects and a lack of efficacy and new investigations were initiated. In a decision dated December 20, 2019, the approval of medicinal products containing kava kava was definitively revoked. Based on the scientific assessment of the Committee for Herbal Medicinal Products(HMPC) of the European Medicines Agency, the benefit-risk ratio is assessed as unfavorable.

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